The anterior cruciate ligament (ACL) runs through the middle of the knee and toward the front. It keeps the tibia (shin bone) from sliding forward and helps control the back and forth motion of the knee joint. Although knee ligament injuries are considered sprains and can range in severity, the ACL is usually torn or nearly torn whenever it’s injured because it bears so much force.
Athletes in sports like football, soccer, skiing, and basketball are at higher risk for an ACL tear, and females in certain sports are also at higher risk due to a variety of physical as well as training variables. Regardless of the sport or activity, though, these most common ways of causing an ACL tear can put enough pressure on the knee to “pop” the ligament:
- Sudden stop or slowing while running (or skiing) forward
- Abrupt change of direction
- Landing wrong from a jump
- Collision directly to the knee
Symptoms of an ACL injury include a popping feeling and instability of the knee at the time of injury, followed quickly by pain and swelling. Tenderness and trouble walking also often happen within 24 hours. Seeing an orthopedic doctor specializing in the knee or sports medicine is important if you have these symptoms. Your doctor will examine you and likely order x-ray images and an MRI scan because it’s very common for other knee joint injuries to accompany an ACL tear.
Surgery is not always necessary for a torn ACL. Low activity patients may opt for bracing and physical therapy to strengthen the other structures of the knee in place of the weakened ACL. However, surgery is the most often recommended solution for those who want to return to sports or higher activity levels. Timing is key for these patients. The doctor may prescribe physical therapy in preparation for surgery because the knee must be allowed to return to a state of minimal swelling and even regain some range of motion BEFORE surgery takes place. Otherwise, range of motion may not return properly at all. Surgery is eventually performed using a tissue graft in place of the torn ACL. More physical therapy is prescribed after surgery. Our doctors have a physical therapy team in our office. They work closely with the therapists to make sure each patient is getting the right treatment every time.