An anterior cruciate ligament (ACL) injury is a tear in the ACL ligament. The ACL is located in the middle of the knee joint. It connects the lower leg bone to the thigh bone. It stabilizes the knee and prevents the lower leg bone from sliding too far forward at the knee.
Anterior Cruciate Ligament Injury
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ACL injury occurs when your knee gets twisted or during a hard landing from a jump. It can also happen with: Sudden stops or changes in directionSidestepping or pivotingDirect contact
ACL injuries are more common in women. Other factors that increase your chance of ACL injury include: Weak knee structureMuscle strength imbalance between the quadriceps and hamstringsPlaying sports that require sudden changes of direction and decelerationUse of incorrect technique for cutting, planting, pivoting, or jumpingPrevious injury or reconstructive ACL surgery
Symptoms may include: A popping sound at the time of the injuryPain and swelling in the kneeLoss of full range of motionWeakness or instability in the kneeDifficulty walking
You will be asked about your symptoms and how you injured your knee. A physical exam will be done.
Your knee will need to be viewed. This can be done with: X-rayMRI scanArthroscopy
Ligament sprains are graded according to their severity: Grade 1—Mild ligament damage.Grade 2—Partial tearing of the ligament.Grade 3—Complete tearing of the ligament.
Talk with your doctor about the best treatment plan for you. Recovery time ranges depending on the grade of your injury. Treatment steps may include:
The ligament will need time to heal. Supportive care may include: Rest—Activities will need to be restricted. Normal activities will be gradually reintroduced as the injury heals. Ice—Ice therapy may help relieve swelling. Heat may be advised when activities begin to resume. Compression—Compression bandages can provide gentle pressure to help move fluids out of the area. Elevation—Keeping the affected area elevated can help fluids drain out or prevent fluids from building up.
Over-the-counter or prescription medications may be advised to reduce pain.
A physical therapist will assess the ligament. An exercise program will be created to help recovery and to stretch and strengthen the muscles.
Surgery may be needed to fully restore function of the knee. The decision to have surgery should be made after discussion with your doctor about your athletic needs, age, and related factors.
To reduce your chance of injuring the ACL, take these steps: Plyometrics
, a form of jumping exercises, can be used to train and strengthen the leg muscles for jumping and landing.
When jumping and landing or turning and pivoting, your hips and knees should be bent, not straight.Strengthen both the quadriceps and the hamstrings.Maintain proper technique when exercising or playing sports.
Anterior cruciate ligament injuries. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=A00549. Updated March 2014. Accessed February 29, 2016.
Anterior cruciate ligament injuries: treatment and rehabilitation. Encyclopedia of Sports Medicine and Science website. Available at:
http://sportsci.org/encyc/aclinj/aclinj.html. Updated April 18, 1998. Accessed February 29, 2016.
ACL Injury: Does It Require Surgery? American Academy of Orthopaedic Surgeons website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=A00297. Updated September 2009. Accessed February 29, 2016.
Griffin LY, Agel J, et al.
Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies.
J Am Acad Orthop Surg.
Knee sprains and meniscal injuries. Merck Manual for Health Care Professionals. Available at:
http://www.merckmanuals.com/professional/injuries_poisoning/fractures_dislocations_and_sprains/knee_sprains_and_meniscal_injuries.html. Updated December 2014. Accessed February 29, 2016.
Ligament injuries to the knee. John Hopkins Medicine website. Available at.
http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/orthopaedic_disorders/ligament_injuries_to_the_knee_85,P00926. Accessed February 29, 2016.
Last reviewed February 2016 by Teresa Briedwell, PT, DPT
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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