Why Choose Cedars-Sinai Marina del Rey Hospital for ACL Injuries?
At Cedars-Sinai Marina del Rey Hospital you will find a nationally-recognized team of skilled physicians dedicated to providing you with the best possible care by diagnosing, treating, and helping with the recovery of anterior cruciate ligament injuries. Our team of compassionate medical practitioners is here to support you every step of the way, from diagnosis to making a complete recovery.
The anterior cruciate ligament is located in the knee, being one of the four main ligaments and the most important one in keeping your leg stable when you twist your body. It connects the femur to the tibia at the center of the knee.
Without this ligament, you could now keep your knee stable and it would wobble and move around when you twist your body. The anterior cruciate ligament can get torn or sprained if the shinbone (tibia) and thighbone (femur) rotate too far in opposite directions or when the knee is bent in the wrong direction.
A torn anterior cruciate ligament has to be treated or else your knee joint will continue to give away and put you at risk for even more injuries to the knee.
Treatment options for a torn anterior cruciate ligament include:
- Arthroscopic reconstruction surgery. A process in which a surgeon makes small incisions in the knee and inserts the surgical instruments through these incisions. A graft from another ligament of the body is used to replace the torn ends of the ACL.
- Physical therapy and strengthening.
You can also start treating your injury at home, before you get the chance to seek professional help, with the R.I.C.E. model of self-care:
- Rest. Rest is necessary for healing, limits weight bearing on your knee, and lowers the chances of other ligaments getting injured as well.
- Ice. Ice reduces inflammation and helps relieve pain. You should ice your knee at least every two hours for 20 minutes at a time.
- Compression. If your knee feels unstable, it is best to wrap an elastic bandage or compression wrap around it to restore its stability, at least to some degree.
- Elevation. When you lie down keep your knee elevated.
Medication for an ACL injury mostly consists of anti-inflammatory drugs to reduce inflammation and analgesics to relieve the pain.
ACL injuries are categorized by severity, as such:
- Grade 1: When the ligament has sustained light damage and is slightly stretched but the knee joint is still stable.
- Grade 2: When the ACL is stretched and becomes loose. This is also referred to as a partial tear of the ligament.
- Grade 3: When the ACL is split into two pieces and fails to keep the knee stable. This is usually referred to as a complete ligament tear.
Symptoms of ACL Injuries
The pain accompanying a torn anterior cruciate ligament can greatly vary from one case to another. The ligament itself has no pain receptors but during the movement that caused the ACL to tear, other parts that do have pain receptors may also be damaged. The most common symptom in all cases is that the knee feels like it will give away or it will easily bend backward.
Other symptoms associated with ACL injuries include:
Diagnosis of ACL Injuries
ACL injuries can be diagnosed using various methods, such as:
- Physical Examination. Oftentimes, the ACL injury can be diagnosed just by a physical exam alone but further tests are required to determine the severity of the injury. Tests performed in a physical examination include:
- Lachman test. During this test, the injured leg is held slightly bent and the doctor pulls on the lower leg (tibia) and observes what happens. If the leg moves significantly more than the uninjured one, the anterior cruciate ligament may be torn.
- Anterior drawer test. In this test, the doctor will pull the lower leg (tibia) forward while the knee is bent 90 degrees. A torn anterior cruciate ligament may be present if the tibia moves excessively forward.
- MRI scan. An MRI is nearly 90% accurate in determining whether an anterior cruciate ligament has been torn and how badly but it is not good at providing details about a partial tear.
- Arthroscopy. This is the best way to learn more about a partial ACL tear. With a camera probe into the knee, a doctor can look at the anterior cruciate ligament and see exactly how badly torn it is.
Causes for ACL Injuries
An ACL injury usually takes place during physical activity. Several things that can cause an ACL injury during physical activity, such as:
- Suddenly stopping or slowing down while running.
- Incorrect jumping or landing.
- Rapidly changing directions while running.
- Contact injuries, for example, a football tackle.
- Overusing the leg with repetitive impact activity — such as jumping, running, twisting, or pivoting.
Risk Factors for ACL Injuries
Sports injuries are certainly the most common causes of ACL injuries, but the ACL can be injured during any trauma.
While anyone can suffer from an ACL injury, some factors put some people at a higher risk:
- Gender. ACL injuries are three times more common in females than in males.
- Participation in certain sports. There are some sports in which ACL injuries commonly occur, such as:
- Previously torn ACL. If you have had an ACL tear in the past, the risk of re-tearing it is 15% higher than the risk of tearing a normal ACL.
- Age. Between the ages of 15 and 45, the risk of ACL tears is higher mostly due to the more active lifestyle and increased participation in sports.
In the case of a Grade I or a Grade II ACL injury, after the initial period of rest, ice and elevation, physical therapy might be all you need to fully recover. For a Grade III injury, however, surgery is often recommended. But, if for any reason, you do not want to undergo surgery, there are some alternative treatments you can try to naturally heal your ACL, such as:
- Acupuncture. Acupuncture promotes blood flow, reduces inflammation, stimulates endorphins (thus relieving pain) and it moves stuck tissue, allowing the body to better naturally heal. It can also be helpful during the post-op recovery period as it removes scar tissue left from the surgery.
- Natural supplements:
- Turmeric. The curcumin contained in turmeric can help reduce pain and swelling and, as long-term studies have shown, it can also reduce blood levels of inflammatory chemicals.
- Ginger extract. Great for decreasing pain and inflammation.
- Epsom salts. A bath with Epsom salts has detoxifying properties which can help ease joint pain.
- Arnica. Arnica has anti-inflammatory properties and is a natural analgesic.
- Essential oils. Essential oils can provide great help in dealing with the symptoms of an ACL tear and help your body heal faster. Here are the most beneficial essential oils in the case of an ACL tear:
- Wintergreen. It relieves discomfort that is related to inflammation of bones, muscles, and joints.
- Peppermint. Has anti-inflammatory properties and helps damaged tissues.
- German Chamomile. Has an antioxidant, anti-inflammatory, and analgesic effect.
- Helichrysum. Also has anti-inflammatory properties and, in addition, it may help clean the blood and improve circulatory functions.
- Lemongrass. Supports inflammatory response and helps with ligaments and tissue regeneration.
- Frankincense. Is also a great anti-inflammatory and it supports the immune system, being good for general healing.
Keep in mind that it is best to always consult with a licensed practitioner before trying any alternative treatments to avoid any complications.
ACL injuries can be prevented if the muscles around the knees are strong and flexible. There are various activities you can do to lower your risk of an ACL injury:
- Always warm-up before any physical activity.
- Stretch daily, if possible, to help maintain flexibility in the joints.
- Strengthen your muscles, especially in your hips and thighs, which are key to providing support for your knees.
- Practice balance. Many injuries come from a loss of balance so it is important to practice keeping your balance in any situation.
- Learn to jump and land safely. Bad landing is another quite common cause of ACL injuries so learning to jump and properly land can significantly decrease your risk of an ACL injury.
- Provide your body with plenty of rest time. Especially if you are playing any professional sports that put pressure on your knees, it is very important to not over-work your body and know when to give it a break to avoid injuries.