Is there any stretch (or place I can apply pressure) that specifically targets the ACL?

Question

I had ACL surgery a couple years ago and things have been great. I've been running more and have some (very minor) discomfort in that knee. I really have no idea if it could be the ACL or not. Is there a stretch I can do that will specifically stress the ACL so I can see if that's the source of the pain?

Answer 1

No you don't want to stress an ACL, esp. if you have had surgery. If it is partially torn, stressing it will only make it worse. It is best to return to your surgeon and/or physical therapist for an evaluation and possibly a new rehab program.

Even if the discomfort is only minor, the pain is telling you that something is wrong and the sooner you address it, the better off you will be. Your therapist can take a look at your shoes, your running form, and test your hip and leg muscles for any imbalances (tightness or weakness). They also might give you specific massage techniques to release any restrictions.

You may want to take a look at some of the running questions and answers to help you identify possible causes of knee pain with running. How to run without damaging your feet, knees or hips. will give you a lot of good information.

Answer 2

Robin is correct on the stretching of ligaments. Ligaments are like the springs in click pens, once they get pulled out, they don't go back as tight as before. This is the reason that once you dislocate a shoulder, it's easier to dislocate again.

The other thing is that there aren't really any stretches that you can apply yourself that will tell you that you have a ligament injury. There are three different common diagnostic tests, but they require the leg to be in specific positions, and a second party testing the knee. (Example: Anterior drawer test, requires the hamstrings to be completely relaxed. Since the hamstrings produce actions in two joints, both joints {knee and hip} have to be bent. Once the hamstrings are completely relaxed, the tester draws the knee forward. An excessive amount of forward motion, or lack of "stop" point indicates an injury. Impossible to do this test on yourself.)

Edited to add: These are not tests that should be done by you and a buddy. These should be done only by a trained professional, as it requires experience, training and if improperly done, could lead to or worsen injury.

Finally, even if you could stretch the area, there is no way for you to specifically pinpoint the pain and say "Yes, that's the ACL". My fear is that you would stretch, get no pain and decide it's ok and then have further injury occur.

My best recommendation would be to go in and have a professional take a look, rather than trying to diagnose it yourself. It's possible that you had a very minor injury at the time of the original ACL injury that has just gotten progressively worse over time and is now starting to cause discomfort/pain.

Edited to fit better with Nathan's request:

Ligaments connect bone to bone. They aren't designed to stretch. The tests for the ACL are basically of the kind where you bend the leg in various ways to completely relax the surrounding muscles (To avoid false negatives), then moving the knee. If the ACL is intact, the knee will have a fairly defined "stop" point, and a limited range of travel. If the ACL (or any of the knee ligaments for that matter) is damaged, the range of travel will be greater and the stop point will feel rather vague.

Answer 3

Something you need to consider is that injuries and surgeries can affect much more in your body than just where you had the injury. Also, pain can refer so that can confuse things as well.

If you're only feeling pain in one side while running, I would think that the issue is an asymmetrical gait. Determining how your painful side is moving compared to your not painful side would be an important first step. That would help narrow down the cause of the pain.

That said, to the second half of your question about pressing somewhere to see if that causes the pain, trigger point therapy is about exactly that. I've read The Trigger Point Therapy Workbook by Clair Davies (and recommended it to family members) and have had good results with it. If you can find it in a bookstore or library you could even flip through to the leg section, find trigger points that refer pain to where you're feeling it and see if you can palpate them.

As far as stretching goes, I haven't read it, but Trigger Point Self Care Manual by Donna Finando is apparently similar and also includes stretching. A note on stretching, as long as you stop the moment you feel some discomfort and don't push further you probably won't make things worse, but given some research has started showing that stretching can cause injury, I'm quite reluctant to recommend or suggest it at all unless you're very certain you know exactly what you're doing. Also, it's my understanding that when ligaments stretch, they don't go back to their old position and end up looser as a result, so I think targetting the ACL specifically would be a bad idea, but targetting various leg muscles might not be. Also keep in mind that if you find a muscle is tight when you stretch it, strengthening it with resistance training is a better course of action than trying to stretch it to loosen it up.