ACL: The Nastiest Injury in Sports

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The Nastiest Injury in SportsBy Neal Gabler on December 3, 2013 www.grantland.com

To be honest, it doesn't look like much. It's short, just over an inch in length, and stubby, about half an inch wide. It is white, slick, and striated like a cluster of angel-hair pasta. It isn't rubbery, and it doesn't have much elasticity. In fact, you wouldn't give it a second thought — not until it self-destructed, which it occasionally does, always at the most inopportune of times. And then you wouldn't think about much else but that gremlin that now sits at the center of so many of our games.

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And then came Dr. William Clancy. Clancy had been recruited in 1974 to head a sports medicine program at the University of Wisconsin. While attending a lecture on ACL reconstruction by a Swedish physician, he had his Eureka! moment. Since Jones, just about everyone using the patellar tendon had left it attached to the tibia and then routed the tendon through the knee and fixed it to the femur. Clancy said he thought the patellar tendon should be harvested with bone blocks on each end, because it would be more flexible and stronger. He would then drill holes into both the femur and tibia, pull the tendon through, and attach the blocks through the holes. He felt this would more closely approximate the actual ACL. The "Clancy procedure," albeit with all sorts of tweaks and refinements, remains the basic form of reconstruction to this day.

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Great article in Grantland. Finally, something useful from Wisconsin. Besides Cheese.
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One thing that people overlook - In the article they talk some about why ACL injuries are continually more common today, and they point mainly to the increased cutting and different movements that put different types of stress on athletes' bodies.

What they don't ever mention is that athletes over the past couple of decades have continually gotten more and more muscular, more physical, faster, stronger, etc. Unfortunately, ligaments don't strengthen along with the muscles. It only takes a small pressure in the wrong direction to snap one, and the bigger, faster, and stronger that athletes get, the more likely they are to sustain an ACL tear.

 
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