ACL Injury: Management, Treatment and Rehabilitation

If you have ever experienced knee injuries, you probably have an idea of how painful it is. Apart from that, other symptoms include swelling of the affected area and unstable knees. When knee injuries or anterior cruciate ligament injuries occur, there  is a usual sudden sound that can be heard, a popping one.

Most people who suffer anterior cruciate ligament injuries are athletes, particularly those who play sports such as basketball, football or soccer, since these sports demand a lot of running and leg activities. Female athletes are the ones who have a higher probability of acquiring these injuries as opposed to male ones.

Diagnosing ACL

Physical examination is done to ascertain the injury. The doctor will ask questions pertaining to the symptoms you have as well as your medical history. He will also check each of the structures of the affected knee and compares the findings to the non-affected knee. Ligament injuries are commonly diagnosed if a comprehensive physical examination of the knee has been undertaken.

Imaging tests can also be done so that your doctor can verify your diagnosis. X-rays are taken in order to see if a broken bone is also there. However, they will not reveal any anterior cruciate ligament injury. Magnetic resonance imaging (MRI) is also done in order to have a better view of soft tissues such as the anterior cruciate ligament. But, most of the time, an MRI is really not needed to come up with a diagnosis of ACL injury.

Management for ACL Injuries

Based on individual needs, management for ACL injuries can vary from person to person. Treatment for a young athlete who is into agility sports most probably will need surgery so that he can return to sports safely. For those who are not as active, and are older, they may be able to go on with a quieter lifestyle without having to undergo surgery.

Conservative Treatment

Torn ACL needs surgery in order to heal. Yet, nonsurgical treatment can still be effective enough for individuals who are older or do not have a high level of activity. Should the knee stability be discovered to be more or less intact, your doctor can just give you options that are simple and do not involve surgery.

A brace might be recommended by your doctor for protection from knee instability. Crutches may also be included so that you do not have to put weight on the affected leg.

Physical therapy may also be started as soon as the swelling goes away. Certain exercises can help bring back knee function as well as strengthen the muscles of the leg that give it support.

Surgical Treatment

Usually, ACL tears can just be stitched or sutured back together. To fix the ACL via surgery and bring back knee stability, the ligament hast to be reconstructed. Your doctor will put in place of your torn ligament a tissue graft. This will then act as a scaffolding for which a new ligament may develop.

There are various sources for grafts. Most of the time, they are obtained from the patellar tendon. This structure runs between the shinbone and the kneecap. Hamstring tendons, located at the back of the thigh, are also another common graft source. At times, quadriceps tendon is used. This runs from the kneecap right in to the thigh. Lastly, an allograft (a cadaver graft) may be used. Which grafts to use can be discussed with your orthopaedic surgeon to help you decide which one is most suitable for you.

Regrowth usually takes time, therefore, an athlete has to wait around 6 months before he can go back to sports after surgery has been done.


Rehabilitation is very important, regardless of having surgery or not, so that you can resume your regular daily activities. To regain the strength and movement of your knees, a physical therapy program is very helpful.

Physical therapy first concentrates on regaining motion to the joint as well as the surrounding muscles if you ever have surgery. Subsequently, a strengthening program is also good so as to give protection to the new ligament. This helps add to the stress to the ligament diagonally. The last phase of rehabilitation is meant for functional comeback for the sport of the athlete.


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Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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