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ACL injury / ACL tear

The anterior cruciate ligament (ACL) is one of the main stabilizing ligaments of the knee, and when it is injured the knee may feel as if it will buckle and give out. Tears or ruptures of the ACL occur frequently in sports.

What are the causes?

These injuries are very common in an athletic population such as soccer, basketball, and football. These sports require athletes to make vigorous and repeated motions that work the ACL, putting it under stress as it continuously provides stability during stop-and-go action and pivoting motions.

Many injuries to the ACL occur when an athlete initiates a sudden turn or “cut”, but the foot stays planted on the court or ground. Landing from a jump with a twisting motion, as might happen in volleyball or basketball, also can injure the ACL, as well as a hyperextension of the knee and deceleration. However, a direct blow to the outside part of the knee is frequently seen in football players due to the nature of contact experienced by these athletes.

How can you tell if your ACL is torn?

Injury to the ACL is painful and most individuals report a “pop” in their knee, followed by a feeling of instability. This feeling hinders athletic activities as well as simple daily activities such as walking down stairs.

ACL injury grading:  

The tear may be partial or complete; a complete tear of the ACL is also known as an ACL rupture.

  • Grade I : slightly stretched ACL. Symptoms are typically mild. The ligament can still keep the knee stable.
  • Grade II :stretching of the ACL to the point of looseness. These injuries are often referred to as “partial” tears. Symptoms are more severe than Grade I tears. Range of motion may be restricted and the knee may occasionally feel unstable (the knee feels like it is “giving out”)
  • Grade III :(ligament rupture) are complete tears (the ACL has been split in two). Grade III tears may also be referred to as an ACL rupture. A person may not be able to bear weight on the injured leg.
Treatment options

Surgery may be recommended to restore knee function, but is not always necessary.

Nonsurgical treatment is most appropriate for grade 1 injuries. This would include immobilization or bracing, physical therapy, and a gradual progression back to regular activities and sports.

Surgical treatment is recommended for individuals with a grade 3 or complete ACL tear. Surgical options may vary based on the type of ACL injury, whether the patient has open or closed growth plates, and the type.

First aid for an ACL injury may include:

  • Raising your leg above the level of the heart
  • Putting ice on the knee
  • Pain relievers, such as nonsteroidal anti-inflammatory drugs (such as ibuprofen)