Knee PainThe anterior cruciate ligament (ACL) is one of the four major ligaments of the knee. Its main purpose is to resist excessive forward movement of the tibia (shin bone) in relation to the femur (thigh bone).

Anterior Cruciate Ligament injuries occur when a person rapidly decelerates, followed by a sharp or sudden change in direction (cutting). ACL failure has been linked to heavy or stiff-legged landing; as well as twisting or turning the knee while landing, especially when the knee is in the valgus (knock-knee) position. This situation is very common in sports such as football, basketball and skiing.

The majority of Anterior Cruciate Ligament injuries occur when a person landing flat on their heels. The latter directs the forces directly up the tibia into the knee, while the straight-knee position places the lateral femoral condyle on the back-slanted portion of the tibia. The resultant forward slide of the tibia relative to the femur is restrained primarily by the now-vulnerable anterior cruciate ligament.

Symptoms

Symptoms of an anterior cruciate ligament injury include hearing a sudden popping sound, swelling, and instability of the knee (i.e., a “wobbly” feeling). Pain is also a major symptom initially in an ACL injury and can range from moderate to severe. Continued athletic activity on a knee with an ACL injury can have devastating consequences, resulting in massive cartilage damage, leading to an increased risk of developing osteoarthritis later in life.

Treatment

The anterior cruciate ligament primarily serves to stabilize the knee in an extended position and when surrounding muscles are relaxed; so if the muscles are strong, many people can function without it.

Conservative (non-surgical) management of an anterior cruciate ligament rupture/tear involves an intense and graduating period of exercise and rehabilitation, often prescribed by a physiotherapist, to strengthen the muscles surrounding the knee, and to regain the finer proprioceptive feedback systems. David Roberts Physiotherapy team have the facilities and knowledge to provide a structured conservative management programme and pre-hab regime if surgery is coming in the near future.

Surgery is often required in athletes or people wishing to continue with a more active lifestyle. This involves open or keyhole surgery to graft a donor tendon (from the patient or a tissue bank) to replace the ruptured anterior cruciate ligament.  A significant period of rehabilitation following surgery is crucial to getting the injured person back to full strength. The surgery is only half of the treatment; without the rehabilitation that follows the knee will not regain its original function. Our widely experienced Physiotherapists will guide you through the process of the specialised rehabliltation programme

Rehabilitation programmes often vary according to the method of surgery and the operating surgeon’s preference but our team will ensure you progress through each step in the correct way to assist best possible healing and recovery. They will take you from walking in on crutches right through to return to your sport/normal activity.

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