The ACL tear – football’s greatest fear

The ACL tear – football’s greatest fear

Rafinha Alcantara, who minutes earlier had come on for Ivan Rakitic, had to be replaced by Javier Mascherano 67 minutes into Barcelona’s Champions league game against Roma last month. During Rafinha’s first touch of the game, he was injured after being brought down from behind by a horrific tackle from Radja Nainggolan. A day after the match tests revealed that the player had suffered a tear to the anterior cruciate ligament (ACL) in his right leg.

Ten days later Barcelona suffered another blow – they lost their best player Lionel Messi. The Argentinian forward went down after just three minutes, having hurt his knee after shooting under pressure from Las Palmas defender Pedro Bigas Rigo. Messi received treatment and returned to the pitch, but was unable to continue. We can say that Messi was just a bit lucky because he suffered a tear to the medial collateral ligament (MCL) of his left knee. He will be out for around six to eight weeks according to a statement from the club’s Medical Staff.

ROME, ITALY - SEPTEMBER 16: Rafinha of FC Barcelona is injured during the UEFA Champions League Group E match between AS Roma and FC Barcelona at Stadio Olimpico on September 16, 2015 in Rome, Italy.  (Photo by Paolo Bruno/Getty Images)
ROME, ITALY – SEPTEMBER 16: Rafinha of FC Barcelona is injured during the UEFA Champions League Group E match between AS Roma and FC Barcelona at Stadio Olimpico on September 16, 2015 in Rome, Italy. (Photo by Paolo Bruno/Getty Images)

The two Barcelona players, along with Liverpool’s Danny Ings, are the latest in a series of those who have had to take an extended break due to a knee injury.

In the past years we saw some of the best players in world be prevented from achieving more in their careers.

Michael Owen, Alan Shearer, Michael Essien, Javi Martinez, Ruud Van Nistelrooy, Holger Badstuber, Robert Pires, Rafinha’s brother Thiago, Roberto Baggio, Radamel Falcao, Ronaldo, and Paul Gascoigne are just some of them.

We mentioned that Messi was lucky despite being out for two months. The reason is that there are several knee ligaments and accompanying injuries, each of which come with a variety of symptoms. ‘La Pulga’ tore the internal collateral ligament of his left knee and was lucky to have escaped a much more serious injury such as anterior cruciate ligament tear. Two months is among the shorter periods of knee injury recuperation, and as we have seen, a number of other versions of the injury can put a footballer’s entire career to a halt. Unlike Messi, Danny Ings was unlucky enough to tear his ACL in Liverpool’s first training with new manager Jurgen Klopp, and is reported to be out for the rest of the season.

So what is it behind these feared injuries? Ligaments are tough bands of tissue that connect the bones in your body. The two important ligaments in the knee, the ACL and the posterior cruciate ligament (PCL), connect the femur or thigh bone with the tibia, one of the bones of the lower leg. Too much stress on these ligaments can cause them to stretch too far – or even snap.

BARCELONA, SPAIN - SEPTEMBER 26: Lionel Messi of FC Barcelona lays injured on the pitch during the La Liga match between FC Barcelona and UD Las Palmas at Camp Nou on September 26, 2015 in Barcelona, Spain. (Photo by Alex Caparros/Getty Images)
BARCELONA, SPAIN – SEPTEMBER 26: Lionel Messi of FC Barcelona lays injured on the pitch during the La Liga match between FC Barcelona and UD Las Palmas at Camp Nou on September 26, 2015 in Barcelona, Spain. (Photo by Alex Caparros/Getty Images)

The posterior cruciate ligament (PCL) is the second major ligament in the knee connecting the thigh bone to the shin bone in the knee. The lateral collateral ligament (LCL) connects the thigh bone to the fibula, the smaller bone of the lower leg on the lateral or outer side of the knee.The medial collateral ligament (MCL) also connects the thigh bone to the shin bone on the medial or inside of the knee.

An ACL injury and other ligament injuries can be caused by twisting the knee with the foot planted, getting hit in the knee, extending the knee too far, jumping and landing on a flexed knee, or stopping suddenly when running and suddenly shifting weight from one leg to the other. About 80% of sports-related ACL tears are “non-contact” injuries. This means that the injury occurs without the contact of another player, such as a tackle in football.

Once they are completely torn or stretched beyond their limits, that’s it. The only option for a professional football player is reconstruction.

“Not everybody who tears their ACL needs a reconstruction,” says Dr. David Teuscher, president of the American Academy of Orthopaedic Surgeons. “Some people don’t have instability, and they don’t have a meniscus tear. If you tear your ACL, you’re going tear one of the meniscus cartilages.”

However, after surgery and recovery, a new problem occurs – the fear of new injuries. We have often seen that players, wishing to protect an injured leg, pay less attention to the other and soon end up with an injuryto the second knee.If they’re not treated right away, ACL injuries and other types of ligament injuries may act up months or years later. They can make your knee give out when you twist or pivot.

Knee injuries are also a major problem in woman’s football. Last year, England international Rachel Unitt become the fourth Notts County player to suffer the injury this season and the ninth player to be injured in this manner in 2014 in the Women’s Super League (WSL) top division.

5 Nov 2000: Paul Gascoigne of Everton on the floor with injury to his leg during the match between Everton and Aston Villa in the FA Carling Premiership at Goodison Park, Liverpool. Mandatory Credit: Shaun Botterill/ALLSPORT
5 Nov 2000: Paul Gascoigne of Everton on the floor with injury to his leg during the match between Everton and Aston Villa in the FA Carling Premiership at Goodison Park, Liverpool. Mandatory Credit: Shaun Botterill/ALLSPORT

“I was with the England teams for 15 years and on average, we would probably have four or five players in the team who have had an ACL injury at some point in their career. So we do see these spikes and troughs. In football, you get forces going through the body at four times the body mass and if players are not able to move correctly, that’s when the risk goes through the roof for injuries. A lot of female footballers have poor hamstrings and poor gluteus medius muscles, which are the muscles at the side of the hips that correct the knee and brings it back into alignment. So we work on them on a daily basis,” said former England chief medical officer Pippa Bennett for BBC.

Medicine has progressed in leaps and bounds in previous years and has managed to find a solution for muscle and tendon injuries and bone fractures, which has allow players to return to the pitch much faster than before. At this point, the biggest concern of players is to avoid an ACL tear by all costs, although the number of these injuries are increasing every year.

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2 Comments on this Post

  1. Hey Molly- I tore my ACL & PCL about 11 months beorfe I applied so I did some research into this. It is a maximum 1 year deferral from the injury or the surgery if you have it. I read that a bunch of people got that deferral shortened. Best of luck and heal quickly

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  2. kaleem mohammed

    To prevent ACL injuries in soccer by few training programs such as balance training, plyometric training, long-duration neuromuscular training, or short-duration warm-up programs. For more: https://www.healthclues.net/blog/en/a-primer-on-sports-injuries/

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