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ACL sprains and tears are the most common injuries to ligaments in your knee. Many people have issues with balance, buckling, or even the joint giving out.
ACL injuries can happen to anyone and can be a game-changer, especially for athletes. That's why many people with an ACL tear need surgery to get back to playing well.
At UPMC, we offer many treatment options for ACL injuries, ranging from non-surgical techniques to ACL reconstruction surgery. The type of treatment depends on how severe your ACL injury is.
Related services include:
A torn ACL is a common injury to the anterior cruciate ligament in the knee. This type of injury can affect anyone.
The ACL is the main ligament that connects your shinbone (tibia) with the thighbone (femur).
Your knee joint has 3 bones:
Four ligaments hold these bones in place. The ACL crosses the middle of the knee, forming an "X" shape and providing stability.
When the ACL tears, your knee can become unstable and may buckle or give way.
ACL injuries account for almost half of all knee injuries. There are about 400,000 ACL reconstructions in the U.S. each year.
Doctors grade ACL tears using a grading system based on how severe an ACL tear is:
Any motion that causes your knee joint to move outside its natural range of motion can lead to an ACL tear or injury. This type of injury occurs more often in activities with:
These types of movements can cause the knee joint to bend backward, twist, or bend to the side. The chance of injury is higher when more than 1 of these movements occur at the same time.
You can also sprain or tear your ACL by falling off a ladder or slipping on a staircase.
Like other body parts, the ACL tends to weaken with age. People over age 40 may be more susceptible to ACL tears.
An ACL sprain or tear isn't limited to athletes, although many are at a higher risk because of the sport they play. An ACL injury can happen to anyone.
This type of injury can impact your day-to-day life and your ability to play sports. Due to the location of the ligament and its effect on the body, it's necessary to treat ACL injuries to preserve:
ACL tears occur more often in athletes who play high-intensity sports, such as:
Sports like these involve quick, frequent movements like jumping, stopping, and changing direction, which can put you at higher risk for an ACL injury.
Female athletes are especially at risk for ACL tears.
Reinjury is the most common complication of an ACL tear. If you've already torn your ACL and you play sports regularly, you're more likely to injure it again.
If left untreated, ACL injuries may result in ongoing joint and mobility issues later in life.
There are things you can do to help lower the risk of an ACL tear or injury.
Practicing strength and stretching exercises can help athletes with balance and coordination.
Allow yourself time to warm up before competition with sport-specific exercises and stretches. A proper warm-up is important for preventing muscle strains.
Many athletes don't bend their knees enough when changing direction or landing from a jump. This puts more pressure on the legs and increases the risk of an ACL injury. This is especially vital for women, as they don't bend their knees as much as men do when landing a jump.
Our experts recommend the following when landing after jumping:
In sports like soccer and basketball, sudden changes in movement are part of the game. This can put athletes at risk for ACL injuries. Practice proper form in agility exercises, such as cutting.
Focus on lower body and core strengthening. A strong core and hips help athletes improve balance. Plus, strong hamstrings and quadriceps work together to bend or straighten the leg. Strengthening these targeted areas can help reduce the risk of an ACL injury.
Exercises that strengthen your legs may help lower the risk of an ACL injury. Some examples include:
ACL injury symptoms can vary. Many people who injure their ACL hear a popping noise in their knee. Other common symptoms of ACL sprains or tears include:
Some people have a lot of pain, while others can walk around for a few hours after the injury. But as the swelling in your knee increases, it's harder to walk and you lose range of motion.
If you think you've injured your ACL, you should see a doctor right away. The best time to diagnose an acute ACL tear is within the first hour of injury — before the knee swells, if possible.
When you see your doctor, they'll get a complete history of your ACL injury and ask you:
The doctor will also do a physical exam or test of your knee to assess the stability of the ligaments. They can diagnose an ACL tear by applying force to the knee and feeling for abnormal motion.
The doctor should also evaluate the uninjured knee for comparison.
Your doctor may order tests to find out the extent of the ACL injury, such as:
UPMC offers many options for treating ACL tears and injuries, ranging from nonsurgical to ACL reconstruction surgery.
The goal of ACL treatment is to stabilize the knee and restore the range of motion. Your doctor will consider the following when recommending treatment:
UPMC also offers an ACL Injury Prevention Program for athletes looking to return to their sport following an ACL injury or to learn how to prevent one.
Minor ACL injuries are often treated without surgery. Your doctor may suggest you use a protective brace and physical therapy.
To treat a minor ACL tear, your doctor may advise you to:
A full ACL tear will not heal on its own. If you live an active lifestyle or play sports, surgery to repair the ligament may be the best option. Without surgery, your knee may be unstable and increase your risk for future injuries.
Most ACL surgeries are done in an outpatient (ambulatory) setting, which means you can go home the same day as your surgery.
Typical surgical techniques for ACL tears and knee injuries include:
Orthopaedic surgeons at UPMC Sports Medicine perform anatomic ACL reconstruction, with a goal of replicating the knee's original anatomy.
Measurements of the uninjured ACL are taken to mimic this as closely as possible.
After ACL surgery, you'll have to eliminate all weight-bearing activities. Depending on the type of ACL tear, your symptoms, and your health history, recovery can range from 3 to 9 months. This is especially important for those hoping to return to physical activities.
You must follow your doctor's orders to rest. Not resting can lead to more knee problems and related complications.
Physical therapy (PT) is also vital to healing from an ACL tear or injury. The goal of PT is to restore your range of motion and stabilize the knee. Your physical therapist will give you exercises to:
You can complete most of the exercises at home or in the gym.
Due to the physical nature of sports, athletes are 15 times more likely than non-athletes to reinjure their ACL after surgery. About 30% of athletes will reinjure their ACL within 24 months of surgery.
Compared to male athletes, female athletes are:
UPMC ACL Injury Prevention Program helps athletes with ACL injuries get back in the game. The team will work with you to create a treatment plan to prevent reinjuring your ACL.
You may be a candidate for the Return to Play program if you are an athlete who has been treated for a sports injury, completed physical therapy, and is looking for additional support to help you safely and confidently reengage with your sport.
