‘We need to think about prevention because ACL injury rates aren’t going down’

Lying in a hospital bed with his leg in a brace, Meta CEO Mark Zuckerberg shared via Instagram on Friday that he’d undergone surgery for an anterior cruciate ligament (ACL) tear. According to Bloomberg, Zuckerberg sustained the injury during a mixed martial arts session that was meant to prepare him for a competitive MMA fight in 2024.

Zuckerberg is one in a string of high-profile individuals to tear their ACL in the sports realm. Earlier this fall, Dallas Cowboys’ cornerback Trevon Diggs and Los Angeles Chargers’ wide receiver Mike Williams each suffered ACL tears that put an end to their football seasons.

“The United States sees approximately 200,000 ACL tears a year. That’s roughly $1.5 billion per year in healthcare expenditures,” says Jennifer Hurrell, PT, DHSc, clinical associate professor of Biological and Biomedical Sciences.

Hurrell has spent 30 years as a licensed physical therapist and more than 20 years in higher education. At Bryant, she teaches “Human Health and Disease,” “Human Kinesiology,” “Functional Musculoskeletal Anatomy,” and “Human Muscles and Movement.”

“We need to think about injury prevention because ACL injury rates aren’t going down,” Hurrell says.

A lengthy recovery

The ACL’s job is to connect the upper and lower leg bones and hold the knee in alignment. Hurrell notes that a tear occurs when the ACL is overstretched by excessive forces on the knee, such as colliding with another object or improper alignment of the leg when the foot hits the ground.

“When your foot hits the ground, force transfers up through the leg, including the knee joint. When we hit the ground at a normal angle and we have sufficient muscle control to hold the knee in a normal position which protects the ACL; however, if we hit the ground at an abnormal angle, our muscles do not have the capability to control the forces on the knee and that can result in an ACL tear,” says Hurrell.

Symptoms include an audible pop followed by pain, swelling, and loss of control. In the first few minutes after the injury, Hurrell says it’s almost impossible to stand on the hurt leg. Additionally, the recovery process varies depending on a patient’s healing strategy. Athletes who plan to return to their sport often undergo surgery, while inactive, older individuals may opt for a non-operative approach involving physical therapy.

“Usually, it takes nine to 12 months before anyone can be back on the field. Some elite athletes who have cutting-edge surgical techniques and the best rehab can be back on the field as early as six months,” Hurrell says, adding that athletes who return too soon risk rupturing the repaired leg or tearing the other ACL.

Preventing injury

Injury prevention programs (IPPs) can reduce ACL incidents by approximately 50 percent, according to Hurrell. These programs implement slow and controlled movements that focus on reeducating the connection between the brain and body. Challenging the joints in forward, backward, and side-to-side motions will help muscles develop the strength, timing, and control needed to protect their ACL.

Hurrell notes that individuals can try plyometric exercises at home since these techniques focus on how the body absorbs force from a jumping to landing state. Start by jumping and thinking about not letting your knee collapse toward the center of your body. As you land, let your knee bend and stay in a straight line with the upper portion of your body.

“Practicing this remaps our motor control and becomes so automatic that, during a sporting event when an athlete is distracted by other players and the pressure of wanting to win, their knee doesn’t migrate toward the midline when they land on one foot,” Hurrell says.

She adds that IPPs should start in early adolescence before the body has a chance to develop bad habits.

“We want to start young athletes off by practicing good mechanics so that healthy and safe movement patterns are normal for their bodies,” Hurrell says.

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