How can we reduce the risk of
primary and secondary ACL injury?
A review of recent literature
By Mick Hughes
(Grad. Cert. Sports Physio, B. Physio, B. Ex. Sci.)

Overview
• ACL mechanism of injury
• ACL Pathophysiology
• Pre-op ACL rehab
• Post-op ACL rehab
• 2nd ACL injuries
• Neuromuscular training programs

Mechanisms of Injury – Non-Contact

Mechanism of Injury – Indirect Contact

Mechanism of Injury - Contact

Pathophysiology Of ACL Injury
• Typical: Valgus stress (landing, cutting, lateral contact)
– Non-contact ACL injuries occur within 30–50 m/sec from initial
contact of the foot onto the ground during sports movements
• Atypical: Hyperextension mechanism of injury
• “Pop” or “crack”
• Immediate pain – most likely unable to play on
• Swelling within 2 hours (haemathrosis)
• Instability
• Can also injure MCL and medial meniscus – “Angry Triad”
• Cartilage defect and bone bruising  Slow rehab

ACL – Who is Most at Risk?

ACL Injury – The Most Common
• Female athletes are 2-8x more likely to sustain
ACL injury than males (Hilibrand et al., 2015)
• Peak incidence F: 14-18yrs, M: 19-25 yrs
(Sanders et al., 2016)
• Non-contact injuries: 70-85% of all ACL tears
(Walden et al., 2015)

ACL on MRI

ACL Presentation
• To access the full 80min presentation and
recording, head over to
www.mickhughes.physio and click on ACL
LECTURE.
• Follow the 3 simple steps to access, and
ENJOY!!
• I hope you enjoy the content presented and
learn something valuable to help your ACL
patient outcomes.