ACL injuries and how acupuncture can help treat them

What is an ACL and how does it get injured?

ACL injuries are some of the most common knee injuries. The ACL, or anterior cruciate ligament, is located inside the knee joint and more specifically helps keep the tibia (the shin bone) from sliding forward from the femur (the thigh bone). The ACL and the PCL (posterior cruciate ligament) form an X in the knee joint and together help keep the knee stable. However, the cruciate ligaments are susceptible to injury when there is a direct blow to the knee, or during a a sudden twisting motion when the foot is planted—as in a quick turn while running. Generally ACL injuries result in a pop sound at the time of injury followed by severe pain and swelling in the knee increasing over two or three days. Often, the injury is accompanied by instability and a sensation that the knee is “giving out”. A particularly severe knee injury might also affect the medial meniscus and MCL (medial collateral ligament), known to many as the “terrible triad”.

There have been numerous recent studies that have documented a higher rate of ACL injuries in female athletes. In fact one study suggests a 4-8-fold greater risk in female athletes with more of an increased risk in the follicular phase (pre-ovulatory) than the luteal phase (post-ovulatory). Studies have also suggested a link between high levels of hormones, like estrogen, and soft tissues tears, like ACL injuries, due to the effect that heightened levels of hormones have on collagen metabolism and thus tissue strength. Whether or not this means women should “train to their cycle” is another topic I’m not covering here.

How can acupuncture help heal an ACL injury

Acupuncture can help treat ACL injuries by decreasing the swelling immediately after the injury, decreasing pain and helping to restore function and proprioception to the muscles in the area that have gone into protective myospasm. Acupuncture isn’t going to repair an ACL tear or completely rupture (a surgeon will do that), but it can help with pain and swelling and help move blood and fluids in the area to help speed along healing. In addition, because of acupuncture’s effect on the nervous system, the limbic system and the body’s hormones, it also helps address the mental and emotion effects of an ACL tear as well as addressing any imbalances in hormones.

With acupuncture and rehabilitative exercises, most patients that sustain ACL injuries which don’t require surgery can expect to be back to activity within a couple of months. Post surgical recover is a bit more complicated and can take up to 6-9 months, however acupuncture can help greatly reduce post surgical swelling and pain to help restore movement and function in the knee more quickly.

Got knee pain but the ACL isn’t it? Check out this post for a longer list of knee injuries.

Resources:

Callison M, Schreiber A, Ryan NT, Livermore M, Scoggins A. Sports Medicine Acupuncture : An Integrated Approach Combining Sports Medicine and Traditional Chinese Medicine. San Diego, Calif. Acusport Education; 2019.

Yu, Warren D. MD; Liu, Stephen H. MD; Hatch, Joshua D. MD; Panossian, Vahé MD; Finerman, Gerald A. M. MD Effect of Estrogen on Cellular Metabolism of the Human Anterior Cruciate Ligament, Clinical Orthopaedics and Related Research: September 1999 - Volume 366 - Issue - p 229-238

N. Lefevre, Y. Bohu, S. Klouche, J. Lecocq, S. Herman. Anterior cruciate ligament tear during the menstrual cycle in female recreational skiers. Orthopaedics & Traumatology: Surgery & Research. Volume 99, Issue 5, 2013. Pages 571-575, ISSN 1877-0568. https://doi.org/10.1016/j.otsr.2013.02.005.