According to a 2007 "Journal of Athletic Training" article, approximately 33 percent of in-season football injuries occur at the knee joint, including a sprain or partial tear to the anterior cruciate ligament, or ACL. The pain and joint instability associated with ACL sprains leads to a loss of playing time and a decrease in athletic performance. Treatment includes rest and ice followed by rehabilitation exercises like straight-leg raises. Consult your physician for treatment and rehabilitation options.
Causes and Risk Factors
Football is a contact sport that involves running with sudden stops and frequent cutting and pivoting or changes in direction. A blow to your knee, twisting of your knee or falling awkwardly on your knee can result in a partial ACL tear. Risk factors include fatigue, knee instability and previous knee injuries. The type of playing surface may also increase the risk of knee injuries such as ACL tears, according to a 2011 article in the journal "Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology."
Symptoms
Symptoms vary based on the severity of your ACL tear, but may include pain, joint instability and swelling. Additional symptoms include bruising, muscle weakness, a "giving way" feeling and joint stiffness or decreased range of motion. Activities like walking or running likely aggravate your symptoms. In some cases, symptoms persist even after conservative treatment or physical therapy.
Treatment
Initial treatment consists of rest, ice, compression and elevation. To further reduce pain and swelling, take anti-inflammatory drugs like ibuprofen. Your physician may recommend wearing a knee brace to promote healing and using crutches while walking to avoid pain and reinjury. After pain and swelling subside, you may begin rehabilitation exercises to regain normal knee range of motion, strength and stability. In severe cases, surgery may be necessary to repair your torn ACL.
Rehabilitation Exercises
Initially, your physical therapist may move your knee in the pain-free range of motion to increase joint mobility. Other range-of-motion exercises include heel slides for knee flexion, and prone hangs for knee extension. Heel slides are performed in a seated position; you slowly slide your heel toward you while bending your knee. Prone hangs are performed lying on your stomach with your leg off the edge of a table. Strength exercises include straight-leg raises, cycling on a stationary bike and stepup. Stability exercises include single-leg balance and step-downs. For step-downs, stand on a step and then slowly bend your injured knee to touch the heel of your non-injured leg on the floor. Do not do exercises without your physician's approval.
Return to Play
Before you can return to your normal activities and sport, you need to perform functional exercises symptom-free. Exercises include squats, lunges, sprints and jumping. Additional football-specific exercises include side-to-side jumping, sprinting around cones or through tires and tackling or contact drills. Your physician may also recommend the continued use of a knee brace to prevent joint instability and reinjury.
References
- "Journal of Athletic Training;" Descriptive Epidemiology of Collegiate Men's Football Injuries: National Collegiate Athletic Association Injury Surveillance System, 1988--1989 Through 2003--2004; Randall Dick, M.S., et al.; 2007
- Chester Knee Clinic & Cartilage Repair Center; Accelerated ACL Reconstruction Rehabilitation Program; Mark De Carlo, P.T.; February 2011
- American Academy of Orthopaedic Surgeons; Anterior Cruciate Ligament Injuries; March 2009
- "Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology;" Comparison of The Incidence, Nature and Cause of Injuries Sustained on Dirt Field and Artificial Turf Field by Amateur Football Players; Ramin Kordi, et al.; 2011
- Human Motion Institute Sports Medicine: Football Functional Exercises
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