Orthopedics
Cruciate ligament injuries
Cruciate ligament injuries, especially of the anterior cruciate ligament (ACL), are among the most common and serious knee injuries, especially in sports with rapid changes of direction such as football, basketball or skiing.
Anatomy and function of the anterior cruciate ligament
The ACL connects the thighbone (femur) to the shinbone (tibia) and stabilizes the knee by preventing excessive forward movement of the tibia relative to the femur. It also plays a crucial role in controlling rotational movements of the knee.
Injury mechanisms and risk factors
ACL injuries often occur due to sudden twisting movements, abrupt braking, or awkward landings after jumps. Studies show that approximately 75% of ACL injuries occur without direct contact with an opponent, often due to sudden changes in direction, abrupt braking, or uncontrolled landings after jumps. There is an increased risk with movement patterns associated with a valgus knee position (knock-knee stance). Women have a higher risk of ACL tears, which is attributed to anatomical differences, hormonal influences, and biomechanical factors.
Symptoms
Typical signs of an ACL injury are:
- A sudden "cracking" in the knee
- Rapid onset of swelling
- Feeling of instability or "buckling" of the knee
- Pain, especially during exertion
diagnosis
Diagnosis is made through a combination of medical history, clinical examination, and imaging techniques such as magnetic resonance imaging (MRI), which provides detailed information about the extent of the injury.
Treatment options
Therapy depends on the patient’s activity level and the severity of the injury:
- Conservative therapy: In cases of mild instability and low activity levels, physiotherapy rehabilitation may be sufficient to strengthen the muscles and improve knee function.
- Surgical therapy: In active patients or with significant instability, ACL reconstruction using autologous tendon grafts is often performed to restore knee stability.
rehabilitation
Follow-up treatment includes physical therapy to restore mobility, strength, and proprioception. Returning to sporting activities is gradual and may take several months, depending on the healing process.
Long-term prognosis
Untreated ACL tears can lead to chronic instability and an increased risk of meniscal and cartilage damage, which promotes the development of knee osteoarthritis. Adequate treatment and rehabilitation are therefore essential for a good long-term prognosis.
Prevention of cruciate ligament injuries
Neuromuscular training for prevention
Neuromuscular training aims to improve muscle strength, coordination, and balance in order to avoid injury-prone situations and modify dangerous movement patterns. The STOP-X prevention program, developed by the German Knee Society, includes specific exercises that can be integrated into regular training.
Core components of the prevention program
- Enlightenment: Understanding injury mechanisms and awareness of risky movements.
- Balance training: Improving balance to stabilize the knee joint. Strength training: Strengthening the leg and core muscles, especially the hip-stabilizing muscles.
- Strength training: Strengthening the leg and core muscles, especially the hip stabilizing muscles.
- Jump and landing training: Learn safe techniques for jumping and landing to avoid uncontrolled movements.
- Running exercises: Integration of running drills to improve movement economy and safety.
Recommendations for practice
- Regularity: Prevention training should be carried out at least two to three times a week.
- Integration:The exercises can serve as a warm-up program before the actual training or game
- Progression: Increase the difficulty and intensity of the exercises according to the individual level of performance.
- Supervision: Instruction and correction by qualified trainers or therapists to ensure correct exercise execution.
Conclusion
Preventing cruciate ligament injuries requires structured and consistent training that integrates neuromuscular components. Programs like STOP-X offer scientifically sound approaches that help significantly reduce the risk of injury and promote long-term health for athletes.
For detailed exercise instructions and training plans, visit the official STOP-X website: