The ACL tear of the knee is the injury every athlete knows about and dreads. It is very commonly seen in sports that require a rapid change of direction, or landing. Sports such as Australian rules football, soccer, basketball and netball have a high incidence of these injuries. There has been and continues to be a lot of research into ACL injury and the appropriate management. As the research and evidence adapts, The Reform Lab Osteopathy adapts alongside with it. Director and osteopath Jackson suffered his own ACL injury and knows first hand that the education and care on these extensive injuries needs to vastly improve. It is now one of his most passionate areas of injury management and risk mitigation.

Did you know Australia has the highest incidence in the world for ACL injuries, with approximately ten thousand per year. Females are 2-8 times more likely to sustain an ACL injury, which is due to anatomy, biomechanics and likely poor strength and conditioning investment/coaching in the female athlete! The vast majority of ACL injuries are due to a non-contact mechanism (70-80%), which really highlights the need for better preparation to reduce the risk of these injuries. This is an area where osteopath Jackson is very passionate about. Exercise and risk mitigation practices in the gym are encouraged to reduce these non-contact injuries. Getting coaching and guidance before injury occurs is the best strategy.

The ACL is often considered the “sensory organ of the knee.” It plays a huge role in proprioception (“the sense that lets us perceive the location, movement, and action of parts of the body” - Taylor, 2009), which is why the whole biomechanical system of the lower limb can be affected post injury. The primary role of the ACL is to prevent the anterior translation of the tibia (shin) on the femur (thigh). It also plays a secondary role in providing rotational and lateral movement stability. The ACL has two distinct fibre bundles, the anteromedial and the posterolateral. The anteromedial bundle is considered the main bundle and its role is to prevent the anterior translation of the tibia on the femur. Whilst the posterolateral plays a role in preventing rotational instability.

A full thickness tear of the ACL is where both bundles are torn. When only a single fibre bundle is torn, the injury is known as a partial thickness tear. Partial thickness tears account for approximately 10-27% of all isolated injuries. These type of injuries can progress to more instability in the following years, which is why appropriate management is essential.

What are the management options for the ACL injured knee?

1. Early ACL reconstruction (surgery) & post operation rehabilitation.

2. Conservative management (non-operation) - There is lots of research showing this is certainly possible and in fact may have better outcomes than those who have surgery.

3. Pre-operation rehabilitation followed by a planned reconstructive surgery and then post-operative rehabilitation.

The best option will determine on the individual as everyone is different and their own ACL story is unique. Your goals and expectations need to be addressed before a decision is made. There are pros and cons to the options above, however your osteopath will discuss this with you providing comprehensive education for a decision to be made.

At The Reform Lab Osteopathy, we are truly unique in the fact we have a fully functional elite gym to guide you through your rehabilitation journey. Osteopath Jackson has learnt everything he knows about these injuries from the worlds leading experts on ACL management. We have the crucial sports science technology from VALD, which will allow us to regularly assess you through your journey. What this technology has been shown in the clinical research is that it can accurately determine your readiness to return to sport. A massive reason why the ACL re-injury rate is so high is unfortunately, many practitioners guess their ACL athlete is ready to return to sport. The Reform Lab Osteopathy will not add to these statistics, as many of those who suffer a re-injury never passed crucial return to sport testing. With the technology in our clinic we don’t guess, we accurately measure your readiness to return to sport! If you want to ensure you are ticking every box in your ACL journey, then we are ideal for you.

Ensure you read our blog ‘Why do we care so much about the ACL?’