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]

Locations

Office Hours

Rosemount

Monday:

8:00 am-5:30 pm

Tuesday:

8:00 am-6:30 pm

Wednesday:

8:00 am-5:30 pm

Thursday:

8:00 am-6:30 pm

Friday:

8:00 am-5:30 pm

Saturday:

8:00 am-12:00 pm

Sunday:

Closed

West Concord

Monday:

8:00 am-5:30 pm

Tuesday:

Closed

Wednesday:

Closed

Thursday:

8:00 am-5:30 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

Testimonials

  • "This is an amazing clinic! Dr. Curt helped me with my low back and hip pain brought on by pregnancy, and made me feel completely comfortable the minute I met him. Very nice, knowledgeable, and truly interested in any issues I have going on. Best of all, there was NEVER any pressure to set up future appointments or sales pressure from anyone there. This is the only clinic I will ever go to from now on!
    Amazing doctors!"
    - Jolene / Rosemount, MN
  • "AMAZING DOCTORS! I had terrible pain in my knee for weeks. It hurt to go up and down the stairs, it hurt and ached driving to work and even just sitting. I was in constant pain. I went in to see Dr. Nick and he knew exactly what I needed and put me back in place. Dr. Nick does a wonderful and thorough job.
    Loved going to these guys"
    - DRT, Rosemount, MN
  • "I have loved going to these guys for years but failed to consult them on a big problem from last summer. I went to my physician who had me go through many tests and had no answers or relief! At my last appointment I mentioned it to Dr. Nick who asked me why I hadn't come in earlier. Good question! After one appointment I felt great relief, not to mention finally getting an answer!

    My problem: Pain in the muscle under my left breast. It was constantly bothering me. I made changes in my clothing, had a mammogram, an ultra sound and numerous consultations. Never once did they recommend a chiropractor. Dr. Nick traced the rib to my back and located the problem area in one appointment!

    Recommendation-Don't wait to get a second opinion! These guys are amazing and I highly recommend them!
    Great people and great doctors"
    - Brenda H., Rosemount, MN
  • "Great people and great doctors, I have seen Dr. Nicholas for two different problems, this last one was giving me so much pain! He is great after one visit there has been alot of improvement with my arm and alot less pain. He and his dad have taken great care in finding the correct way to take care of me. If you have never been to a chiropractor or have had a bad experience please give them a try you will never go anywhere else!

    WORTH YOUR TIME, MONEY AND THE RELIEF YOU CAME FOR!"
    - Rose, Rosemount, MN