ACL injuries don’t just plague athletes

by Dr. Chris Singh

The anterior cruciate or ACL ligament is one of two internal knee ligaments. These two ligaments play an important role in the stabilization of the knee joint. The ACL is a tough band-like structure that connects the thigh bone to the shin bone.

Most ACL injuries occur during physical activities that require sudden stopping and starting or quick changes in direction. Sports such as basketball, tennis and soccer tend to cause a higher incidence of ACL injuries.

In my practice I often see ACL injuries in professional truck drivers. Many times the injuries are due to slips and falls. I recently treated a patient who injured his ACL after slipping on the wet deck of a float trailer. The major cause of this incident was the driver was not wearing proper footwear. Another common practice that can lead to ACL injuries is jumping off the back of a trailer or out of the cab of a truck.

Awkward landings from a jump often put tremendous stress on the ACL ligaments. As a result, I always recommend that drivers use three-point contact when getting in and out of a truck or trailer.

Patients often report a loud popping sound at the time of an ACL injury. Severe pain usually occurs instantly or within minutes. Significant joint swelling will continue to worsen for hours after injury. Often, a feeling of joint instability will follow an ACL injury. Due to the severity of pain and swelling, most patients seek medical attention immediately.

Your health care professional will take a detailed history and perform a physical examination. If necessary, tests such as X-rays or MRIs will be ordered to better visualize the knee.

The initial goal of treatment is to reduce swelling and control pain. Rest and ice application is a good place to start. Your doctor may prescribe pain or anti-inflammatory medications.

Rehabilitation therapy is the next step in treatment. Therapy will initially include the use of crutches and possibly a specially-designed knee brace. Stretching and strengthening exercises will be utilized to bring the knee back to full functional ability. While the ACL is healing, it is best to avoid strenuous physical activities that require pivoting and jumping.

In the most severe cases in which the ligament is torn, surgery may be the only option. There are several different surgical techniques. Your doctor will advise you as to which technique is best for your particular case.

Nowadays, most knee surgeries are performed through small incisions around the knee joint. This significantly reduces the healing time.

As I always say, prevention is the best treatment. Although it is impossible to avoid all ACL injuries, many can be prevented by using common sense. As mentioned earlier, avoid jumping down from the back of trailers or cab of the truck. Utilize proper footwear to reduce the chances of slips and falls. Finally, try to keep your leg muscles strong and flexible by performing a regular exercise and stretching routine. This routine can be very basic consisting of a few stretches and strengthening exercises.

Keep these tips in mind and you will be well on your way to preventing an ACL injury.

Until next month, drive safely.

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