Effects of ACL injuries on Motion


When people have ACL injuries, it takes a lot of time to regain normal motion, and sometimes it never happens. So how are ACL injuries different from other injuries movement wise?

What is the anterior cruciate ligament (ACL) injury?

People who are active in sports are prone to injuring the ACL. The ACL is a ligament that is present in the knee and can tear or sprain due to rapid motion or change in directions. It can also occur as a result of an incorrect landing or a fall. People who participate in basketball, soccer or football are more likely to suffer from an ACL injury.

What are some of the symptoms of ACL injury?

When you suffer an ACL injury, it is vital that you seek treatment as soon as possible. The more you continue putting pressure on the hurt knee, the worse the injury and the harder it will be to treat. But sometimes it isn’t your fault that you do not report the problem early. Some of the symptoms may seem like those of a less severe kind of injuries. If you find yourself having the following symptoms, your knee pain could be as a result of ACL injury.

  • A swollen and painful knee
  • You feel discomfort during walking
  • You cannot move your knee as you usually would.
  • There is tenderness at the knee joint

What are the treatment options for ACL injuries?

The severity of the injury determines the treatment a patient will get. However, if the injured person is young and active and there is a tear in the ligament, surgery is the best option. Older patients may decide not to get surgery but they will no longer be active as their knees won’t let them.

But even when you have reconstructive ACL surgery, there is some disappointing news. Patients will still face a higher risk of disability from osteoarthritis. Additionally, 30% of patients will suffer re-injury especially when they go back to active sports.

ACL injury induced sensory visual motor compensations

One of the reasons why ACL re-injury is common even after rehabilitation is the optical motor compensations as a result of the knee injury. They are as a result of visual-motor compensations. What this means is that when a person has hurt their knee, and they start walking again; they feel like they cannot “trust” their knee anymore. They will therefore not walk as they used to and will be looking before stepping like they are learning to walk.

Visual motor compensations are as a result of brain plasticity. Brain plasticity is the re-organization of the brain for time to time to accommodate changes. For instance, when you learn something new, your brain will re-organize itself to accommodate the new activity.

When you hurt your knee, and it remains disused, the brain no longer receives somatosensory signals from that area. Brains plasticity then stops catering to the knee area. This is why people on rehabilitation struggle and use their sight rather than brain signals to walk.

Is there a solution to visual motor compensations?

One of the solutions is to reprogram the brain to start receiving somatosensory signals from the knee. The best way to do this is by using visual motor training. The training involves limiting sight by using blindfolds or strobe glasses.

The limited sight stimulates the brain to start receiving somatosensory signals from the knee area. It takes a while for the brain to get used to the somatosensory signals but it has been found to work better than neuromuscular training alone.

Final thoughts

ACL injury rehabilitation can be daunting and exhausting both financially and emotionally. You may have even come to almost giving up. But visual motor training is here to help make the process a lot more successful. Hopefully also prevent re-injury.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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