Anterior Cruciate Ligament Tear

A common injury that occurs in sports people who are involved in explosive sports that change direction quickly or impact sports is an injury to the ligaments of the knee.
The knee is made up of 2 primary ligaments that hold the structure in place and prevent movement of the bones in 2 distinct planes. The collateral ligaments run parallel to each other,superior to inferior along the lines of the leg. They almost form a natural splint like structure that holds the knee in place and prevents the bones from sliding sideways out of alignment. The other ligament is the Cruciate ligament which is a crossed ligament deep in the posterior knee space that resembles a cross (hence the name) or two fingers crossed.
This structure is often a ligament that gets worn and stressed as it stabilises the knee joint in the frontal plane and during ‘rotation’. Imagine your foot being planted and you trying to turn a corner sharply on a turf field. The bones are rotating against each other like a twisted tea towel. To stabilise this motion, the Cruciate Ligament is there to keep the bones from over-rotating and rupturing the knee capsule.
You often hear of athletes rupturing their anterior cruciate ligament (ACL),this refers to the ligament that is at the front of the cross. It’s a dramatic injury often associated with an audible pop after a landing from a jump or a sharp turn on a sporting field. The Cruciate Ligament attaches from the Femoral Head (thigh bone) to the Tibia (the larger of the two bones in the lower leg) Injury here creates a looseness of the knee whereby the end ROM when you bend the knee is not solid and has a ‘squidgy’ feel.
Many factors determine how to treat a torn (partial tear) or ruptured (complete tear) of the ACL. The severity of the tear and the degree of movement or impact that the patient may be likely undertake in the future is a major concern. Is the patient likely to undertake impact sports in the future or are they at the tail end of their career? This is a very real concern for those facing ACL surgical repair.

Symptoms of a Torn ACL
• There may be an audible pop or crack at the time of injury.
• A feeling of initial instability; may be masked later by extensive swelling.
• This injury is extremely painful, in particular immediately after sustaining the injury.
• Swelling of the knee, usually immediate and extensive, but can be minimal or delayed.
• Restricted movement, especially an inability to fully straighten the leg.

Cause of an ACL Tear
As with any sprain, an ACL injury is the result of excessive stretching or tearing of the ligament.
An ACL injury most commonly results from:
• A sudden stop or change of direction.
• A twisting motion at the knee joint.
• A blow or sudden impact to the front of the knee.
Athlete’s involved in sports that require a lot of running and change of direction and speed; (especially contact sports) are most susceptible to ACL injury.

ACL Injuries: How Massage Therapy May Benefit Your Recovery
When injury occurs, muscles act as a protective mechanism and tighten around an area of injury. Fascia is connective tissue located under the skin. Restrictions in the fascia tissue can become tight due to scar tissue and lack of range of movement. Massage helps to manage tightness and helps to restore blood circulation in the tissues.
Massage is used to treat tight muscles post injury. Muscles commonly tighten after injury which leads to restrictive movements. Injury can affect a muscle's optimum length which results in an increase of tightness. Muscles are made up of overlapping fibres. If a muscle is tight, fibres overlap too much causing lack of flexibility. Massage can help increase the temperature of tissues to loosen and stretch them. Stretched fibres allow muscles to function better and injury recovery to be improved.
Massage is also an effective treatment to reduce scarring after injury. Scarring is the natural healing process of damaged tissues. The body produces collagen fibres and sends them to repair around an injury site. Collagen fibres differ in texture to normal tissue fibres. Collagen is tough in texture and lays across the direction of muscle fibres. Scarring can be restrictive and aggravate to cause pain. Massage Therapy uses specialised techniques to loosen, break down and realign collagen fibres. Reduced scar tissue increases normal function of soft tissues, decreasing pain and tightness.