The ACL lies in the middle of the knee joint and is one of the main stabilising ligaments of the knee, the others being the Posterior Cruciate Ligament and Medial and Lateral Collateral Ligaments. The ACL helps control and stabilize relative femoral/ tibia (thigh/shin bone) movement. The PCL passes in the opposite direction, forming a cross pattern hence the name.

The function of the ACL is to prevent excessive forward movement of the tibia (shin bone) relative to the  the femur, the PCL prevents excessive posterior movement. An ACL tear or partial rupture is a fairly common knee injury resulting from playing sports that involve twisting and turning, rapid changes in direction with the knee bent and landing with a flexed knee under load of body weight. Skiing injuries are a common cause. Direct impact from the side is also a significant cause of ACL damage such as tackles in Football and Rugby. Interestingly ACL injuries are between 2 and 8 times more likely in women than men, no one knows quite why although it may be to do with hormone levels and anatomical differences.

There are a number of signs and symptoms found and reported in ACL injury such as:

• Local pain in and around the knee.
•  Snap or pop sound and pain sensation deep within the knee at the time of injury.

• Knee pain and local tenderness to touch.
• Knee instability and gross restriction of movement.
• Swollen knee possibly immediately or definitely in a couple of hours post trauma.
• Positive orthopaedic tests undertaken by the osteopath or physio/surgeon

The advice here is fairly straightforward and unequivocal. If you think you have significantly injured your ACL or knee generally, then seek a professional surgical opinion immediately. As an osteopath, we are used to assessing these injuries and referring patients as appropriate. Testing is initially mechanical/ orthopaedic in nature initially and performed within the clinic, however MRI is usually the most appropriate and informative imaging and if something is found, referral to a specialist usually follows.