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Tears or ruptures of the ACL (anterior cruciate ligament) are very common.

So common that it affects approximately 250,000 individuals.

And that statistic is in the United States alone.

What are the likely causes?

Individuals who are engaged in sports are more prone to ACL injuries.

ACL injury can also often occur as a result of the following:

Pivoting
Single-leg landing
Direct trauma (common in contact sports)
Cutting
Twisting force (applied to the knee when the person lands on one foot)

An ACL injury can be very painful and most people will hear and experience a “pop” in the knee when it occurs.

This is followed by feelings of instability.

ACL injuries will not only make activities like walking down the stairs difficult but it will also hinder patients from engaging in athletic activities.

What are the risk factors?

While everyone can have ACL injuries, there are several factors that can put people at a higher risk.

Some of the most common risk factors include:

Gender

Compared to males, females are more prone to ACL injuries.

Age

Majority of ACL tears often occur between the ages 15 to 45.

Oftentimes, this can be attributed to higher sports participation and an active lifestyle.

Single-leg cutting, pivoting, and landings

A huge percentage of ACL injuries (70 percent) can be attributed to sudden deceleration (i.e. cutting, landing on one leg, and pivoting).

Individuals who participate in sports like volleyball, tennis, lacrosse, football, and downhill skiing are more prone to ACL injuries.

Direct blow outside the leg or knee

ACL injuries from contact often result from direct blows to the knee when it is hyper-extended or slightly bent inward.

What are the common symptoms?

For those with acute ACL tears, one or more of the following symptoms will be present:

Deep knee pain
Swelling
Restricted range of motion (difficulty in straightening the affected area is also evident)
Instability (this can become noticeable when performing activities that put stress and strain on the affected area like walking down the stairs or pivoting)
Affected knee may feel warm to the touch (this can be attributed to likely bleeding within the joints of the knee)

Without proper medical attention, swelling and pain might eventually disappear on its own after several weeks but the instability will persist in most cases.

Patients with ACL injuries will also experience difficulty standing up from a sitting position and going downstairs.

What are the treatment options?

While surgery may sometimes be required, not everyone who develops an ACL injury will have to undergo one.

Certain factors like age, activity level, as well as other injuries will have to be taken into account before the doctor will decide if surgery is an option.

Active individuals who are involved in sports/activities that will not require sudden stops or turns (i.e. cycling and swimming) and those who do not experience any instability are likely candidates for non-invasive treatment alternatives.

Non-surgical treatments are often facilitated by a physical therapist.

The main goals would include maximizing strength, balance, and proprioception (body positioning).

What can patients expect during the recovery period?

For patients who will have surgery, post-operative rehabilitation will be needed to maximize long-term healing.

Primary focus will be on balance, proprioception, core strength, and range of motion.

Apart from physical therapy programs, home exercise programs might likely be prescribed.

Some surgeons might also recommend using no braces albeit there’s no evidence yet that will support its benefit.

In most cases, athletes can already engage in their chosen sport 6 to 12 months after the surgery.

However, only orthopedic surgeons are able to determine for sure when it will be truly safe to return to routine athletic activities.

Checking with an orthopedic surgeon is the recommended route as returning prematurely might put the ACL graft in serious risk.

For help with ACL injuries, please visit www.bjios.sg immediately.

When the tendon that connects the back of the leg to the heel (Achilles tendon) becomes swollen and painful, the condition is known as Achilles tendinitis.

Achilles tendinitis is very common among runners who drastically increase the intensity or the duration of their runs.

It is also prevalent among middle-aged people who play sports like tennis and basketball on the weekends.

Causes

Achilles tendinitis is likely to manifest when:

There is a sudden increase in the intensity or amount of physical activity
The calf muscles are very tight or not stretched out
Running on surfaces that are hard like concrete
Running too often
Not wearing footwear that provides the right support
There is a lot of jumping involved, for instance when playing basketball
When the foot is drastically turned in or out

Achilles tendinitis that develops due to arthritis is common among middle-aged and older individuals.

A bone spur or growth may also develop in the back of the heel bone and may irritate the Achilles tendon as a result.

This irritation will often result to swelling and pain.

Symptoms

Common symptoms of Achilles tendinitis can include:

Pain in the heel and along the tendon’s length when walking or running
Pain and stiffness in the affected area in the mornings
Difficulty when standing up using only one toe
Swelling in the area affected

Risk Factors

Several factors have been known to increase the risk for Achilles tendinitis.

Some of the factors are:

Sex

The condition is more common among men than in women.

Age

The likelihood of the condition occurring more increases as one ages.

Training options

Running on hilly terrains and wearing ill-filling shoes can also increase one’s risk of developing Achilles injury.

Medical conditions

Individuals with psoriasis and high blood pressure are more prone to developing the condition.

Physical problems

Those with a naturally flat arch are likely to put more strain on the Achilles tendon. Obesity and tight calf muscles have also been identified to increase tendon strain.

Prevention

Preventing Achilles tendinitis from happening is not exactly possible.

However, there are certain measures one can be exercised to help reduce one’s risk.

For starters, the following measure would help:

Increasing activity level gradually.

Every time you start an exercise regimen, it is recommended that you start out slow and increase the duration and the intensity gradually as you go along.

Stretch regularly.

Ensure to stretch the calf muscles and the Achilles tendon before and after exercising. This is done in order to retain flexibility.

Cross-train.

Make sure you alternate high impact activities like jumping or running with low impact ones like cycling and swimming to help ensure lesser strain is placed on the Achilles tendon

Treatment

Most of the time, Achilles tendinitis will respond to home remedies.

However, in cases where the symptoms become severe and persistent, other treatment options might be recommended.

Medications

OTC medications like ibuprofen and naproxen might be prescribed to help ease the pain and the swelling.

If the condition will not respond, stronger medications might be given.

Physical therapy

A physical therapist may suggest the following treatment options:

Exercises

Therapists will recommend stretching and strengthening exercises to promote tendon healing as well as healing of the supporting structures.

Orthotic Devices

A shoe insert or a wedge that can elevate the heel slightly can help relieve strain. It can also provide the much needed cushion so force that is exerted in the tendon is lessened.

Surgery

If the condition will not respond to conservative treatments, surgery to repair the tendon might be necessary.

If you need help with Achilles tendinitis, please visit www.bjios.sg so you’ll know how to get competent help to effectively manage the condition.

ACL Injuries: Who Are at Risk?

Ways to Manage Achilles Tendinitis