The ACL: The Crucial Knee Ligament


Are you an athlete? Do you have children involved in sports that might be susceptible to a knee injury? Your anterior cruciate ligament (ACL) is located in the center of your knee, connecting your femur (thigh bone) to your tibia (shin bone). The ACL provides stability to prevent forward movement and rotation of your knee joint especially while running, cutting in sports, or skiing down a mountain. A complete or partial ACL tear is common in both contact and non-contact sports. An ACL injury can leave a person unable to finish out a sports season and even possibly result in surgery. Many studies have shown that prevention programs can decrease your risk of sustaining an ACL tear.


Females are 4-6 times more likely to injure their ACL due to overuse of their quadriceps muscle (thigh muscle), knees coming together more during landing, and decreased ankle, knee and hip bending during athlete performance compared to males. (1, 2) Other risk factors include: footwear, surface type (e.g. grass, snow, ice, turf, wood), knee laxity (e.g. looseness), foot overpronation (flat feet), and body mass index (BMI). (3)


Screening examinations by a physical therapist can identify if you have any of these predisposing factors for an ACL injury. The examination may include an assessment of your stomach (core) and leg strength, hip, knee, and ankle range of motions, and completion of a series of functional tests to help determine if you are at risk for an ACL injury. (1, 2) Your mechanics will be assessed during tasks such as jumping off a box to the floor, during single leg jumps or with cutting motions. Once these factors are identified, your physical therapist can then develop an individualized treatment plan focusing on strength, sports mechanics, and flexibility to help you reduce these risk factors and in turn reduce the risk of ACL injury. Your physical therapist can educate and train you on the proper way to land to improve absorption of weight through the legs and muscles avoiding increased forces through the knee.


Have you ever had knee pain or a feeling of instability in your knee after playing in a sports game or skiing?


Free Weights or Machines?














One of the main objectives of physical therapy treatment is to strengthen weak muscles. Usually if a muscle is weak, the forces on your body become unbalanced. This can lead to pain and an inability to perform a normal daily activity. A common question posed by patients is: “Should I strengthen my muscles with free weights or machines?”


Machines are designed to keep your body in proper form to work the muscle(s) indicated. Pictures are often attached to the equipment to indicate the muscle(s) being strengthened and proper set up.


Free weights can be more challenging because you have to use your muscles to stabilize and balance your body while performing the exercise. In addition, free weights allow you to increase the range of motion of an activity as well as lend creativity to developing exercises that mimic your daily activities. For example, a bicep curl on a machine usually just targets the bicep, but with free weights your shoulder, neck, back and leg muscles also turn on to perform the exercise. As a result of the greater demand on your stabilizing muscles, it is important to focus on your form when using free weights. Failing to do so could lead to injury.


Our physical therapy clinics are focused on restoring normal function and reducing your pain. Daily activities at work, home and play all require your stabilizing muscles to work. Therefore, we prefer to use free weights during your rehabilitation program to help retrain your muscles to work properly with your daily routine. We focus on proper form with each free weight exercise to prevent re-injury or creation of a new injury.


Despite continued debate by some health professionals, both methods are effective ways to strengthen muscles. However, if one of your goals is to strengthen in a functional movement pattern, consider free weights over machines. Our physical therapists at Sports PT of NY can help you establish your functional free weight routine with a referral from your MD or via Direct Access.