Injury Report: Jamal Anderson, Atlanta Falcons

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NAME: Jamal Anderson

TEAM: Atlanta Falcons

POSITION: Running Back

INJURY: Torn ACL

HOW IT HAPPENED

Anderson was injured in the Falcons' Sept. 20 game against the Dallas Cowboys. While running left, he cut right and immediately fell to the ground. He lay on the turf for five minutes clenching his right knee; then, he was helped up and limped off the field. At first, the team said that it was just a sprained knee, but it was later confirmed he tore the anterior cruciate ligament (ACL) and would miss the entire season.

PLAYER BIO

Jamal Anderson led his team to the Super Bowl last season, but he may be better known for his end zone dance called the "Dirty Bird." He set team records with 410 attempts, 1,846 yards gained, 12 100-yard games, 16 touchdowns, and 6 consecutive 100-yard games. He also set the league record for attempts in a season and is ranked 9th all-time in running yards. The '98 season marked his first Pro Bowl appearance. After being drafted in the 7th round of the 1994 NFL draft, he first made his mark in 1996, when he gained 1,055 yards in 12 starts. He rushed for 1,000 yards in three consecutive seasons and is widely considered second only to Terrell Davis as the league's top back.

WHAT IS INVOLVED IN AN ACL TEAR?

The anterior cruciate ligament is one of four ligaments in the knee joint that stabilizes the knee throughout its full range of motion. The ACL's specific function is to keep the knee from bending forward and from rotating. It is used in pivoting maneuvers -- for example, when running or quickly moving laterally. The ligament is directly behind the patella (kneecap), in the center of the knee. The ACL can be injured in many ways, the most common being a combination of bending the knee and forced rotation of the lower leg. Also common is force applied to the outside of the leg pushing inward, as often happens during a clipping injury.

DIAGNOSIS

A sports physician can easily diagnose a torn ACL. By moving the knee and testing its motion, doctors can determine that the ACL has been damaged. Another good indictor of a torn ACL is blood inside the knee joint; if this occurs, there is a 70-80% chance that the ACL is torn. An MRI (magnetic resonance image) can also detect the injury.

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TREATMENT

Just 5-7 years ago, torn ACLs commonly ended athletes' careers. For athletes and other patients involved in pivoting sports or labor-intensive jobs, ACL reconstruction surgery is recommended. For less active people, there is nonsurgical treatment. These patients can strengthen the quadriceps and the hamstring and wear a brace. But neither exercises nor braces can give them full support, stability, or strength. The surgery entails taking a graft of another ligament from the patient's body (an autograft) or from another body or a cadaver (an allograft). That graft is placed in the knee, where the original ACL had been, and fixed in place using a screw, glue, or a staple. During the recovery period, the body incorporates the new ligament, and it replaces the ACL.

PREVENTION

There is no way to prevent ACL injuries in contact sports. However, recent studies have shown that female athletes are at a higher risk of sustaining ACL injuries than male athletes. The reason may be that there are anatomic differences that predispose women to this injury.

RECOVERY

The average recovery period is 6-8 months. The patients begin walking quickly after the surgery, and physical therapy begins within 2 weeks. At that time, the patient begins stationary bicycle exercises and quadriceps and hamstring strengthening. In 10-12 weeks, patients can begin jogging on a treadmill, swimming, and golfing. At around 4 months, the patient can begin pivoting maneuvers and drills. Finally, after 6-8 months, the athlete is able to return to his or her sport.

LONG-TERM OUTLOOK

With modern treatment, a torn ACL is no longer a career-ending injury. Treatment works very well and allows many athletes to compete at their pre-injury levels, although some who have suffered a torn ACL may feel that they lose some of their maneuverability.

Medical information was provided by Michael J. Ciccotti MD, director of sports medicine at the Rothman Institute at Thomas Jefferson University Hospital in Philadelphia. Ciccotti is also the team physician for the Philadelphia Phillies.

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