Injury of the week, we look at ACL rupture.

Daniel Rich from the Brisbane Lions looks to be the first marquee player gone for the season. Rich ruptured his ACL on the weekend putting him out of action for the next 12 months. This week we look at the ACL rupture so you have an insight on what Rich will be going through over the next 12 months.

The Anterior Cruciate Ligament (ACL)

The ACL is a ligament within the knee between the femur (thigh bone) and tibia (shin bone) – see image below.  It has a critical role within the knee to stabilise the joint especially with turning or twisting motions.

Athletes who participate in high demand sports like AFL, soccer and basketball are more likely to injure their anterior cruciate ligaments because of the twisting and turning that is required. If the load applied to this ligament is too great it can be torn or ruptured. This can happen as a player quickly tries to change direction without any contact from an opponent at all, or as a result of a twisting mechanism caused by a knock or tackle. A ‘’pop’’ sound and/or sensation classically occurs at the moment of rupture and it is usually extremely painful for a period. This can subside within a few minutes, sometimes to the point where the individual thinks they can return to play but the knee will likely collapse the first time they try to change direction.

Without a functioning ACL, an athlete is generally unable to change direction without the knee joint collapsing and in most cases will require a knee reconstruction where they replace the ruptured ACL with a section of patella or hamstring tendon. There are however cases where individuals can continue their sport without surgery but usually in less demanding sports. Tiger Woods famously played for several months on a torn left ACL. He was still able to win 9 of the 12 tournaments he competed in. This injury is rare in golf and he reports it was sustained while running. He finally had it repaired in April 2008.

The rehabilitation post reconstruction is generally considered to take 12 months to return to AFL, following quite detailed protocols that can vary slightly between surgeons. For the first few weeks the focus is on reducing post surgical swelling and restoring range of movement before integrating a very structured strengthening program.  Between 12-20 weeks, straight line running often starts before progressing onto sport specific activity in the final months.