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Published: 12 February 2019

Over the past few years we have seen a dramatic increase in the number of females participating in AFL, particularly since the introduction of the AFL women's competition earlier in 2017.

Along with this has come an increase in related injuries, particularly ACL tears.

What is the anterior cruciate ligament (ACL)?

The anterior cruciate ligament is one of four main ligaments in our knee. Sitting at the centre of the knee, it runs from the femur to the tibia and acts to stablise the knee.

Females are two to nine times more likely to injure their ACL compared to males

ACL injuries are also more common in females via a non-contact mechanism such as landing from a jump, rapidly stopping, or suddenly decelerating with a change in direction. Whilst we know that females are more prone to these types of injuries, the contributing factors as to why are still unclear.

Symptoms of an ACL injury

Individuals often report a popping sensation and swelling can be seen almost immediately.

When an ACL injury occurs, there is risk of damaging other structures in the knee depending on the mechanism of injury. The structures that can be damaged include the shock absorbing cartilage in the knee (meniscus) and the medial collateral ligament (MCL).

How to treat ACL injuries

The first point of treatment for these injuries should be the RICE principles (Rest, Ice, Compression and Elevation).

Early review by a physiotherapist can assist in appropriate diagnosis, reducing swelling, regaining range of movement and to minimise wasting of the surrounding muscles.

An MRI is generally recommended to determine the severity of the injury and if surgery is indicated.

Will I need knee surgery?

Patients who do not wish to return to sport can be managed without surgery, however a surgical opinion should be obtained. If surgery is recommended, the ACL is repaired through a graft from either the hamstring or patella tendon (a tendon at the front of your knee).

Recovery from surgery can take between 9-12 months and can be dependent on the type of graft performed.

Rehabilitation begins with gentle range of movement and strengthening, balance and regaining normal walking patterns. This can then progress to further gains in range of movement, full strength, straight line running, and agility, returning to restricted sport specific drills and finally returning to sport.

How do I prevent an ACL injury?

Prevention is key to reduce the risk of injuring your ACL. A typical ACL prevention program should include strengthening of the quadriceps, hamstrings and calf muscles, single leg balance (both static and dynamic), plyometric training and agility drills.

An appropriate assessment of predisposing factors can also assist in developing individualised prevention programs for those individuals who may be at a higher risk for injury. These can also be easily implemented into weekly trainings as part of the warm-up or training program.

Whilst there are certain instances in which an ACL injury is unavoidable, engaging in preventative exercise can reduce the risk of non-contact injuries occurring.