Everything You Need to Know About ACL Injuries

Not just athletes, but anyone can suffer from Anterior Cruciate Ligament (ACL) injuries. So, what exactly happens when this ligament gets injured? How does it tear, and how can you tell if that’s what you’re dealing with?

We’ll break down how ACL injuries happen, what symptoms to watch for, and answer some of the most common questions we hear.

What is an ACL injury?

An ACL injury results from an ACL tear in your knee. It is one of your knee ligaments and connects your thigh bone (femur) to your shin bone (tibia). An ACL forms an “X” shape inside your knee with your posterior cruciate ligament (PCL). While an ACL is closer to the front of the knee, a PCL is closer to the back of it.

Imagine ACL is like a strap that connects your bones and prevents your knee from bending or rotating too much. An ACL injury happens because of sudden high intensity force to the knee that bends or twists it farther than its natural limit.

Types of ACL Knee Injuries

Grade 1: The injury stretched your ACL enough to damage it, but it’s still in one piece and holding your knee bones together.
Grade 2: The injury stretched your ACL so much that it was partially torn and loosened.
Grade 3: A complete tear of your ACL is in two pieces.

What are ACL Injury Symptoms?

Common signs of an ACL injury include:

A popping sound or sensation in the knee
Swelling shortly after the injury
Pain, especially when putting weight on the knee
Feeling of instability or the knee “giving out”
Reduced range of motion in the knee

What Causes ACL Tears?

ACL tears occur when excessive force or unnatural movement strains the knee beyond its limits. This often happens when the knee twists or shifts too suddenly.

Typical causes of ACL Injury include:

Sports injuries
Car accidents
Slips and falls

Who is at Risk for ACL tears?

ACL injuries can affect anyone, but they’re most common among athletes, especially those in sports with quick stops, twists, and direction changes, such as:

Soccer
Football
Basketball
Gymnastics
Lacrosse

What to Expect During Your Doctor's Visit for an ACL Injury

Your first appointment typically starts with a detailed conversation. Your doctor will ask about your symptoms, how the injury happened, and your medical history to get the full picture.

Then comes a hands-on exam, where your doctor will carefully check your injured knee, comparing it to the other side. Most ligament injuries, including ACL tears, can be identified just through this thorough physical examination.

Imaging That Might Be Used

To confirm what’s going on or rule out other issues, your doctor might suggest:

X-rays – While they can’t show ligament damage, X-rays help spot any related bone injuries.
MRI scans – These give a clearer look at soft tissues, including your ACL, meniscus, and cartilage. MRIs aren’t always necessary to diagnose a tear, but they can be useful to see if anything else in the knee is affected.

What are the Treatment Options for an ACL tear?

Treatment depends on your lifestyle, activity level, and overall health.

Active individuals and athletes, especially those in agility-based sports, often need surgical reconstruction to restore stability and safely return to competition.

Less active or older adults may recover with non-surgical treatment, such as physical therapy and lifestyle adjustments, especially if their daily activities don’t require intense knee movement.

There are two main approaches to ACL Injury Treatment: repair and reconstruction.

ACL Repair

This is a less common option and only suitable for very specific cases, typically when the ligament has cleanly torn off from the bone. It’s mostly used in acute injuries and select patients.

ACL Reconstruction

This is the gold standard for most people. It involves replacing the torn ligament with a graft, which could be:

Autograft – using your own tendon (usually patellar, hamstring, or quadriceps tendon)
Allograft – using donor tissue (more common in older or less active patients)

Who Should Think About ACL Reconstruction Surgery?

If you’re an active adult, playing sports that involve quick moves, twists, or heavy lifting at work, ACL surgery might be a smart option. Even older adults can benefit from surgery if they stay physically active.

For kids and teens, surgery needs extra care. Their bones are still growing, so doctors weigh the risk of growth problems. But research shows that delaying treatment can lead to more damage inside the knee, like tears in the meniscus or cartilage. If your knee feels unstable and keeps giving way, you may be at risk of injuring other parts of your knee, making surgery a stronger recommendation.

Sometimes, ACL injuries happen alongside other knee damage, like:

Meniscus tears
Cartilage damage
Ligament sprains (like MCL)

This combo, especially common in sports like football and skiing, is called the “unhappy triad.” In these cases, surgery often helps everything heal better, especially if meniscus repair is done at the same time.

Rehabilitation After ACL Surgery

Physical therapy plays a critical role in recovering from ACL surgery, often starting right after the procedure. The key to a strong recovery lies in your commitment to rehab. Thanks to modern surgical methods and secure graft fixation, recovery is now faster and more focused than it used to be.

The First Few Days Post-Surgery

During the first 7 to 10 days, your priority is to:

Keep the surgical site clean and dry
Begin gentle exercises to straighten the knee and activate the quadriceps

Icing your knee regularly helps ease pain and swelling. Your surgeon might recommend a brace or a passive motion machine to help you bend and extend your knee, though studies show the machine isn’t essential for a good outcome.

Whether you use crutches and how much weight you put on your leg will depend on your surgeon’s advice and whether other injuries were treated during surgery.

What Rehab For ACL Injury Aims to Achieve

Recovery goals include:

Reducing swelling
Keeping your kneecap mobile to avoid stiffness or pain
Restoring the full range of motion
Building strength in your quadriceps and hamstrings

When Can You Get Back to Sports After ACL Injury Treatment?

You’re typically cleared to return to sport when:

Pain and swelling are gone
You’ve regained full knee movement
Your leg strength, endurance, and function are fully restored
Your sense of balance and movement control are back (thanks to neuromuscular training)

Most athletes return to full activity within 6 to 12 months, depending on their individual progress.

Wearing a knee brace when resuming sports isn’t always required, but many find it provides extra confidence.

Recover Stronger with MJ Naidu Hospitals

ACL injuries can be life-altering, but with the right care, recovery is more than possible. At MJ Naidu Super Specialty Hospital in Vijayawada, patients receive world-class orthopedic treatment backed by over 40 years of expertise. If you are an athlete aiming to return to peak performance or someone seeking relief from knee injuries or instability, our team of renowned orthopedic surgeons offer personalized care, advanced surgical techniques, and comprehensive rehabilitation programs.

From accurate diagnosis to post-surgery recovery, MJ Naidu Hospitals combine cutting-edge technology with compassionate support, helping you get back on your feet with confidence.

FAQ:

Q.1 How do I know if I have an ACL tear?

If you hear a pop during a sudden knee movement, followed by pain, swelling, and a feeling that your knee is unstable or gives way, there’s a strong possibility of an ACL tear.

Q.2 What should I do if I suspect an ACL tear?

Consult a sports medicine provider or orthopaedic specialist as soon as possible. They’ll examine your knee and may order an MRI scan to confirm the diagnosis and decide if surgery or other treatment is necessary.

Q.3 Who is at risk for ACL injuries?

Athletes involved in high-intensity sports like football, soccer, basketball, or any activity requiring sudden stops, pivots, quick turns, or jump landings are at higher risk of tearing their ACL. Surprisingly, around 80% of ACL injuries occur without any physical contact, often triggered by unexpected movements during play.

Q.4 How soon can I get back to playing after an ACL injury?

Most athletes can return to competitive play within 8 to 9 months following ACL surgery, provided they complete a full physical rehabilitation program.

Q.5 What does the rehab process include?

Rehabilitation should involve a gradual return-to-sport program tailored for the athlete, their coach, and trainer. It’s important to include formal physical and psychological readiness testing to ensure a safe and confident comeback post ACL injury.