What Is an ACL Injury?

By Deborah Holmes, PT

In the knee, there are four main ligaments that hold the knee together and keep it stable. The function of the ligament is to attach bones to one another. The anterior cruciate ligament (ACL) is one of the ligaments inside the knee joint. This particular ligament prevents the lower leg bone, the tibia, from sliding too far forward or rotating on the thigh bone, the femur.

The ACL can be injured during sports or activities that require excessive pivoting or twisting of the knee. The ligament can also be injured during hyperextension or lateral trauma to the knee. The athlete may feel a sense of instability of the knee during activity. An evaluation by a physical therapist is indicated. Further evaluation by an orthopedist will determine if surgical reconstruction of the ligament is needed. If surgery is performed, the athlete spends several months in physical therapy rehabilitation to regain full function of the knee in order to return to sports.

Dr. John J. Klimkiewicz is an Orthopedic Surgeon with MedStar Georgetown University Hospital. He performs about 150 repairs of the ACL a year and feels that physical therapy is extremely important for his surgical repairs.

“I have a rehabilitation guideline, which outlines several phases. The patient may start physical therapy right after injury, during hospitalization, and then 3-9 months of supervised out-patient physical therapy. Progression through each phase should take into account patient issues (i.e. healing and function) and physician advisement.”

Selecting a team

Elizabeth Tracy knows a lot about ACL injuries. She injured her knee during a skiing accident that started the tear in her left ACL several years ago.

“I finished off the tear over a couple of years by ignoring strengthening exercises, doing the split vertically against a wall and finally with a nasty hoo-la-hoop incident. I called an old roommate who had done her post-grad work at Georgetown Hospital. I told her I needed someone who knew what he/she was doing. She told me to see Dr. John Klimkiewicz at Georgetown.”

Once you are discharged from the hospital, your work has just begun. You walk on crutches and have bandages wrapped around your knee while the surgical site heals.

Follow the Directions

It’s good to see the outcome of all of your hard work. In Tracy’s case, Dr. Klimkiewicz expects full recovery and return to previous activity level. Tracy fully understands her limitations and agrees that starting physical therapy sooner rather than later stops you from creating bad habits.

“I have a tendency to push myself too far too fast. I am doing everything in my power to follow the directions of my doctor and physical therapist working out at the gym on a regular basis, but not beyond their recommendations.”