Anterior Cruciate Ligament Tears

 The problem

• The ACL is the stabilising ligament of the knee, and acts to prevent buckling of the knee
• The mechanism of injury is usually from a pivoting action on a grounded foot, usually during sport
• Injury can be as a partial or total rupture and management may change according to degree of damage
• When the ACL is completely torn, surgery is a strong possibility to reconstruct the ligament

Interesting facts

• A ‘pop’ or ‘crack’ sound is often heard during injury
• Usually there is initial pain, although with a complete tear the pain subsides quickly (within minutes) but the knee often feels ‘unstable’, and may give way
• Often ACL injuries can occur in combination with injuries to other structures such as the medial collateral ligament or medial meniscus

What you can expect/look out for

• Immediate swelling and bruising of the knee
• The knee will feel ‘unstable’ and may buckle or give way on you

Hints for self management

• Initial injury management is as for most soft-tissue injuries;
• Rest and immobilise, use crutches to assist with walking
• Ice for 20 minutes every 2-3 hours for the first 3 days
• Compress the area to manage swelling, with a bandage or tight leggings
• Elevation, as able, lying on your back with leg elevated
• Seek diagnosis by seeing your GP or visiting one of the experts at Sydney Sports & Orthopaedic Physiotherapy, and the decision to confirm with imaging such as MRI may be made at that time

Management options 

• ACL tears require review by an Orthopaedic Surgeon
• The surgeon will discuss with you both conservative and surgical options
• With a partial tear or in an individual who does not play high-level sports, it may be decided to manage the knee non-surgically with physiotherapy and exercises – you will want to seek an expert knee physio to guide you through this process
• A full tear may be managed with a surgical reconstruction, using a patellar tendon or hamstrings graft, or more recently with a synthetic ligament (LARS) 

More information

• A knee reconstruction will mean time away from sport and significant rehabilitation
• Return to sport in most cases is after 6 months 

At Sydney Sports and Orthopaedic Physiotherapy our highly qualified physiotherapists specialise in the assessment, treatment and prevention of neuromusculoskeletal injuries.

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This handout was prepared by Sydney Sports and Orthopaedic Physiotherapy and is intended as a general information service. Please note that the information provided is not intended as a substitute for advice from a registered physician or healthcare professional. If symptoms persist, please consult your doctor.