ACL Injuries: Navigating the Challenges

Medically reviewed by Dr Bryan Wang ✅

ACL tears are one of the most soul-crushing and common injuries amongst footballers.

Sports enthusiasts often find themselves in the relentless pursuit of achieving excellence in their respective disciplines, often pushing their bodies to the limit in doing so. In this pursuit, the prospect of knee injuries, an injury that would affect an athlete’s journey greatly, looms ominously. 

Some may argue that out of the many knee injuries one can get, the anterior cruciate ligament (ACL) tear seems to be the most forbidding, often casting a shadow on the careers of various athletes. In the recent Women’s World Cup, many top players had to miss out due to this very injury. In partnership with Sportplus Singapore, Dr Bryan Wang of Beacon Orthopaedics and Nadhra Aqilah share with us in the below video on navigating the challenges of ACL injuries, a common problem for athletes.

Bouncing Back: Navigating The Challenges of ACL Injuries

What sports have the most ACL injuries?

Though out of the four ligaments, the ACL may seem insignificant in its size, it is probably the most important ligament in the knee, playing a very important role in what we call rotational stability of the knee. As the ACL affects rotational stability of the knee, we most commonly see this injury in pivoting sports where rotational movement occurs a lot.

Famous footballers like the English Premier League’s Ivan Perisic and England captain, Leah Williamson have been sidelined due to this injury as the rupture of the ACL can have profound impacts on an athlete’s performance. Locally, Albirex Niigata’s Nadhra Aqilah recently bounced back from an ACL injury as well. The biomechanics of their high-intensity sport puts immense strain on the knee joint, making it susceptible to the injury.

“What happens is that patients typically pivot on a foot that is planted in the ground. They hear a pop sound and then there is immediate swelling of the knee due to bleeding or homeostasis to the knee,” Dr Bryan Wang, orthopaedic surgeon at Beacon Orthopaedics explained.

What should I do if I have an ACL tear?

“Usually after a suspected ACL tear, it’s highly recommended for one to go to see an orthopaedic or knee specialist.

Apart from a clinical examination where the stability of the knee will be assessed, MRI scans will be ordered to confirm the diagnosis.

Types of ACL injuries 

The ACL test can often be categorised into three grades. Grade one, the least severe, is ACL sprains where there is partial stretching but the ligaments are intact. Grade two are partial tears while grade three are complete tears of the ACL. According to how a patient gets graded, they then go on to receive different types of treatments for their injuries. 

“Very often we will have collaborative discussions with patients and the treatment options, it's really dependent on their personal preferences and their desire to return to sports,” Dr Wang emphasised. 

He then adds that as long as somebody is passionate in sports and plans to return to their active lifestyle whether it is in football, rugby, or golf, then he would recommend a surgical reconstruction of the ACL.

As for non operative treatments which apply for grade one and two ACL tears, Dr Wang adds that they will initially be instructed to rest and be provided with anti-inflammatory medication to let the swelling subside.

The timeline of an ACL rehabilitation process

“A little bit of cycling and a little bit of pivoting activities may be allowed, but a full return to their sport will typically involve about nine months to a year,” he said. 

“It is a very slow and long process of behaviour detection, but it is actually a very important part to ensure a successful outcome for your ACL reconstruction surgery.” 

Nearing the end of the ACL reconstruction journey, Dr Wang says that patients typically do need to be protected in the knee brace.

“Even though certain ranges of motion points may be reachable at this point, the knee should still be protected if there are other injuries involving the meniscus source of the knee for the first six weeks,” explained Dr Wang.

This is due to the fact that ACL injuries can occur along with other injuries. For example, an ACL tear often occurs along with tears to the medial collateral ligament (MCL) and the shock-absorbing cartilage in the knee (meniscus). 

However, once the knee brace comes off, with good rehabilitation and motivation, most patients are able to go to the full range of motion.

This article is written in collaboration with SportPlus Media.