Following AC Milan's Serie A win this year, Zlatan Ibrahimovic took to Instagram to reveal the win was especially bittersweet since he had to power through the season without an anterior cruciate ligament (ACL) in his left knee.
His left knee was swollen for six months, and he could only train ten times in six months.
The footballer revealed he had surgery to put in a new ACL following the treatment he had to endure to continue playing during the season. He had more than 20 injections and emptied his knee once a week for six months, and was on painkillers the entire time. The pain kept him up at night, saying he 'never suffered so much on and off the pitch."
The post generated equal amounts of concern and admiration from fans. Though fans were aware he had an injury-ridden season, the full extent of his injuries was never revealed. According to osteopath Dr Lisa Gadd, the ACL helps stabilise the knee; it is essential for jumping, landing and change of direction- it's difficult to imagine how he managed to score eight goals in 27 games during the season.
While Gadd says playing with an injured ACL is not impossible with the proper treatment, it's not ideal. Working closely with elite AFL teams and Ironman athletes, the founder of Melbourne-based Living Health Group shares how athletes can continue to perform with an ACL injury and what treatment and post-recovery looks like.
#Can you explain what an ACL injury is in a nutshell?
#What are some of the most common causes of an ACL injury?
#How does an ACL injury affect athletic performance?
#What's the typical treatment for ACL injury?
Can you explain what an ACL injury is in a nutshell?
An ACL injury is a tear or sprain of the knee's anterior cruciate ligament. This ligament connects the femur (thigh bone) to the tibia (shin bone); it is one of the main ligaments stabilising the knee. ACL injuries most commonly occur during sports that involve a sudden stop or changes in direction, jumping and landing, such as soccer, netball and football. Injured people often hear a pop or feel a "popping" sensation in the knee when an ACL injury occurs. The knee may also swell, feel unstable and become difficult to bear weight.
What are some of the most common causes of an ACL injury?
ACL injuries are common in sports and activities that place stress on the knee, such as slowing suddenly and changing direction, pivoting with a foot firmly planted, landing awkwardly from a jump, or from direct contact such as a football tackle. These injuries are common in sports such as AFL, soccer and netball.
How does an ACL injury affect athletic performance?
The ACL helps stabilise the knee; it is essential for jumping, landing and changing direction. Playing football without an ACL would affect any athlete's ability to jump, land and suddenly change direction due to the lack of stability in the knee, swelling in the knee and feeling like the knee may give way.
Playing without an ACL is possible; a strong rehab program is necessary to keep all the surrounding structures, such as the glutes, core hamstring, quad, and calf strong, and reduce swelling in the knee.
What's the typical treatment for ACL injury?
For most athletes with a fully ruptured ACL that are playing sports that involve jumping, landing and changing direction, often a surgeon's opinion is recommended. ACL reconstruction is surgery performed to replace a torn anterior cruciate ligament.
Before surgery, patients undergo a rehab program to help reduce pain and swelling, increase the range of movement in the knee and strengthen the muscles around the knee, hip and pelvis.
What is the rehabilitation process like? How long does it take for someone who's undergone surgery to recover?
ACL reconstruction can take between 8-12months to recover. Post-surgery goals are to reduce the swelling around the knee, increase the knee's range of motion and work on strengthening the knee muscles, hamstring, glutes and core. Once strength is regained, return to running, jumping, and change of direction are the focus.
Can ACL injuries fully heal on their own? Can someone with this injury expect to fully recover and regain a complete range of motion after surgery?
Partial rupture of an ACL does not heal on its own due to the poor blood supply to the ligament. Fully ruptured ACLs that undergo reconstructions are repaired, and patients can regain full range of motion and return to sport if following a rehabilitation plan with their practitioner.
Also see: The benefits and dangers of icing injuries for recovery and pain management