SportsDoc Update: ACL Injuries, Chuckie Keeton, 10/9/13
1280 The Zone - October 9th, 2013
The ACL or Anterior Cruciate Ligament is becoming one of the more common knee injuries in sports. For reasons we don't understand completely, women are 5-8 times more likely to have an ACL Tear than men. ACL Tears can occur from non-contact, where a sudden twisting of the knee occurs and the foot stays planted. Athletes describe feeling or hearing a pop, then instability in the knee. Many are still able to walk on the knee afterword, however. The pain from the injury does not come from the ACL that is torn but from other structures such as other ligaments and cartilage that are also torn.
In Keeton's case, the MCL (Medial Collateral Ligament) or the ligament that runs along the inside of the knee reportedly was also torn. This is fairly common when the knee is injured from contact. Usually the MCL gets stretched first, and then as the twisting of the knee continues, the ACL snaps. Some are able to function quite well without an ACL because muscles around the knee learn to protect the knee. Most high level athletes however are encouraged to have the injury repaired. Current recommendations are for an individual to rehab their injury until the pain and swelling are reduced and, in particular, normal range of motion and muscle function are attained before during surgery. When the MCL is part of the injury, as Keeton had, recent studies have shown that is probably best to brace the knee to protect it and allow the MCL to heal for a few weeks before doing surgery on the ACL. If range of motion and good muscle function can be gained before surgery the knee seems to do much better after surgery. This is why there may be a delay from the time of injury and when the repair is actually done. This may take several weeks.
Once surgery is performed, a graft using the hamstring tendon, the patellar tendon or a cadaver tendon is used to replace the torn ACL. Rehab begins immediately with range of motion exercises, but there are many protocols for return to play based on the surgeon and his bias. Most recommend avoidance of cutting, change of direction sports for 6 months. That would take Keeton out of spring ball. Jogging and weights can begin at 2 months. Most athletes take a full year to regain normal function on an ACL injured knee, but if all goes well should expect an essentially normally functioning knee. The knee is never 100% but can be 95-98% which will still function well. Keeton should be able to return for next season and still be effective We wish him luck.
There is some research done that has shown ACL injuries in girls/women can be diminished by having them participate in a 6 week conditioning program involving specific drills. Stay tuned for a tweet to let you know when we have that information available to look at and use on The Zone website @theSportsDoc.