Running is becoming increasingly popular, primarily because it's easy to do, requires minimal equipment, and offers significant health benefits. However, despite these benefits, there's one common injury risk for runners: ACL ( Anterior Cruciate Ligament) injuries .
This injury is usually associated with sports that involve a lot of twisting movements, such as soccer or basketball, but in fact, runners can also experience ACL injuries due to incorrect technique or excessive training load.
Understanding the causes and how to prevent it is essential to maintain performance and prevent long-term knee joint damage.
What is an ACL Injury?
The ACL is one of the main ligaments in the knee, responsible for maintaining stability when the leg is supporting weight, turning, or stopping suddenly. An ACL injury occurs when the ligament tears due to rapid, sudden movement or excessive stress on the knee. In runners, this injury can occur suddenly or gradually due to repetitive movements that put excessive stress on the knee.
An ACL injury is a serious injury. If not treated properly, damage to the ligament can lead to knee laxity, chronic pain, and even the risk of osteoarthritis later in life.
Why Do Runners Suffer ACL Injuries?
Although running appears to be a sport with a straight and stable movement pattern, the following factors can increase the risk of ACL injury:
1. Improper Running Technique
Hard landing techniques, excessively long strides, or unstable knee positions while running can put excessive stress on the ACL. These habits can lead to long-term injury.
2. Uneven Running Surface
Running on potholes, steep descents, or rocky terrain can make it easy for your foot to slip or twist suddenly. This sudden rotational movement is what often triggers an ACL tear.
3. Weak Calf and Thigh Muscles
The quadriceps, hamstrings and muscles around the pelvis function to maintain knee stability. If these muscles are weak or unbalanced, the knee ligaments, including the ACL, will work harder, making them more easily injured.
4. Excessive Exercise Intensity
Drastically increasing running distance or speed without adequate warm-up can increase the risk of injury. The knee joint requires gradual adaptation to increased loads.
5. Ill-fitting Shoes
Wearing shoes with inadequate cushioning or that are worn out can change the way your foot strikes and affect knee movement, increasing the risk of injury.
ACL Injury Symptoms to Watch Out For
ACL injuries usually cause symptoms such as:
- A “pop” sound is heard in the knee when the injury occurs.
- Severe pain that appears suddenly
- Swelling several hours after injury
- Difficulty stepping or walking
- The knee feels unstable as if it is about to "fall off"
If these symptoms appear, immediately stop the activity and check with a doctor for further evaluation.
How to Prevent ACL Injuries
Preventing ACL injuries is much easier than treating them. Here are some steps you can take:
1. Do a proper warm-up
Before running, warm up for 5–10 minutes with dynamic stretches like leg swings, lunges, and high knees. Warming up increases muscle elasticity and prepares joints for activity.
2. Strengthen Leg and Core Muscles
Strength training exercises like squats, deadlifts, glute bridges, calf raises, and core exercises are essential for maintaining knee stability. Strong muscles help protect the ACL from excessive stress.
3. Improve your running technique
Use shorter strides, lean slightly forward, and land on the middle of your foot to reduce stress on your knees.
4. Wear the Right Shoes
Choose running shoes that suit your foot shape and the terrain you'll be running on. Replace your shoes every 500–800 km to maintain optimal cushioning.
5. Increase Intensity Gradually
Follow the 10% rule, increase your running distance or duration by a maximum of 10% per week so your body can adapt without increasing the risk of injury.
6. Get enough rest
Give your body time to recover. Excessive training without rest can lead to muscle fatigue and make your knees more susceptible to injury.
ACL injuries don't just happen to professional athletes; they can also affect even seemingly healthy runners. By understanding the causes, recognizing the symptoms, and implementing the right preventive measures, you can run more safely and comfortably without compromising your knee health. Make exercise a healthy lifestyle, not a source of injury.
Article written by Dr. Reygais Razman, Sp.OT, M.Kes (Orthopedic and Traumatology Specialist, EMC Cikarang Hospital).