The Torn ACL: A Comprehensive Analysis

Jonathan Daniel

How many times have we seen "(insert player's name here) tore his ACL: out for season" scroll by on ESPN's ticker at the bottom of the screen while watching the ol' boob-tube? Too many. But exactly how much about this injury do you know?

Other than knowing that it is an injury that occurs in the knee and that it keeps players out for an inordinate amount of time (see Derrick Rose), I would venture to guess that not many sports fans really know much about the torn ACL. In this article I will attempt to provide a deeper comprehension of what is quite possibly the worst injury in all of sports.

Deeper comprehension of this injury is essential to sports fans for three reasons:

1.) To give better understanding of what the ACL is, what purpose it serves, and why tearing it is so problematic.

2.) To give an idea of how long it will take before their favorite player is back in action.

3.) To give a sense of reality to fans with unrealistic expectations of players returning to their previous forms after recovering from their injury (In other words, not every player who tore their ACL will bounce back like Adrian Peterson did in 2012.).

What is the ACL and what purpose does it serve?

eHealthMD describes the anterior cruciate ligament (ACL) as follows:

The anterior cruciate ligament (ACL) is one of the most important of four strong ligaments connecting the bones of the knee joint. The function of the ACL is to provide stability to the knee and minimize stress across the knee joint. It restrains excessive forward movement of the lower leg bone (the tibia) in relation to the thigh bone (the femur) and it limits rotational movements of the knee.

Where exactly in the knee is this pesky ligament located?

2013-02_acldiagram_medium

(Photo rights belong to www.ACMC.com)

Well what causes it to tear?

A tear in the ACL is caused by two different movements of the knee: hyperextension and/or internal rotation of the knee. These movements most often occur when an athlete cuts from one direction to another, decelerates too quickly from a high rate of speed, lands awkwardly when coming down from a jump, or powerfully planting on a hyperextended knee.

What essentially happens when an athlete tears his ACL is that the ligament is ripped in half due to the hyperextension and/or internal rotation of the knee, resulting in a sensation of instability which makes walking (or even standing up, for that matter) nearly impossible.

How Is It Treated?

The incredible thing about this injury is that no two ACL tears are exactly alike. Due to this variation, it becomes a lot harder to effectively pinpoint how to go about treating it. In fact, beyond applying ice and compression to the spot, there really is no clear way to treat this injury.

What doctors do know, however, is that sewing the ligament back together is generally ineffective because of where it is located. Due to the fact that it is located in the middle of the knee, it is constantly being bathed in fluid which prevents a clot from forming around the stitches. This is problematic because the blood clot serves as a seal of sorts, and without this seal the surgery was all for nothing because the ligament won't properly reconnect.

Other techniques, such as synthetic ligaments and transplanting other ligaments from the knee have been attempted, but due to the different variations of the injury it is nearly impossible to say with any certainty that any particular method works the best.

When it comes down to it, the effectiveness of an athlete's recovery is determined by which orthopedic surgeon is operating on the knee and what their approach to treating it, how the athlete goes about rehabilitating it after surgery (if they have surgery on it all), and how lucky the athlete is.

How long will my favorite player be out?

Due to the many variations of the ACL tear, it is quite uncertain to say how long the recovery period is. In some cases, a player will be back in action within a year (see Adrian Peterson) and in others the athlete will be out for a much longer period of time (again, see Derrick Rose). On average, however, a successful recovery from a torn ACL takes anywhere from four to six months with a successful rehabilitation and exercise program.

It's easy to view athletes as objects and injuries as malfunctions. A lot of this can probably be attributed to the objectiveness of games like Madden or NBA 2K in which the player is automatically back to normal after sitting out a certain amount of time after sustaining an injury.

When you see that player has ripped his ACL, oftentimes you think, "That stinks. At least they will be back next year". In reality, however, not all players have miraculous comebacks like Adrian Peterson. In fact, a lot of players are never quite the same after suffering from a torn ACL. It's important to understand that coming back from a torn ACL is miraculous enough as it is, and that expecting some sort of instant return to form after a player returns to action is simply unfair and unrealistic.

The Bottom Line:

The torn ACL is a tricky injury which takes time, patience, and luck to recover from. Thirty years ago, a torn ACL would almost certainly mean the end of a player's career. Since then, medicine had advanced tremendously, making recover from this injury more possible than ever. With strides being made in the medical field every day it is possible that a universal treatment may be on the horizon. It's important not to be complacent and become stagnant in our medical progress, however, until one day a sure-fire treatment has been discovered and the damage of this gruesome injury is minimized and the threat of ending an athlete's career is completely neutralized. Isn't the future just a bright and exciting prospect?

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