ACL Injuries In New Zealand: Insights And Prevention

Like many other countries around the world, our ACL injury rate here in New Zealand is on the rise. While our neighbours across the ditch saw their prevalence of ACL injuries increase by 43% between 2000 and 2015, with a staggering 74% surge among those aged under 25, we Kiwis see more than 5000 ACL ruptures and 3000 ACL surgeries every single year. This means that understanding, preventing, and effectively managing ACL injuries is a top priority. Here’s what you should know.

 

ACL Injuries

Your anterior cruciate ligament (ACL) is a vital component of the knee joint, connecting the shin bone (tibia) to the thigh bone (femur) and preventing excessive forward movement of the tibia relative to the knee. An ACL injury occurs when this stabilising ligament is strained, torn, or ruptured, often resulting from forceful movements during activities like sports, running, or jumping.

 

What Causes An ACL Injury?

ACL injuries stem from forceful movements that stretch the ligament beyond its capacity. Activities such as sudden pivoting, running stops, and incorrect landings from jumps can lead to ACL injuries. Collisions, whether in sports or accidents, can also cause significant damage to the ligament.

 

Signs and Symptoms

Some people notice a popping sensation during the incident, followed by weakness, swelling, and difficulty bearing weight on the affected knee. While pain is a common symptom, it’s not universal, as the ACL lacks nerve endings transmitting pain signals.

 

Prevention Strategies

While certain ACL injury events are unavoidable, emerging evidence supports the identification and improvement of biomechanical and neuromuscular risk factors. Women, who are 3-6 times more likely to sustain ACL injuries, benefit from screenings and interventions including targeting factors such as:

• Ligament dominance, where muscles fail to absorb ground reaction forces, increasing the risk of ligament rupture.
• Quadriceps dominance, stabilising the knee primarily with the quadriceps, elevating injury risk.
• Leg dominance, having a preferred leg, leading to muscle asymmetry and increased ACL injury risk.
• Core dysfunction, the inability to control the core precisely, potentially related to growth spurts.

Preventative screenings and dynamic warm-up programs have shown remarkable success, reducing non-contact ACL injury risk by up to 70%. Those with a history of ACL injury face an increased risk of recurrence, making targeted interventions crucial. Strengthening the quadriceps, hamstrings, and glutes, mobilising the hip, and refining jumping and landing techniques play pivotal roles in reducing ACL injury risk.

 

Podiatry Treatment For ACL Injuries

When dealing with ACL injuries, current or past, our podiatrists tailor your treatment options to your specific circumstances, considering factors like activity levels, medical history, and personal preferences, among other factors. Podiatry treatment aims to:

• Alleviate pain and inflammation: podiatrists employ targeted strategies to reduce pain and inflammation, enhancing overall comfort during daily activities.

 

• Restore knee function and range of motion: through specialised interventions, podiatrists work to restore optimal function and a healthy range of motion in the injured knee.

 

• Strengthen muscles around the knee: podiatric interventions focus on strengthening key muscles surrounding the knee, particularly emphasising the quadriceps and hamstrings.

 

• Monitor and support kneecap alignment: precise monitoring and support for kneecap alignment are integral components of podiatry treatment, ensuring proper joint mechanics.

 

• Enhance flexibility: podiatrists incorporate flexibility exercises into the treatment plan, promoting the restoration of normal joint movement.

 

• Improve neuromuscular control: addressing neuromuscular control issues is a key aspect of podiatry treatment, contributing to enhanced stability and reduced injury risk.

 

• Refine technique and function: as significant recovery progresses, podiatrists focus on refining movement techniques and functional abilities during various activities, including walking, running, squatting, hopping, and landing.

 

• Return-to-sports rehabilitation: tailored rehabilitation programs facilitate a safe return to sports, incorporating exercises and activities that mimic the demands of specific sports.

 

• Reduce the risk of reinjury: podiatrists work closely with individuals to implement strategies aimed at minimising the risk of ACL reinjury, emphasising ongoing care and injury prevention.

 

Frequently Asked Questions About ACL Injuries

One frequent concern is the higher risk faced by women compared to men, attributed to anatomical differences such as a wider pelvis, less muscle mass around the knees, and hormonal variations. A pivotal question often revolves around the ability to walk post-injury, with the misconception that walking negates the possibility of an ACL injury. However, professionals emphasise the necessity of a thorough diagnosis to accurately assess the extent of knee injuries.

Another prevalent worry centres around the potential impact on one’s sports career or participation in social sports teams following an ACL injury. While recovery downtime is expected, it doesn’t necessarily spell the end of sporting pursuits. Noteworthy examples from the 2021 NRL season, where nine players sustained ACL injuries or tears, demonstrate that a well-managed recovery can lead to a successful return to the field. Another frequently asked question delves into the natural healing capacity of the ACL. Unfortunately, the anterior cruciate ligament lacks a direct blood supply, impeding autonomous healing.

Individuals often inquire about alternatives to surgery and whether non-surgical approaches are viable. Here, podiatrists stress the importance of consulting with a professional to explore options and understand the pros and cons associated with each. Lastly, concerns about misdiagnosis arise, with individuals wondering about alternative sources of knee pain. Podiatrists advise that knee pain may result from various issues such as meniscus injuries, collateral ligament injuries, PCL injuries, knee dislocations, or fractures, emphasising the necessity of accurate diagnostic assessments.