Knee: Ruptured ACL

Five weeks ago I went climbing and injured my left knee. It happened just as I stood up from a drop knee. The doctor said that I ruptured my ACL.

1. What is it this ACL exactly?

2. The doctor told me to wear a support. What kind of knee support should I wear?

3. The doctor also told me only to swim for exercise, but I am currently in the desert and there is no swimming pool here. What about cycling?

4. Finally, will I be able to recover completely or not?

Albert Boenardi , Bandung, Indonesia

The knee has four major ligaments: one on each side (medial and lateral collateral ligaments) and two that cross in the middle, called your anterior and posterior cruciate ligaments (ACL and PCL, respectively). Together these hold the knee joint together, and in a position that allows the muscles to articulate the bones smoothly. The two menisci are kidney-shaped cartilage discs that do several things, but primarily act as shock absorbers between the ends of the femur and tibia.

I looked at your MRI report and you have a partially torn, not fully ruptured, ACL. It sounds like your knee is recovering well. If you can run and exercise without much pain, then I would say you are free to do most anything you like. I would avoid strenuous drop knees for another couple of months as they turn your knee into a wishbone. I wouldn’t bother with a brace, given your current state. That said, there are many brands of ACL braces. They are all bulky and pains in the proverbial. It takes a lot of plastic to replace a one-inch piece of ligament!

Doctors are fans of swimming. Chasing a black line up and down a pool is akin to watching paint dry. I sink like a stone and am consequently less than fond of it. It is, however, low impact and good for knee rehab (and the badly broken, in general), where sudden loading is not advisable. Road cycling is also good, as long as you have eyes in the back of your head to avoid the geriatrics, road ragers and the distracted.

Scar tissue is weaker than the sublimely pure cells you were born with, but you can make that puppy functionally stronger by strengthening the muscles that give control and stability to the knee. Google “ACL Rehab Program” and you will find plenty of info.

This is the first installment of a new medical-advice column, and to kick it off the editors submitted questions. Need medical advice? Send your questions for Dr. J to jjackson@bigstonepub.com.