ACL Sprain/Tear

ACL sprain/tear is a partial or complete tearing of the anterior cruciate ligament (ACL) of the knee. ACL is the primary (~85%) restraint to limit anterior translation of the tibia. The anterior cruciate ligament (ACL) is thus one of the key ligaments in the knee, providing stability and support during movement. It connects the thigh bone (femur) to the shin bone (tibia) and helps control back-and-forth motion.

An ACL sprain or tear occurs when the ligament is overstretched or torn, often due to sudden changes in direction, stopping abruptly, or landing awkwardly from a jump. These injuries are common in high-impact sports like basketball, soccer, and skiing, but they can also occur during everyday activities if the knee is twisted or stressed.

The symptoms of an ACL sprain/tear are as follows:

• A loud "pop" sound or sensation at the time of injury.
• Immediate swelling and pain in the knee.
• Difficulty bearing weight or walking.
• A feeling of instability or the knee "giving out" during movement.

ACL injuries are classified into three grades:

Grade 1 Sprain: Mild stretching of the ligament, causing minimal damage.
‍Grade 2 Sprain (Partial Tear): The ligament is partially torn, leading to some instability.
‍Grade 3 Sprain (Complete Tear): The ligament is completely torn, causing significant instability and loss of knee function.

The general measures to deal with ACL sprain/tear include crutches, braces, tensor, and kinesiology tape. Acupuncture can help with recovery of ACL sprain/tear by improving the function of muscles that allow movement of the knee as well as increasing circulation and healing of the tissue and ligaments around the knee. 

Treatment Case: 32 year old female

   The patient is a hard-working manager of a marketing firm, who enjoys tennis and other activities. A few weeks ago, she twisted her right knee while pivoting to hit a backhand shot. She  heard a "pop" and experienced immediate pain and swelling. She underwent an MRI and was diagnosed with grade 2 ACL sprain and was discharged after emergency measures.
   
   Afterward, she rested and took some pain medication, but it has been hard for her to recover mobility and function of the lower limbs. Currently, she experiences some mild pain in the right knee, especially with weight-bearing activities. There is still some mild swelling and stiffness in the joint, and she experiences difficulty in bending the knee fully.

   The treatment focused on control of inflammation and pain of the knee, as well as improving the function of the tendons of the quadriceps femoris, which moves the knee. The patient came in for regular biweekly sessions of acupuncture under the IMEAST (Intramuscular Electroacupuncture Stimulation Treatment). The patient was also instructed to continue the isometric exercises and stretching she was first discharged with.

   Early improvements in pain and swelling were seen within the first two weeks, with progressive gains in strength and stability by the sixth week. While recovery was relatively slow due to the critical nature of her injury, she was able to return to tennis after eight weeks of regular treatment.