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SYMPTOOM!

De oorzaak, symtomen en behandeling van de voorste kruisband blessure.

General

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Cause

Symptoms

Exam

Treatment

What is an anterior cruciate ligament?

In the middle of the knee are the anterior and posterior cruciate ligaments. They cross each other and are therefore called cruciate ligaments. The anterior cruciate ligament can support about five to six times the body weight. The anterior cruciate ligament consists of two bundles four centimeters long and together are one pinky finger thick.
voorste kruisband anatomie

One bundle prevents the tibia from sliding forward relative to the femur. The other bundle prevents rotation of the tibia. In addition to being a stabilizer, the cruciate ligament is also a sensor. Through complex reflexes, muscles are controlled in milliseconds. The function of the knee depends on a good muscular system that, together with the other ligaments and fascia, provides stability. With a torn or insufficient anterior cruciate ligament, the anterior and posterior instability can be handled well with training. Rotational instability is much more difficult to resolve with training and usually results in an unstable knee with sports.

Why does an anterior cruciate ligament tear?

The anterior cruciate ligament tears in 45 milliseconds. A trained athlete can tighten his muscles in 80 milliseconds. So in some situations, simply put, you're just too late. In sports, changing direction, landing after a jump or slowing down after a sprint are the most common causes of a cruciate ligament tear. This always involves a deceleration of speed.

The chance of tearing the anterior cruciate ligament during a match is 10 percent higher compared to training. During a match, it's all about something. You don't want to lose and will put in just that extra step or acceleration to grab the ball, for example. This can put the body in positions where the muscle system cannot adequately control the knee. It almost always involves non-contact trauma. "There was no opponent around" is what clients often say.

Women are about 25 percent more likely than men to tear their cruciate ligament. The same percentages apply in young people under the age of 21. In addition, young people are more likely to have a re-rupture (tear again) after anterior cruciate ligament reconstruction. Before returning to the sports field, proper rehabilitation, patience and taking your time are essential.

Risk factors

  • Female gender Young athlete (<21)
  • Turn sports ( pivoting high impact sports) such as field hockey, soccer, basketball, handball, skiing etc.
  • Hypermobility
  • Weak hamstrings
  • Reduced trunk stability
na een voorste kruisband blessure weer skiën

Contact trauma

A contact trauma is a knee injury caused by the acting force from outside. A shoulder thrust or collision between two athletes are examples of contact trauma. An accident in traffic or a fall down the stairs are high-energy traumas. Contact trauma and accidents are generally more serious injuries than noncontact trauma.

During skiing, percentage-wise, compared to other sports, most cruciate ligament injuries occur. Not counting the apres ski. Team sports such as basketball, handball, field hockey and soccer are also notorious for cruciate ligament injuries.

Wat zijn de symptomen van een kruisband blessure?

First, there has been a trauma moment. Usually the foot is fixed on the ground and you twist the knee by braking abruptly, changing direction or landing after a jump. At the moment of injury, you may hear a tearing sound or pop. As a rule, overstretching or twisting the knee also strains or tears (partially) the knee capsule. The inner or outer ligament and/or meniscus may tear (partially). After the rupture of the cruciate ligament, slight to severe swelling occurs in the knee. This is because small blood vessels in the cruciate ligament rupture and start bleeding.

 

Voorste kruisband blessure

Swelling limits bending and stretching. The knee feels stiff and movement is difficult. Sometimes you feel nauseous or dizzy immediately after the trauma when you want to stand and walk. You may have muscle pain in your hamstrings in the following days. The knee is painful for the first few weeks and is usually in a slight flexion because of the swelling.

It is important to stretch the knee properly. Therefore, do not place a pillow or other object in the hollow of the knee. The knee will stiffen and intensive exercise is needed to regain proper extension. A locked knee due to an upturned meniscus is one reason that full extension is not possible. (see meniscus injury)

voorste kruisband oefening

Upper leg strength will decrease rapidly and significantly due to fluid in the knee (reflex inhibition). Less muscle strength means decreased stability, coordination and reflex movement. The chance of slipping through the knee again in the first few months with an unexpected movement increases. The knee is affected. "The heart attack of the knee" is what orthopedic surgeon van der Hart calls it. The patient experiences the sensation of the lower leg sinking away relative to the upper leg (sensation of knuckles rubbing together). This is called "giving away.

After tearing the cruciate ligament, the pain subsides quickly. The capsule of the knee and the inner or outer ligament may remain sensitive for a long time. Many people experience long-term bone bruising (bone bruise). This can last an average of three to six months. It eventually recovers on its own.

A torn cruciate ligament can cause instability while walking and during unexpected movements. After targeted rehabilitation, restrictions in daily life decrease and even running is often possible again. Sports involving contact and turning and twisting are generally not recommended. It is important to assess this in close consultation with your doctor and physical therapist.

4. Hoe gaat het verder als ik mijn risico op hart- en vaatziekten weet?

De eerste stap van de revalidatie is het vocht in de knie reduceren, het verbeteren van de kracht, en het optimaliseren van de buiging en strekking. Maar ook: het bespreken van de behandelmogelijkheden en de voor- en nadelen van een operatief en conservatief traject.

De tweede stap is gericht op het verbeteren van de functionele kracht, coördinatie en stabiliteit. De intensiteit wordt op geleide van de belastbaarheid opgebouwd en de oefentherapie richt zich steeds meer op jouw sport. Behalve het trainen van de spieren rondom de knie, is het belangrijk om de gehele keten te trainen. Denk hierbij aan de romp, heup en enkel. Ook de conditie moet in deze fase opgebouwd worden.

5. Hoe gaat het verder als ik mijn risico op hart- en vaatziekten weet?

De eerste stap van de revalidatie is het vocht in de knie reduceren, het verbeteren van de kracht, en het optimaliseren van de buiging en strekking. Maar ook: het bespreken van de behandelmogelijkheden en de voor- en nadelen van een operatief en conservatief traject.

De tweede stap is gericht op het verbeteren van de functionele kracht, coördinatie en stabiliteit. De intensiteit wordt op geleide van de belastbaarheid opgebouwd en de oefentherapie richt zich steeds meer op jouw sport. Behalve het trainen van de spieren rondom de knie, is het belangrijk om de gehele keten te trainen. Denk hierbij aan de romp, heup en enkel. Ook de conditie moet in deze fase opgebouwd worden.

6. Hoe gaat het verder als ik mijn risico op hart- en vaatziekten weet?

De eerste stap van de revalidatie is het vocht in de knie reduceren, het verbeteren van de kracht, en het optimaliseren van de buiging en strekking. Maar ook: het bespreken van de behandelmogelijkheden en de voor- en nadelen van een operatief en conservatief traject.

De tweede stap is gericht op het verbeteren van de functionele kracht, coördinatie en stabiliteit. De intensiteit wordt op geleide van de belastbaarheid opgebouwd en de oefentherapie richt zich steeds meer op jouw sport. Behalve het trainen van de spieren rondom de knie, is het belangrijk om de gehele keten te trainen. Denk hierbij aan de romp, heup en enkel. Ook de conditie moet in deze fase opgebouwd worden.

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