ACL Injury and Chiropractic

ACL injury

The knee is a hinge joint and stability is provided by the large thigh muscles (the quadriceps and hamstrings), the cartilaginous medial and lateral menisci, the medial and lateral collateral ligaments, and the anterior and posterior cruciate ligaments. The cruciate ligaments are located within the knee joint and provide front-and-back stability to the knee. Specifically, the anterior cruciate ligament (ACL) helps prevent the shin bone (tibia) from sliding too far forward with respect to the thigh bone (femur). The cruciate ligaments also provide rotational stability to the knee.

The cutting maneuver, in which the foot is planted, the knee is flexed, the thigh is internally rotated, the shin is externally rotated, and with subsequent powerful contraction of the quadriceps is a position of vulnerability for the knee. Cutting maneuvers are common in sports such as soccer, basketball, football, and lacrosse. Cutting maneuvers may also be utilized in daily life, such as with the need to suddenly bend and twist the lower body.. Sudden, unanticipated cutting maneuvers may result in knee injury. Structures that may be damaged include the medial meniscus, the medial collateral ligament, and the ACL. This complex of injuries is known as O'Donaghue's triad. If there is significant joint swelling post-injury, it is likely that the ACL has been severely sprained and possibly ruptured.

Prevention is always the optimal policy, as third-degree ACL sprains (torn ACL) typically require ACL reconstructive surgery. Postoperative rehabilitation includes progressive physical therapy and at-home exercise. This recovery period usually ranges from 8 to 12 months.

Prevention of ACL injuries involves flexibility routines and lower extremity strengthening exercises. Flexibility activities may include yoga, Pilates exercises, and regular stretching of the quadriceps, hamstrings, and calf muscles. Lower extremity strength training includes squats, lunges, quadriceps extension, hamstring curls, calf raises, and toe raises. A primary result of an ongoing flexibility and lower extremity strength training program is optimization of knee proprioception, that is, increased neurological activity of the knee joint regarding its positioning in 3-dimensional space. Enhanced proprioception will help distribute cutting maneuver physical forces around the knee joint more effectively, reducing the likelihood of injury. As well, flexibility and exercise programs provide resilience and increased strength to the musculoskeletal structures comprising and supporting the knee.

Regular chiropractic care provides necessary support for both knee injury prevention programs and postoperative recovery. By detecting and correcting sources of biomechanical dysfunction and nerve interference, regular chiropractic care helps create a physiological environment by means of which you and your family can obtain the greatest benefit from your exercise activities. In the same way, if ACL reconstruction ever becomes necessary, regular chiropractic care helps assist the effectiveness of the recovery program and helps your body achieve the greatest benefit from rehabilitation protocols.

Benjaminse A, et al: Revised Approach to the Role of Fatigue in Anterior Cruciate Ligament Injury Prevention: A Systematic Review with Meta-Analyses. Sports Med. 2019 Jan 18. doi: 10.1007/s40279-019-01052-6. [Epub ahead of print]

Biscarini A, et al: Knee flexion with quadriceps contraction: A new therapeutic exercise for the early stage of ACL rehabilitation. J Biomech 49(16):3855-3860, 2016

Smeets A, Malfait B: Is knee neuromuscular activity related to anterior cruciate ligament injury risk? A pilot study. Knee. 2018 Nov 8. pii: S0968-0160(18)30903-30907, 2018. doi: 10.1016/j.knee.2018.10.006. [Epub ahead of print]

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Atlas Chiropractic of Sarasota

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Testimonials

  • "Dear Dr. Zabawa,
    I want to thank you for being my #1 healthcare provider.
    I have been under chiropractic care for 40 years and of the many chiropractors I have been treated by,
    you and your precise atlas adjustment are the best.
    It really is gentle and effective. I've had migraines, scoliosis, herniated L4-L5, and sciatica -
    and in the 11 yrs of being under your care I have had no problems or re-occurrence of any
    of my former symptoms.
    You are the best and I thank you."
    Judy B.
  • "Hi, I'll always remember the wonderful things you've done for me at Atlas Chiropractic of Sarasota.
    I thank Dr. Zabawa for getting me up and running!
    My last chiropractor said there was nothing else they could do for me, and I felt as if my life was over.
    (I couldn't even play video games without pain.)
    Now that I've been introduced to your atlas adjustments: I'm lifting weights again, working (making money),
    and yes - even playing video games. Wow!
    THANK YOU!!!!!"
    Lyle H.
  • "We've had 40 years of various types of chiropractic therapies (sometimes weekly),
    but have never felt truly aligned until now."
    Marsha & Alain M.
  • "I was diagnosed with scoliosis as a child, and through good habits & care have managed to avoid surgery.
    About 30 years ago my research into spinal maintenance led me to upper cervical chiropractic
    (specifically orthospinology) over general chiropractic.
    This is just phenomenal. When my atlas is adjusted and my spine is aligned, it is amazing how good I feel.
    It helps the nerves and muscles of the body function so well, and I believe it has been the key to slowing
    the spinal degeneration caused by my scoliosis.
    * And it's so non-invasive! *
    Now that I live in Sarasota, I am so glad to be under the care of Dr. Zabawa.
    It's no surprise that he came highly recommended. I have always been impressed with
    the professionalism and care I've received at Atlas Chiropractic of Sarasota.
    It compares to anywhere in the country."
    Kyle Ann M.
  • "Very thorough. Quick recovery after a car wreck!"
    Nathaniel B.
  • "For 3 years I had been having headaches every day.
    I even went to a neurologist for my headaches, but he said they were a condition of menopause :(
    A friend suggested going to Dr. Z because of the unique procedure he uses and the great results.
    Dr. Z took care of me and within about 3 months my daily headaches were gone.
    What a relief!
    I don't think I've had one since :)"
    Allaesia M.
  • "I lived in pain with an undiagnosed broken back for 23 years since a horse & buggy accident as a teenager.
    When I injured my back again as an adult, the x-rays showed that I had fractured a vertebra back then,
    as well as this time.
    I received some help from going to regular chiropractors in recent years, but still lived in pain.
    I am so thankful that I found Dr. Zabawa.
    After 35 years and lots of pain, within a month or so
    I was PAIN FREE!
    It is amazing how such small adjustments to the atlas vertebra in my neck have made such
    a big difference to my life.
    To this day, I come in periodically to maintain my new found health.
    Praise and glory to God."
    Mary T.