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The anterior cruciate ligament (ACL) is a ligament in the knee. It attaches the end of the femur to the top of the tibia (shin), and its function is to prevent the tibia from excessive forward movement. Essentially it stabilizes the knee joint along with three other ligaments (PCL, MCL, and LCL). The knee is surrounded my many powerful muscles such as the quadriceps, hamstrings and gastrocnemius muscles. Therefore to strengthen the overall knee joint, these muscles should be the focus. There are varying degrees of ACL tears, first degree being considered moderate and not requiring surgery. However, a complete tear, or third degree tear usually requires surgery as well as significant rehabilitation. Symptoms of an ACL tear are bruising and swelling, and pain in the back and/or front of the knee. The knee may also feel unsteady, as if it might “give-out”.
There are more than 200,000 ACL injuries every year, with 70% of them being in athletic populations. Women are typically more likely to tear their ACL than men, however the reasoning behind this is unclear, but different biomechanics due to a wider pelvis, and a larger Q-angle may be the culprits. The most typical mechanisms for an ACL tear are landing from a jump, pivoting quickly or falling awkwardly. In many instances, ligament injuries are referred to as the “unhappy triad” because in some cases the medial collateral ligament (MCL) as well as medial meniscus are involved as well.
The most effective way to prevent knee injuries from occurring is to strengthen the muscles around the knee. By increasing strength, power and flexibility, the chances of tearing the ACL or other ligaments is greatly reduced.
Squats: Strengthening the quadriceps is extremely important in preventing knee injuries. By having increased strength in the quad muscles, jumping, landing, and pivoting is much easier and the musculature is less likely to fatigue.
Calf Raises: There are many muscles on the back of the lower leg. The gastrocnemius (calf) muscles are very important for power development during running, sprinting and jumping. They originate on the back of the lower end of the femur and are therefore important for knee stability. The gastroc muscles also promote landing with the foot directly beneath the lower leg, allowing the body to land in a very sturdy position. Turning the toes out and in can target different aspects of the gastroc muscles. Turning the toes in encourages the use of the lateral head of the gastroc which is typically underdeveloped in most individuals, while turning the toes out will target the medial head of the gastroc.
Glute Bridges: Increasing the strength of the gluteal muscles is also very important in preventing ACL injuries. The function of the glute muscles is to extend the leg backwards. However, if the glute muscles are weak, the hamstring muscles will take over, which can result in shifts in the pelvis which can actually lead to an ACL injury.