Twenty-year-old Erica Garcia has played ice hockey since she was 14, so the Highland, CA, native was delighted when she was recruited to play for the Manhattanville College Valiants in 2007.
During her sophomore year, Garcia took to the ice in 20 games, set new career highs with 11 assists and 12 points, reached a career-best four-game point streak and had an assist in three of her last four games of the season. The Valiants won their league in the NCAA each year she’s been on the team.
“Things were going great until Friday, February 13, 2009” says Garcia. “That’s when I was hit from behind in a game, fell to the ice and was diagnosed with an ACL tear. I thought it was the end of the world.”
It turns out the ACL, or anterior cruciate ligament, is one of the most commonly injured of the knee ligaments. In the U.S., it happens to about 200,000 persons annually; 100,000 ACL reconstructions are performed each year. People who participate in basketball, football, ice hockey, skiing and soccer have a higher incidence of the injury.
And although golfer Tiger Woods and New England Patriots quarterback Tom Brady both recently underwent ACL reconstructive surgeries, the injury is more common in female athletes. “Women suffer ACL injuries at a significantly higher rate than men,” says Kevin Plancher, M.D., Manhattanville College team doctor, the head physician for the Long Island Lizards professional lacrosse team, and team physician for the United States Football League (USFL).
“Male and female pelvis and lower-extremity alignment, physical conditioning, muscular strength, neuromuscular control and the effects of estrogen on ligament properties are all different,” says Dr. Plancher.
ACL repair surgery
The goal of ACL reconstructive surgery is to prevent instability and restore the function of the torn ligament, creating a stable knee so the patient may resume sports and an active life.
“The good news,” says Dr. Plancher, “is that ACL repairs have long-term success rates of 82-to-95 percent. Surgical repair involves replacing the torn ACL with a graft from another tendon – the hamstring, quadricep or Achilles tendons, for example.”
Recovery and rehabilitation usually take three-to-six months.
“The surgery took place and that day I was in physical therapy,” she adds, “which I did threeto-four times a week. The therapy involved quad strengthening, a lot of lateral movement with restriction bands, leg presses and learning to balance with a BOSU ball.
“At the six-month mark, I was cleared to skate. I actually feel more than 100 percent better now and know I’m faster on the ice.”
“It’s wonderful to see how this surgery restores not just a patient’s physical ability,” says Dr. Plancher, “but, in Erica’s case, it also restored her hope and confidence that she could continue doing what she loves to do.”
What is an ACL injury?
An anterior cruciate ligament, or ACL, injury is a tear in one of the four knee ligaments that joins the upper leg bone with the lower leg bone. The ACL keeps the knee stable. Injuries range from mild, such as a small tear, to severe, such as when the ligament tears completely or when the ligament and part of the bone separate from the rest of the bone.
How does an ACL tear occur?
Your ACL can be injured if your knee joint is bent backward, twisted, or bent side to side. The chance of injury is higher if more than one of these movements occurs at the same time. Contact – or being hit by another person or object – can also cause an ACL injury.
About 80 percent of sports-related ACL tears come from “non-contact” play, and happen when pivoting or landing from a jump. When the ACL is torn, the knee “gives out” and cannot support the body.
What are the signs of an ACL tear?
Symptoms of an acute ACL tear include:
– feeling or hearing a pop in the knee at time of injury
– pain on the outside and back of the knee
– knee swelling within the first few hours of the injury, which may be a sign of bleeding inside the knee joint.
– limited knee movement because of pain and/or swelling the knee feels unstable, buckles or gives out
How is an ACL tear diagnosed?
Your doctor will ask you questions about how you injured your knee, how it feels, etc. Then he’ll check for stability, movement and tenderness in both the injured and uninjured knee.
You also may need x-rays, which show damage to the knee bones, or a magnetic resonance imagining (MRI) scan, which can show damage to ligaments, tendons, muscles or knee cartilage.