ACL - Knee Deep in Ligaments


If you've ever thrown out your knee, you may have more in common with your pro sports heroes. An anterior cruciate ligament tear could mean surgery and months of physical therapy. There aren't any absolutes in avoiding ACL problems, but awareness is the key.

The ACL is the smallest of the four main ligaments of the knee, but it is the primary stabilizer. Injuries have a tendency to occur when the foot is firmly planted and the knee is twisted. Any sport that requires acceleration, change of direction and deceleration can increase the chances of suffering an ACL tear.

"The majority [of ACL patients] are injured in a competitive sport, and need surgery," says William Levine, M.D., director of sports medicine at Columbia-Presbyterian Medical Center in New York. To help prevent future instability in the knee, surgeons use arthroscopic techniques to replace the torn ACL with a graft of the patellar tendon.

As with all injuries, the best way to handle ACL strains is not to get them. Stretching will keep the muslces and tendons flexible so they can help absorb shock. For strength and endurance, a combination of stretching and weight training targeting the quadricepts and hamstrings is essential. Muscles should be warmed up gradually before excertion and stretched thoroughly after your workout. Don't bounce while stretching and always exhale as you go into the stretch. Hold each stretch for 30 seconds to the point of mild discomfort.

By concentrating on effective quad and hamstring excercises, you'll keep on sprinting instead of ending up in an MRI tube with your orthopedic surgeon by your side.

Sitting Hamstring Stretch Sit on the floor with both legs straight. Press your chest to your thighs and hold. Keep your eyes focused on your feet.
Reaching Hamstring Stretch Sit with one leg extended straight in front of you and the other leg bent with the knee flat on the floor. Lean forward over the extended leg until you feel tension in the hamstring. Keep your eyes focused on your feet, reaching your hands towards your toes.
Quadriceps Stretch Hold on to a wall for balance, grasp one leg above the ankle, and pull the leg up and back. Move slowly and smoothly. Repeat with the other leg.
Lying Leg Flex Lie face down on the floor with your arms under your chin. Flex one leg toward your buttocks and lower slowly. Do three sets of 10 to 15 repetitions with each leg. This exercise can also be done standing; add ankle weights for extra resistance. Or use the leg-curl machine, standing with one set of 10 to 15 reps.
One-Legged Squat Standing six to 10 inches away from a chair or bench with your back to it, rest one foot on the seat, sole up. Balancing on the other leg, squat slowly. When your thigh is nearly parallel to the floor, push up. Repeat eight to 15 times, then switch legs. Standing squats and lunges can also be performed to increase quadriceps strength.
Wall Sit Stand with feet shoulder-width apart and your back against a smooth wall (1). Slowly slide down the wall as though you're lowering yourself into a chair (2). Stop before you reach 90-degree mark. Hold for 30 to 60 seconds, then push back up to a standing position. Perform 5 to 10 reps.

References

Shari Rosenblum
Men's Fitness, June 2000