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ACL Injury

The ACL (Anterior Cruciate Ligament) is perhaps the most-feared injury amongst all athletes. In football, it is invariably a season ending injury. Without a functioning ACL, an athlete is generally unable to change direction without the knee joint collapsing. Modern-day athletes are fortunate that the ACL can be reconstructed with advanced surgery but even in the best of hands, an ACL reconstruction will keep an athlete out of sport for up to 12 months. In addition, there is a lifetime increased risk of further problems both to the affected knee as well as the opposite knee.

Some football players have suffered multiple ACL injuries, including former Melbourne Demons player David Schwarz (who has had 3 reconstructions on the same knee) and Nik Kosef of the Manly Sea Eagles (who has had 2 reconstructions on each knee).

Most football players who have an ACL injury elect to have a knee reconstruction. In the general community, it has been quoted that up to 20% of football players may be able to play football without needing an ACL reconstruction however this figure is lower in the elite sporting population (less than 10%). In the rugby codes, forwards may be able to continue playing without a reconstruction as their position involves less change of direction. Former Penrith player Matt Adamson continued after a complete ACL injury in the NRL. Players may possibly be able to return within weeks if they don't undergo surgery.

One of the most difficult decisions in sport is when to return a player after an ACL reconstruction. The tendon used for reconstruction has been shown to take many months before they are able to achieve their full strength. It is well known that the risks of re-injury are greater if a player makes an early return to sport. There is a general consensus amongst doctors that athletes can minimise their risk by waiting at least 12 months before returning to sport. Ultimately it is a joint decision between players (and their parents for young athletes), coaches and doctors to decide whether the potential benefits of an earlier return (under 12 months) is worth the increased risk of reinjury. This is a difficult decision.

Tiger Woods famously played for several months on a torn left ACL. He was still able to win 9 of the 12 tournaments he competed in. This injury is rare in golf and he reports it was sustained while running. He finally had in repaired in April 2008. He continued to experience pain during his rehabilitation in 2009.

Australian Open and French Open winner, Mary Pierce, ruptured her ACL in a WTA Tournament in October 2006. She has not been able to make a comeback to competitive tennis since this injury.

ACL knee braces may be useful in athletes requiring extra stability to improve their sporting confidence after an injury or reconstruction.
WARNING: Some viewers may find this footage distressing.
ACL Tear Darren Lockyer
Darren Lockyer sustained a season ending ACL tear in July 2007.
(Image sourced from The Daily Telegraph)
ACL Tear Terry Campese
Terry Campese is assessed on field. He sustained an ACL tear in the 2010 finals match against the Wests Tigers.
(Image sourced from smh.com.au)
ACL Tear Tiger Woods
Tiger Woods clutches his left knee in pain during the 2008 US Open.
(Image sourced from The Seattle Times)