Sports injuries explained: Ruptured anterior cruciate ligament

Athletes the world over dread hearing the phrase ‘ruptured cruciate ligament’, and with good reason too. Here’s a rough breakdown of one of the most feared injuries in sport.

In 2010, Henry Shefflin started for Kilkenny in the All-Ireland hurling final against Tipperary despite suffering a serious knee injury in the semi-final against Cork.

The hype leading up to that final must have been music to Tipp’s ears. Not only were we inundated with talk about the 'Drive for Five', there were also tales doing the rounds about the lengths to which King Henry and fellow injury victim John Tennyson went to in an effort to get fit.

Seemingly, they had managed Lazarus-like recoveries and would defy both logic and medical science to take the field in Croke Park and lead the Cats to their historic milestone.

We all know what happened next. 13 minutes into that game, Shefflin hobbled off the pitch a broken man. Tennyson actually managed the full game, but was helpless to prevent the Tipp juggernaut. Not long after that game, however, Tennyson went under the knife and missed the entire 2011 season as a result.

Even the great King Henry couldn't beat the dreaded cruciate

It goes to show that even the toughest of competitors can’t beat some injuries and they don’t come much worse than rupturing the anterior cruciate ligament in your knee.

Numerous GAA players have fallen victim to the injury, particularly in recent times, Munster’s Niall Ronan suffered one earlier this year, while it is also very common in football, with Roy Keane, Robbie Fowler and most recently, Nemanja Vidic amongst the high profile victims.

On the surface, a ruptured anterior cruciate ligament doesn’t appear to be the most devastating of injuries. Victims aren’t necessarily going to breakdown in agony on the pitch as they would if they broke a leg, for example.

One of two cruciate ligaments in the knee joint (the posterior is the other), a ruptured cruciate ligament is a more debilitating injury and it severely impairs the stability of the knee and its ability to move.

It can be caused through impact, but just as easily it could be through an awkward fall or landing, an acute change of direction or an absolutely freak occurrence (Michael Owen suffered his making a simple pass).

Shefflin, who has ruptured the anterior cruciate ligament in both of his legs, has spoken in the past of hearing a pop in his knee and instantly fearing the worst, which is the case for lot of cruciate injury victims.

Symptoms also include severe swelling, quite an amount of pain and near complete instability in the affected knee, which is fit to collapse under any weight whatsoever. Usually, an MRI scan will confirm a victim’s worst fears.

The recovery process can be gruelling and if you hear of people returning after six months or so, it’s either a little premature or because they’ve put some serious work in.

Without going into too much detail, surgery is often required in more severe cases, allied with a punishing regime of muscle rehabilitation aimed at increasing the stability and movement in the knee and building up the surrounding muscles for greater support.

The treatment of ruptured cruciate ligaments has come on in leaps and bounds from the old days where it could often go unnoticed, or end an athlete’s career entirely.

That said, it is still one to be avoided at all costs.