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Cruciate ligament Injury

Stuart Fossella - Sunday, February 10, 2013 | Comments (0)
Posted 6 years ago

Anterior Cruciate Ligament (ACL) injury

Words you really don't want to hear your Physio mention

The good folk of Cheltenham all seem to be packing up their skis and snowboards....

So it must be that time of year when the crisp clean air of the mountain ranges is calling us with the promise of the white stuff. But have you prepared yourself properly for the 6 plus hours of intense exercise a day that you are about to undertake?

Are you one of these people that in truth drives a desk for 50 weeks of the year, doesn't take meaningful, regular exercise, and then pushes yourself hard either skiing or snowboarding for one, or if you are lucky two weeks of the year?

If so then you should be prepared for your physiotherapist to tell you that you might have torn or ruptured your Anterior Cruciate Ligament (ACL). Why is this the case then??

Well let’s discuss some Anatomy and help you to understand what all the fuss is about.

The following link provides a 3D image of the ACL and provides you with some further reading regarding anatomy Healthline

The ACL is one of the four main ligaments of the knee that help to keep the joint stable. It runs from the front of the shinbone and heads up and backwards to attach to the back of the thighbone. As with all ligaments it 's role is to provide stability between bones and resist external forces to prevent the knee from collapsing.

In reality the ligaments don't do all of the work, strong and accurate muscle control aids to keep the knee aligned, but the role of the ACL cannot be underestimated. This can be demonstrated by the fact that in most cases it will be surgically reconstructed, it 's that important!

Unfortunately without the ligament the knee is considered unstable, and the joint is at risk of developing secondary arthritic changes, and nobody wants that do they?

So now you hopefully have an understanding why the ligament is so important and realise why you don 't want to damage it.

Oh, and we haven't even mentioned that the rehabilitation after surgery will take up to 9 months before a return to contact sport is allowed by your surgeon!

So what 's the relationship with skiing, snowboarding and the ligament??? Tears of the ligament normally occur when the knee is subjected to a twisting force whilst the foot is fixed. So using skiing and snowboarding as an example.... fixed foot (bindings), twisting force through the knee joint when the body heads of in the opposite direction to the knee in sharp or awkward turns or falls.

It can be the most minor of movements, but if it’s in the wrong position, that can be enough to over stretch, tear or rupture the ACL. It is important to stress that everyone 's anatomy is different, and some of you will unfortunately, naturally be more prone to damaging your ligament.

The point we are trying to make is that if your muscles are not suitably conditioned and fitness is low, then the less control you have over the muscles around your knee. Remember, that these muscles add reinforcement to ligaments. If you don't have the muscle control it's going to put you at greater risk of sustaining this type of injury.

And what is more concerning is that it is not always a painful injury. So you might not even realise you have sustained it.

    So...to help prevent an unwanted holiday horror....

  • Do conditioning, strengthening and balance exercises of the thigh muscles, hamstring and knee joint before the ski season starts. This is your number one means of protection against ligament injury.
  • Try exercises such as squats, lunges, single leg dips and hamstring curls.

And any other advice can we offer you...

  • Ski / Ride easier at the end of the day, when you are typically fatigued.
  • Avoid difficult trails, big air, lots of moguls, and speed on ice.
  • Take it easy in the late afternoon
  • Be careful getting on and off chairlifts.
  • Do regular stretching exercises for the hamstrings, quadriceps, hip, back, shoulder. The more you stretch, the less likely you are to snap.
  • Use gear that is fit to you and is tuned up.
  • Check your bindings for release tension. Do not set them too tight!

If you are unsure or need a pointer in the right direction regarding what exercises are suitable for you? Contact Us, and see how Straight Back Physiotherapy can help prevent ski injury.

If you still have time before your trip why not try to make a visit to Gloucester's very own dry ski slope for a warm up. Check it out Gloucester Ski & Snowboard centre.

We have seen it all first hand and too many times that we care to remember when we were working out in New Zealand on the ski slopes. It's enough to make a grown man cry, hobbling in on a swollen knee "that doesn't feel quite right".

Remember: preparation is prevention!!!!


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