This time I want to talk a bit more at length about my own experience with a complete ACL (Anterior Cruciate Ligament) tear. There’s actually a lot of information about this online already — in the US alone, around 200,000 ACL surgeries are done every year. But maybe this will be of interest to someone, or the information here will be of some use.
To my own surprise, it doesn’t actually take much to end up with a fairly unpleasant injury like this (there’s always some backstory involved, of course, but everyone’s is a bit different). I managed to fully tear my ligament in what looked like a very simple fall while downhill skiing. Maybe I should first explain a bit about where the ACL actually is and what exactly it does.
Four major ligaments help support and stabilize the knee. Two are on the sides of the knee, and two are inside the knee, running between the shinbone and thighbone, crossing each other. Logically, that’s also where their name in Estonian comes from — the (anterior and posterior) “crossing ligament.”
If we didn’t have knee ligaments, the knee would come out of joint quite easily. Each ligament has its own role in stabilizing the knee. The primary job of the anterior cruciate ligament is to make sure the shinbone (tibia) doesn’t move too far forward relative to the thighbone (femur). The ACL also helps with knee rotation and ensures the knee doesn’t hyperextend — in other words, bend backward.
But if there’s enough force involved, the ACL can rupture. That doesn’t necessarily mean a complete tear has occurred right away. To picture it a bit more vividly, imagine taking a piece of string and pulling it apart from both ends. The string gives a little at first and some fibers snap, but if you use enough force, the string breaks completely. The same thing can happen with knee ligaments when they end up in an unnatural position.
I’ll go on here talking about the situation where the ligament is completely destroyed. Surprisingly, something like this may not cause much pain at all. I personally felt something like a small jolt at the back of my knee, along with a pop-like sound. Symptoms also include swelling of the leg, the knee giving way, and a feeling of instability (like the knee is “floating”) while walking. The knee may also lose its original range of motion, as the body’s own protective reaction to stabilize the leg. In a worse-case scenario, the torn ligament can also pull off a small piece of bone, and other ligaments or the meniscus can often get damaged along with an ACL tear. That’s why I’d recommend taking even mild pain seriously after a trauma like this.
But to be sure, there’s no avoiding a visit to the doctor. Most likely, an X-ray will be taken and the knee will be physically examined to test whether any ligament is torn or not. If something already seems off during the examination, you’ll be sent to get an MRI scan too, to confirm and help make a more precise diagnosis.
Strength and stamina to you going forward. What happens next once you have the diagnosis is a whole other topic, and I’ll write about it in more detail next time.
