Defining Knee Injury, what is the ACL, and how do you damage it?

One of the more common knee injuries is a tear in the ACL, a tough band of tissue that joins the thigh bone to the shin bone. This damage can occur from a number of scenarios; however, they are more often than not sport injuries. 

At Mount Sinai, we have noted that the most frequent causes for a torn ACL is a sudden change of movement, landing badly from a jump or fall, or the result of a collision in a tackle – scenarios which usually arise in high demand sports like soccer, football or basketball.

Outside of competitive sports, we find that people develop ACL damage by changing direction rapidly, stopping suddenly, and slowing down while running. These are all movements that are exaggerated when playing sports, which is why you are less likely to tear the ACL when not participating in high-level sport.

Female athletes have a significantly higher incidence of ACL injury than male athletes, this is believed to be due to physical conditioning, strength, and neuromuscular control. It is also believed to be linked to differences in pelvis and lower extremity alignment, increased looseness in ligaments and the effects of oestrogen in the body.

What is the ACL?

The anterior cruciate ligament runs diagonally through the middle of the knee and prevents the tibia sliding out in front of the femur as well as providing rotational stability to the knee. You can imagine it as an X running through the knee.

You also have collateral ligaments, which are found on the sides of your knees. These control the sideways motion of your knee and brace it against unusual movements.

Damage to the anterior cruciate ligament (ACL) may require surgery to regain full function of the knee – but this will be dependent on several factors such as the severity of the tear.

How severe is the damage?

As usual, we class the sprains into 3 classes which increase in severity incrementally.

·        Grade 1 – The ligament is mildly damaged. It has been stretched, nudged, or pushed ever so slightly out of its comfort zone. You will still be able to keep the knee joint stable.

·        Grade 2 – The sprain will have stretched the ligament to the point in which it has become loose and will most likely mean there is a partial tear to the ligament.

·        Grade 3 – This type of sprain is commonly understood and referred to as a complete teat of the ligament. It will have split into two pieces and completely destabilized the knee joint.

It is worth noting that partial tears are usually rare – most ACL injuries are near complete tears.

If you have recently torn your ACL and would like to speak to one of our physicians, please contact our switchboard at (212) 241-6321 to discuss options.

How to Protect Your Achilles Heel in Basketball

It has always been very apparent to humankind that the Achilles heel is a serious physiological blind spot – so much so that the Greeks decided to centre a myth around this all-too-human-inadequacy. Our anatomic weakness becomes very apparent in games like basketball which require frequent sliding, stop-starting, and sudden twists. That’s why it is not surprising that every year the emergency department, doctors’ offices, and local clinics treat 355’130 basketball ankle related injuries. Whether you’re defending, blitzing, or chasing a rebound – your Achilles is always at risk of letting you down, and potentially ruining your career for the foreseeable future. This week, we want to show you some top tips to prevent this from happening.

Maintaining a healthy weight during the off-season will allow you to jump back into basketball seamlessly. You won’t have to blow off any cobwebs upon restarting your season, your coordination will still be spot on, and if you do make a mistake then you will not be punished by carrying excess weight. The Achilles is extremely weak, and one slip up could mean the end of the line for you this season.

You can also avoid damaging your Achilles by preparing yourself before a game with stretches, running, jumping jacks, cycling and long-term flexibility training. Always warm up and stretch before you play – especially in colder months if playing outdoors to avoid stiffening up.

You can significantly reduce the risk of damaging your Achilles tendon by ensuring you have appropriate equipment. Generally, the most important piece of equipment are your shoes as a good pair can save you a trip to the hospital whereas an inappropriate pair could land you in all sorts of trouble. Basketball shoes that fit, have no skid soles, and offer support to your ankles reduce the odds of you damaging your ankle.

You can further increase the odds to your Achilles surviving a rough game by using ankle braces or tape to stabilize the region.

Finally, ensure your technique is correct and your understanding of the intricacies of the game is finessed when playing. Technique improves your coordination and self-control meaning you will be less of a danger to yourself. Imagine landing a 3 pointer then twisting your ankle when landing. And understanding the game means you play your assigned position and therefore control the area around you. Listen to your coach’s advice and learn the game. Understanding your role better allows you to better avoid collision and injury from illegal or unexpected contact.

If you have recently damaged your Achilles tendon and would like to speak to one of our physicians about it, please contact our switchboard at (212) 241-6321