Why are we having so many ACL injuries?
- There has been a 70% increase in ACL reconstructions in those under 25 years of age over the past decade
- ACL injuries affect women more than men
- Re-rupture rates are as high as 30% within 2 years for those under the age of 20
- We need to appreciate that there are many modifiable and non modifiable injury risk factors for an ACL injury
- Modifiable risks include strength and muscular control (Eg landing technique)
- Non-modifiable risks include anatomy, genetics and hormones
What can we do about it?
- Recent research tells us that we can reduce the risk of a first time ACL injury by 50% through neuromuscular and strength training programs such as the FIFA 11, PEP Program, Netball KNEE program or AFL Footy First Program.
- To reduce the risk of a second ACL injury following surgery research suggests that we wait at least 9 months prior to returning to sport (remember this is a good outcome even for a pro athlete), but more importantly pass a series of tests including strength, hop and functional tasks under the guidance of your physiotherapist.
What to do if you have ruptured your ACL?
- Options are surgical reconstruction vs non operative management – a decision that is based on many factors and should be made with the guidance of your physiotherapist and orthopaedic specialist – Some will cope without an ACL (and yes, even return to pivoting sports)
- Appreciate there are also a number of ACL grafts that can be used for ACL reconstruction with some being more suitable for different age group, sports played etc
- If surgery is decided, it is important to understand that recent evidence clearly demonstrates a period of pre surgery physiotherapy leads to improved strength and function at 2 years post operatively compared to those who do not perform pre surgery exercises – delaying surgery for 6 weeks following your injury to focus on getting ready for surgery has extreme value in the long run!!!