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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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  • "I have benefitted tremendously from the chiropractic care I received from Dr. Anderson. Not only has the adjustments helped alleviate my stiffness and aches, but it has helped me have more energy and just feel more balanced over all. A few months ago, I was able to resume a favorite hobby of mine: golf. Due to my previous pain, I never thought that’d be possible."
    Back Pain
  • "I was very impressed with the chiropractic care I received from Dr. Anderson. I had received chiropractic in the past for my neck pain, but not to this level of care. After only a few sessions, my symptoms began to disappear, especially my neck pain, and I know I would not have been able to perform to my everyday work functions without the treatment I received."
    Neck Pain
  • "May says, Dr. Luke is the Best Chiropractor Doctor, I have gone to in all my life. Before seeing Dr. Luke, I used to receive massages and I took Advil daily. I had symptoms of lower back pain, headaches, and pain in my abdomen. Dr. Luke and his style of Chiropractic relieved my headaches and lower back pain; Chiropractic has made me feel much better since I started adjustments with Dr. Luke. Event the pain in my abdomen is gone. I never thought another Chiropractor would be beneficial but I found out that Dr. Luke is the Best that there is. He does make a huge difference and would recommend Dr. Luke to everyone. Thank You, Dr. Luke!"
    May & Zen Abe
  • "I am a professional landscaper constantly using my back and body my work is very physical. With severe back pain especially in my lower back area. I would tell anyone the importance of proper alignment, which leads to a good physical body. Your body needs correction and you must take the steps to correct your problem. Whoever hesitates to correct the body's misalignment will lead to malfunctioning and a crippled body. Dr. Luke adjusted my body to have correct alignment. I'm back to work and good to go. Mahalo, Dr. Luke!"
    Edward Chang
  • "I used to get adjusted every couple of months thinking that was all my body really needed. Since I have come to Dr. Luke I have had my back, neck and elbows adjusted. I no longer have headaches or migraines. Awesome environment as well!"
    Brittany Feiteira
  • "Awesome!!! Helped both my husband and I. First it was my husband- his shoulder would lock up and was stiff and painful. 1st treatment with Cold Therapy/adjustments his shoulder unlocked!!! no more pain or stiffness.
    Then recently I injured my knee, I was on pain medicine and told by my doctor I would need surgery to fix this. I ended up in Dr. Luke's office and have already felt tremendous relief. I mustered up the courage and one day got my back and neck adjusted as well. OMG!!! I am truly enjoying my smooth turning neck and less lower back stiffness due to the adjustments, Don’t be scared just do it !!! And feel great.
    Both my husband n I continue our visits with Dr. Luke . We enjoy the easy going atmosphere . Dr.Luke will teach you how to care for your specific condition . Come and check it out !!! You will be amazed and most happy that you did.."
    Derrick & Lisa Tanabe