What is ACL?

The Anterior Cruciate Ligament (ACL) is the ligament that connects the femur bone (upper bone in the knee joint) with the tibia bone (lower bone in the knee joint). There are two ligaments. They cross each other to form an X, with the anterior cruciate ligament (ACL) at the front and the posterior cruciate ligament (PCL) at the back. The anterior cruciate ligament runs diagonally in the middle of the knee.

What is the function of ACL?

It prevents the tibia from sliding out in front of the femur and provides rotational stability to the knee joint.

What are ACL sprain, ACL laxity and ACL tear/rupture?

Damage to ACL can present in the form of sprain, or tear/rupture. It can be slightly stretched (Grade 1 sprains) or it can become loose due to stretching (Grade 2 sprains) or there is a complete tear (Grade 3 sprains).

What are the causes of ACL sprain, ACL laxity and ACL tear/rupture?

The anterior cruciate ligament can be injured in several ways:

• Changing direction rapidly
• Stopping suddenly
• Slowing down while running
• Landing from a jump incorrectly
• Direct contact or collision

What are the common symptoms of ACL sprain, ACL laxity and ACL tear/rupture?

One or more of the following symptoms can be seen after ACL injury.

• Pain
• Swelling
• Stiffness
• Reduced Range of Motion
• Tenderness
• Lack of stability
• The feeling of giving away
• Discomfort while walking, stair climbing, jogging, jumping.

What is the impact of ACL tear or sprain on daily activities?

• ACL injury can significantly impact a person’s ability to perform daily activities.
• Activities such as walking, prolonged standing, climbing stairs, and getting up from a seated position to sitting on the ground, jumping, jogging or running can become difficult or impossible.
• It can also affect participation in sports and exercise.

What are the risk factors for developing ACL tear or sprain?

• Obesity (increased body weight)
• Lack of proper strength and conditioning
• Repeated joint injuries
• Joint overuse

What happens during consultation at BILD Exercise Clinic?

• The doctor will examine the patient.
• A detailed history regarding the onset and progression of the disease will be noted.
• A record of previous treatments tried will be noted.
• Strength differences of different muscles around the knee joint will be analysed.
• Previous reports such as MRI, X rays will also be seen and discussed.

Is it necessary to have any investigations done before or after the consultation?

• It is NOT compulsory to have any investigations done before consultation.
• You can bring your previous report.
• Blood tests are NOT asked for.

What questions to expect from your doctor

The doctor may ask some of the following questions:

• Where exactly does it hurt?
• Since when do you have this problem?
• What was the trigger or nature of injury (if applicable) for the beginning of pain
• How would you describe the pain — dull, sharp, burning?
• What are the previous treatment modalities tried by you?
• What makes the pain worse? What makes the pain better?
• How does the pain affect your sleep and life?

How to prepare for your consultation with the doctor?

• Wear comfortable clothes. Preferably wear pants or shorts that can be pulled slightly above the knees to help examination of knee joints.
• Don’t consume painkillers (at least 12 hours before) while coming for consultation. Painkillers mask the symptoms and interfere with understanding of symptoms.
• Bring all the previous reports, investigations, and medication prescriptions. It is NOT necessary to have investigations or tests to be done before.
• Write down all your questions on paper or on a mobile phone that you want to ask the doctor.
• It is always useful to bring a companion with you during consultation.

What treatment can be offered at BILD Exercise Clinic?

• Based on the examination, reports, and medical and surgical history doctor will prescribe home-based exercises. Home-based exercise prescription contains diagrams, figures and detailed instructions.
• If needed few sessions of specific exercises can be conducted at the BILD Exercise Clinic.

What types of exercises are covered at BILD Exercise Clinic?

 As needed one or more of the following exercises are prescribed and administered.

• Exercises for strength
• Mobilization exercises
• Exercises for stability
• Exercises for balancing
• Exercises for endurance
• Exercises for Impact and load-bearing

What are the goals of the exercise treatment at BILD Exercise Clinic?

• Decrease joint pain and stiffness.
• Improve joint stability and muscle strength.
• Delay or reverse the further progression of symptoms.
• Improve joint mobility and function.
• Improve the quality of life with respect to knee joints.

As with any medical or exercise intervention the outcome varies from patient to patient.

Which technology might be used (as per the need) at BILD Exercise Clinic?

• Strength training equipment such as leg press, leg curl, abduction, calf raise and toe raise machines (MATRIX, USA and others)
• Anti-gravity treadmill (NASA, USA)
• Robotic Isokinetic Strength Training machine (KINEO, ITALY)
• Balance stimulating equipment
• Resistance bands
• Weight sled
• Cardio equipment such as cycle, elliptical, versa climber, Jacobs ladder etc.

The selection of technology and exercise protocol is determined by the doctor.

What kind of treatment is NOT offered at BILD Exercise Clinic?

• Painkillers or Anti-inflammatory medications
• Vitamin supplements
• Ointments and creams of any kind
• Any other pharmacological/drug treatment
• Hormonal Therapy or injectables of any kind
• Intra-joint injections of any kind
• Surgery of any kind

How to reach BILD Exercise Clinic OPD at Deenanath Mangeshkar Hospital?

• Reach the Super Speciality Building (SS building/new building) lobby/main entrance before time. Wheelchairs are available in the lobby and parking for needy patients. Click here for the Google map location of BILD Exercise Clinic.
• Parking is available based on availability. You can prefer public transport such as bus, auto-rickshaw, cab or taxi.
• If you are not registered as a patient and appearing for the first time as a patient at Deenanath Mangeshkar Hospital then try to come at least 15 minutes before the appointment time to complete the simple registration process at the ground floor reception of the super specialty building.
• Get an OPD entry pass (for patients) and an attendant pass at the ground-floor reception.
• Choose appropriate lifts (life no.1,2,3 ) at the ground floor to reach BILD Exercise Clinic OPD on the 11th floor.
• Depending upon patient numbers some waiting period is expected. Comfortable sitting, clean drinking water, a book reading section, clean toilets, changing rooms, and a cafeteria (on the ground floor and seventh floor) are available at your service.