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We chose to study an ACL injury because in a common injury in young people that are active in sports. It also allows us to show how an ACL injury can be prevented when young people are active or playing sports

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A soccer player is struggling to get up after he injured his ACL in his knee.

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Pivoting with your foot firmly planted is one of the causes of an ACL Injury.

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Another common cause of an ACL Injury is landing awkwardly from a jump. this is usually common in engaging in extreme sports

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Landing awkwardly from a jump ACL injury symptom

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wearing footwear that does not fit properly

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wearing footwear that does not fit properly

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Wearing shoes that do not fit properly can cause rotational stress on the ACL.

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Young athletes in high school and college and in professional sports are the most affected by an ACL Injury.

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Females are also affected by ACL injury cause of hormonal influences and through sports.

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Most at risk athletes for contact sport 

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Most at risk athletes for contact sport 

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Football players have the highest risk for ACL injuries. Usually since they could take a direct hit to the knee.

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Most at risk athletes for non-contact sport 

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Most at risk athletes for non-contact sport 

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The non-contact sport that are more likely to have ACL injuries include skiers, soccer players, and basketball players.

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some other factors that increase risk of ACL injuries are increased body mass index, smaller femoral notch, smaller ACL, hyper-mobility, and joint laxity

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Primary anatomical Structure of ACL injury 

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Primary anatomical Structure of ACL injury 

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The anterior cruciate ligament (ACL) is one of the two ligaments that help stabilize the knee joint. the ligament is made of connective tissue and fibers that connect the femur to the tibia bone.

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Primary anatomical Structure of ACL injury

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2nd anatomical part that makes up the ACL 

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2nd anatomical part that makes up the ACL 

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When the ACL is torn it affects the connective tissues making it to be stressed in which therefore causes damage to the tissue

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This shows how an ACL injury translates the Anterior tibial

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Anterior tibial translocation sign | Radiology Reference Article | Radiopaedia.org

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The anterior tibial translocation sign or anterior drawer sign (a.k.a. anterior translation of tibia) is seen in cases of complete rupture of the anterior cruciate ligament and refers to anterior translocation (anterior tibial subluxation) of the…

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Representation of what can happen to the valgus during an ACL Injury

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ACL Injuries tear into the ligament fibers.

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The ligament is only slightly stretched, but still able to keep the knee stable.

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A partial tear of the ligament occurs to the point where it is loose.

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Complete tear of the ligament, where it is completely torn in half or off the bone, which causes the knee to be unstable. This is the most common grade of ACL tear.

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ACL injuries can cause swelling on the knee

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ACL Injuries make it difficult to bend of straighten the knees

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difficulty walking or putting weight the affected leg 

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difficulty walking or putting weight the affected leg 

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ACL Injuries make it hard to walk or put weight on the affected leg

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Some people could have a popping sound or sensation in the knee.

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The doctor will test your range of motion and check your knee for pain and any swelling

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Doctors can conduct an Xray or MRI to determine if a patient has an ACL Injury

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The ACL could be reconstructed with autograft from your own body or allograft from a donor body.

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Some non-surgical treatments includes physical therapy, bracing the knee, or RICE method (rest, ice, compression, elevation)

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An ACL injury can be treated using the RICE method in which stands for Rest, Ice, Compress and Elevate. The cost for this treatment is between $15-$70 and this treatment can be done anywhere and its affordable, so it is not covered by insurance. If this treatment is not done the ACL injury will swell, the muscle will get weak, and the injury can be chronically painful.

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Medications can help to reduce pain and swelling of an ACL Injury. The cost of medication of an ACL Injury varies but it is 100% covered by insurance and all your pay is copay, so nothing is out of pocket to purchase. Although if medication is not taken for an ACL Injury pain and swelling will increase and become unbearable.

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Physical Therapy is used to make your knee stronger in small steps during an ACL Injury. The cost for Physical Therapy is $2880 with insurance, but with insurance you only pay a copay between $25-$50 per visit or you pay a deductible before your coverage gets activated. If you don't get physical therapy for an ACL Injury the affected patient will face prolonged recovery, muscle weakness and limited motion in the knee.

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The long term consequences and complications

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The long term consequences and complications

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Some of the long term physical effect of ACL injury is osteoarthritis, instability of knee, muscle weakness, limited physical activity, and possible increase risk of re-injury.

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An ACL injury can limit physical activity this could lead to depression, anxiety, fear, and loss of identity. This mostly common in athletes since they're no longer perform at the same level as before.

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After ACL surgery, people have reporting having sleep disturbance. This is usually due to pain and swelling post-op. As well as limited mobility making it uncomfortable to sleep. lastly possible side effect of pain medications can also have effect on sleep.

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This could help people cope with their anxiety, depression, or stress due to ACL injury. This type of treatment focus on being able to identify and change negative thoughts or behaviors. CBT treatment can be delivered by the following professional therapists, psychologists, psychiatrists, clinical social workers, and licensed counselors.

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Goal setting can help build up confidence and self-efficacy. By creating a plan that work toward an achievable goal that could be tracked and celebrated could help motivate through recovery. This treatment could be delivered by therapists, counselors, and coaches.

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Guided imagery is a relaxation technique that uses mental visualizations to promote healing and recovery. This reduces stress by creating a peaceful and relaxing environment. This treatment can be delivered by therapists, psychologists, certified imagery practitioners, or self-guided.

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Physical  or Occupational Therapy- Weight Bearing

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Physical  or Occupational Therapy- Weight Bearing

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After surgery or even after the initial tear of the ACL, crutches are recommended to keep body weight off of the knee to prevent further damage and to allow for some mobility. Ideally, crutches are used as a short-term treatment, usually lasting 2 weeks or until your doctor/physical therapists determines the ACL has healed properly.

