The anterior cruciate ligament (ACL) is the key ligament which bonds together the upper and lower parts of the leg at the knee. ACL injuries account for more than two-thirds of all knee injuries in skiers and are fairly common in other sports such as volleyball, basketball, and racket sports. To prevent ACL injury it is important to have strong quadriceps and hamstrings. A ruptured ACL is typically diagnosed by a doctor – an MRI exam is advisable, as this can also identify whether the meniscus (cartilage in the knee that provides cushioning) is damaged as well. If your meniscus is damaged, you should definitely avoid exercises that could aggravate this condition. There are occasions where surgery is not necessary, or not worth the potential for further damage, as the ACL is not always crucial for people that do not exercise heavily. As with all recommendations for surgery, it is usually advised to get a second opinion.
If you have chosen to have ACL reconstructive surgery, remember that proper post-surgery rehabilitation is very important, perhaps even more important than the surgery itself. Activities should set out to promote healing, increase flexibility in the knee and strengthen surrounding muscles. Your physical therapist will probably set up a “passive range of motion” program, and put you in a hinged knee brace for a month or two to prevent hyperextension or hyperflexion in the knee. An important point for ACL patients to remember after surgery is thatevery effort must be made to increase range of motion and flexibility at the knee. Weakness in the knee can usually be eliminated by extra strengthening exercises, but increased stiffness can sometimes be permanent if not corrected by further surgery.
The most common cause of an tendon inflammation (tenosynovitis or tendonitis) is overuse of the affected tendon. Rest of the affected tendon is all that is required in some cases. Other treatments such as anti-inflammatory drugs or a steroid injection are sometimes needed. Infection of a tendon is an uncommon cause but needs treatment with antibiotics if it occurs.