Anterior Cruciate Ligament (ACL) Injuries

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Anterior Cruciate Ligament (ACL) Injuries


Anterior Cruciate Ligament (ACL)

One of the most common knee injuries is anterior cruciate ligament or tear.

The anterior cruciate ligament is the major ligaments in your knee. The athletes who participate in high demand sports are more commonly to injure their anterior cruciate ligaments. Many people feel a “pop” in the knee when an Anterior Cruciate Ligament (ACL) injury occurs. Your knee may swell and become painful to bear the bodyweight

Depending on the severity of your anterior cruciate ligament (ACL) injuries; Treatment includes rest and rehabilitations exercise help you to regain strength and stability. A proper training program helps you to reduce the risk factor of Anterior cruciate ligament (ACL) injury.


Anatomy of ACL

Anterior Cruciate Ligament (ACL)

Three bones combine to form your knee joint

  1. thighbone (femur)
  2. shinbone (tibia)
  3.  the kneecap (patella)

the kneecap (patella) sits in front of the joint to provide protection. These bones are connected by ligaments. There are four primary ligaments in the knee. The ligaments which attached to bones act like strong ropes to hold the bones together and keep your knee stable.


Collateral Ligaments

Collateral ligaments are found on the sides of the knee. The medial collateral ligament is found inside the joint and the lateral collateral ligament is found outside the joint. Medial and Lateral collateral ligaments can control the lateral motion of your knee and brace it against unusual movement.

Cruciate Ligaments

Cruciate Ligaments are found inside the knee joint. Cruciate Ligaments cross each other to form (X) shape. The anterior cruciate ligament is found anteriorly and the posterior cruciate ligament is found posteriorly. Cruciate ligaments can control the back and forth motion of your knee.

The anterior cruciate ligament runs crossways in the middle of the knee. It prevents the tibia bone from sliding out and provides rotational stability to the knee.


Types of ACL injury

Anterior Cruciate Ligament (ACL)

The tearing of the ligament is called a sprain. An injured sprain is divided into grades based on severity. An ACL injury is divided into three grades.

Grade I Sprain

  • In grade, I fibers of the ligament are stretched but there is no tear.
  • Little tenderness and swelling are found.
  • There is a firm end feel
  • Ligaments are slightly stretched but still provides adequate stability to the knee joint.

Grade II Sprain

  • Fibers of ligaments are partially torn or incomplete torn with hemorrhage.
  • Little tenderness and moderate swelling.
  • Joint feel unstable.
  • There is still a firm endpoint.

Grade III Sprain

  • Fibers of ligaments are completely torn(ruptured).
  • There is tenderness but limited pain.
  • There may be a little swelling or a lot of swelling.
  • Ligaments cannot control knee movements.
  • No endpoint is evident.

ACL injury symptoms

Symptoms of an ACL injury usually include:

  • A loud (pop) sensation in the knee.
  • Severe pain and unable to do any activity.
  • Rapid swelling.
  • Loss of range of motion.
  • A feeling of instability. (instability to bear weight on the leg)
  • Tenderness along the joint line.
  • Discomfort while walking.

ACL injury Causes

ACL injuries often occur during fitness and sports activities.

  • Suddenly slow down and changing direction.
  • Pivoting with your foot firmly planted.
  • Landing awkwardly from a jump.
  • Stopping suddenly.
  • Received a direct blow to the knee.

Risk factors

There is several factors that increase your risk of ACL injury.

  • Poor conditioning.
  • Wear footwear that is not fit properly.
  • Playing on the artificial turf surface.
  • Using poorly maintained sports equipment.
  • Participate in these sports, football, basketball, soccer, and gymnastic.


People who experience ACL injury have a higher risk of osteoarthritis in the knee. Arthritis may occur if you have surgery to reconstruct ligaments.

There are multiple factors to influence the risk of arthritis, like the severity of the injury, the presence of related injuries in the knee joint.


Proper training and exercise help you to reduce the risk of ACL injury. Physicians, Physical therapists, athletic trainers, and sports medicine physicians can provide instruction and feedback that can help you to reduce the risk of ACL injury. They include;

  • They performed exercise that strengthens leg muscles (hamstring exercise)
  • They performed an exercise to strengthen the core (including hips, pelvis, and lower abdomen)
  • Some training is performed to improve technique when performing pivoting and cutting movements.



Anterior Cruciate Ligament (ACL)

Treatment is based on the examination, patients’ symptoms, growth plate, type of injury of the ligament, and type of sports activity goals. Learn more about ACL tear treatment.

The young man who is involved in sports activity will require surgery to safely return to sports.

The older man who is not involved in sports will require a quieter lifestyle without surgery.

Nonsurgical Treatment

Nonsurgical treatment is best for those patients who have Grade I sprain. This treatment includes physical therapy, immobilization or bracing and regular activities and sports exercise (rehabilitation exercise).

  • Physical therapy

The physiotherapist starts some rehabilitation programs. Specific exercise is performed to restore function to your knee and strengthen the leg muscles. Patients need this physiotherapy a few days in a week to get your knee back in working order.

  • RICE is the formula used by a Physiotherapist.
  • RICE:
  • Rest,
  • Ice,
  •  Compression (with an elastic bandage),
  •  and Elevation (raising the knee)
  • Bracing

Some doctors may recommend a brace to protect your knee from instability. For more protection doctors given you crutches to put your weight on crutches than the knee. Bracing provide you extra support.

  • Medication

Anti-inflammatory drugs are used to reduce the swelling of the knee and pain. Your doctor may suggest or prescribe something stronger or over-the-counter pain medicine. For intense pain, you can contact your doctor.

Over-the-counter pain medicine such as acetaminophen or ibuprofen (Advil, Mortin)


Surgical Treatment

Surgery is recommended for those who have a grade III sprain. A surgeon will remove the damaged ACL and replace it with a tissue to help a new ligament grow in its place. With the proper Physiotherapy patient who has surgery can play sports again within 9 to 12 months. ACL surgery is 90% successful in restoring knee stability

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