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Performing balancing or movement exercises after an ACL tear helps build the muscle back around the knee, which helps strengthen/stabilize the area and prevent another tear. Focus areas are going to be the knee, quadriceps, and hamstrings in the legs, by shifting body weight, moving objects, or even changing position of the leg itself to activate those muscle groups.

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When an ACL tear occurs, the motor function of the knee and the brain can have a disconnect or miscommunication. Retraining the brain by dual-tasking or performing multiple tasks at once can help reform the neural pathways used when it comes to movement. A physical therapist can have the individual balance and catch/toss a ball, answer questions while performing a task, or even perform a task in response to a verbal stimulus.

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Exercise Training Specific Muscle groups 

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Exercise Training Specific Muscle groups 

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By focusing on training the muscles around the knee, it helps stabilize the ligaments in the knee, preventing another tear and maintaining knee alignment. If the individual is already active, then including these exercises in their sets would not be challenging. If not, then starting training might be difficult for them (5). Focusing on low-impact training would be the starting step for coming back from an ACL injury. A physical therapist or even personal trainer can help with these workouts.

Quadricips- Squats, lunges, and leg curls

Hamstrings- curling heel back towards the glutes with resistance bands and straight leg raises.

Hip muscles- side-lying leg raises, hip thrusts, and hip abductions.

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Wearing knee braces (daily or during exercise)

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Wearing knee braces (daily or during exercise)

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Wearing a brace can help the muscles, joints, and ligaments stay in their correct positions and prevent them from misaligning. The brace can also help prevent swelling of the knee and reduce the pain. It would be best to have a physical therapist recommend a certain brace that would work for the individual's needs, but one could be bought without assistance. These braces can be easily purchased and assist with pain, so this lifestyle change would be a 2 on the scale of 1-10.

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Staying hydrated and consuming nutrient-dense foods will help the muscles reform, repair, and regain strength. Protein, specifically, is the main ingredient in rebuilding muscles. Getting food from a variety of different sources- eggs, pork, chicken, soy products, and beans- can help bring a multitude of nutrients into our bodies. Changing diets and knowing what to eat can be hard, but with the help of a dietitian can be simplified. Maintaining a healthy diet can be very challenging to do, so on a scale of 1-10, for more individuals, it would be a 6-7.

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female athletes are more prone to ACL injury due to anatomical, biomechanics, hormonal factors. This is mostly from wider pelvis and smaller body size. As well as hormonal fluctuation that affect the ligament elasticity.

Some of the challenges that they may face during prevention is while there are prevention programs. There usually don't cover anatomical, biomechanics, or hormonal factors. Diagnosis challenges are there could be a lack of access or fear of being seen as weak that may delay diagnoses. Treatment challenge is that there is a higher risk of re-injury rate for females

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The risk of ACL injuries increase for the youth and adolescent athletes most likely due to growth development, lack of neuromuscular control, and active in competitive sports.

Some challenges that they could face with prevention, diagnosis, and treatment is that there is a lack of prevention programs in school/clubs. There is a higher risk of re-injury if they decide to return back to sports. There could be difficulty maintaining consistent with rehabilitation. As well as a fear or pressure to return to sport without completing treatment.

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By wearing proper footwear and possibly a knee brace if needed could help stabilize the joint and keep everything in alignment.

Some barriers to this could be that good quality footwear could be expensive that not everyone may be able to afford it or want to spend their money on that. For a knee brace, it could be uncomfortable to wear and limit mobility that could affect their performance.

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Proper conditioning and warm up could help your body prepare before exercising or games. As well as help reduce the risk of injury and possible re-injury.

Some barriers with this could be managing to maintain and stay consistent with warming up. Also time constraints could lead to people skipping warm ups.Another reason is that some don't realize the importance of warming up since there isn't a immediate benefit to this kind of prevention.

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These programs are focus on exercises that work on improve coordination and neuromuscular control. This usually reduces the risk of ACL injury by lessening the strain put on the ACL.

Some barriers to this preventative treatment is that a lot people don't see the importance, aren't educated about these programs, or lack access to this kinds of programs.

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technologies used to prevent an ACL Injury 

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technologies used to prevent an ACL Injury 

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A wearable device such as a knee brace can prevent any further ACL Injuries. The purpose of this device is to prevent the knee from tearing so that an ACL Injury does not occur. Although using a knee brace can prevent an ACL Injury it can come with some downsides such as muscle weakness, skin irritation and restricted range of motion.

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Wearable devices to prevent an ACL Injury

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Technologies that used to diagnosis ACL injuries 

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Technologies that used to diagnosis ACL injuries 

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-MRI (magnetic resonance imaging) machine are used to take scan of the soft tissue to confirm the injury and the severity. The negative aspects is high cost, limited availability, time consuming, and certain patient may not be able to undergo if they have metal implants or pacemakers.

-Ultrasound imaging is another kind of machine that could be use to assess the injury but would show less details. The negative aspect of this kind of imaging is that there is a lower accuracy due to the limited view that these scans provide.

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In public health they can plan out training strategies to an individual's risk profile towards an ACL Injury. Thus, making this plan to target the individual because training is planned out for their individual needs. Although challenges can come with this plan such as the level of discipline to stick with it, pushing too hard and getting drained from the training.

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personalized training plan to prevent an ACL Injuries

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It's main objective is to raise awareness and prevent any serious injuries in youth sport. They target individuals in youth sport.