Anthony Kasch, MD, specializes in sports medicine at Sanford Orthopedics & Sports Medicine in Bismarck, North Dakota. Dr. Kasch received his medical degree from the University of Colorado School of Medicine in Aurora, Colorado, and completed his orthopedic residency training at the University of Arizona in Tucson, Arizona. He also completed a scholarship specializing in sports medicine at Kaiser Permanente in San Diego, California. Call (701) 323-8920 to schedule an appointment.
Sanford Health News recently sat down with Dr. Kasch to answer questions about common sports injuries: ACL tears and breaks.
Answer: The anterior cruciate ligament (ACL) connects the femur (thigh bone) to the tibia (tibia). ACL is located in the center of the knee joint and controls the rotation and forward movement of the tibia. It is one of the main stabilizing ligaments of the knee joint.
When the knee is forced beyond its normal range of motion, the ligaments can tear and cause the knee to become unstable. This is especially noticeable in activities such as walking downstairs or turning with one leg.
A tear or rupture of an ACL may be caused by contact or non-contact injury. Contact injuries are caused by direct trauma to the knee, such as when a football player hits the side of another player. A non-contact injury may occur when someone’s foot rotates suddenly while still on the ground, or when an athlete lands on the ground by mistake and overextends the knee after a jump.
A: When injured, people often feel or hear a bang in the knee, followed by severe pain and instability. Other symptoms may include swelling, soreness, and sudden leg flexion or "sagging" when trying to stand. People may also experience limited range of motion, inability to bear weight, tenderness around the knee joint, bruising, and in some cases numbness below the knee.
Answer: ACL tear is one of the most common knee ligament injuries, accounting for more than 50% of all knee injuries. Although anyone can damage their ACL, certain activities such as skiing, football, and rugby put people at higher risk.
A: If someone may have an ACL tear, they should see a sports medicine expert and follow the RICE method immediately.
Rest: Avoid activities that cause knee pain until the symptoms subside.
Ice: Use the ice pack several times throughout the day, every 10 to 20 minutes.
Compression: Tighten a tight elastic bandage around the knee.
Elevation: Keep your knees higher than your waist.
Sports medicine specialists will assess the injury before developing a treatment plan. This will include checking the knee for swelling, tenderness, pain points, and movement limitation before considering non-surgical and surgical treatment options.
Answer: A torn anterior cruciate ligament (ACL) is one of the most common knee ligament injuries. When the knee is forced to exceed its normal range of motion, ligament damage often occurs, causing the ligament to stretch or tear.
If someone suspects an ACL injury, they should see a sports medicine specialist for treatment and rehabilitation assessment of their injury.
Without treatment, the swelling and pain usually subside within a few weeks, but instability may continue to hinder a person’s ability to exercise or even perform daily activities, such as standing from a sitting position, walking downstairs, or turning on one leg.
Answer: Candidates for non-surgical treatment include those with knee instability that does not affect daily life, and those who do not participate in activities that involve sudden stops or turns. Non-surgical treatment options may include physical therapy, wearing knee pads, restricting knee movement, and taking drugs such as ibuprofen or naproxen.
The recovery time varies from person to person and may take several weeks to several months. Because not all ACL injuries can be completely healed by non-surgical treatment, those who wish to resume exercise or physical activity should discuss surgical options with their provider.
Answer: The necessity of surgery to repair an ACL tear depends on the severity of the injury and a person's lifestyle. If someone’s ACL tears completely, it will not be able to heal on its own. Sports medicine specialists can help determine whether surgery is the best option.
A: In most cases, surgery involves ACL reconstruction, replacing the torn ACL with tissue called a graft. This tendon tissue is taken from another part of the body. Today, with the advancement of innovation, patients can usually go home on the day of surgery to begin recovery.
Answer: Within a few days after the operation, the patient can meet with a physical therapist or expert to start an exercise program tailored to his specific injury. Rehabilitation is essential for improving range of motion, increasing strength, and restoring balance in the long term. Generally, athletes can resume sports 9 to 12 months after surgery.
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