We see this injury all too often.
Injury of the week – ACL
What a great start to the 2018 AFL Mens season. Not so great was injury Tom Liberatore suffered in the first quarter of the Western Bulldogs match versus GWS, it has been confirmed that Tom has ruptured his ACL in his right knee and will be out for the 2018 season.
The ACL is an all too common injury in the AFL and many other fast-paced dynamic sports. Let us look at an ACL rupture and what players like Tom will be doing to get back on the field.
The Anterior Cruciate Ligament (ACL)
The ACL is a ligament in the knee between the femur (thigh bone) and tibia (shin bone). 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 the 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, landing awkwardly from a jump, 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, an elite athlete will require an ACL reconstruction where they replace the ruptured ACL with most commonly 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.
We wish any elite athlete a slow, progressive recovery.