An anterior cruciate ligament (ACL) tear is a common knee injury, often affecting athletes. Your knee may buckle in the moment, and walking may be limited during recovery.

The ACL is a knee ligament that attaches the shinbone to the thigh bone. During certain sudden or twisting moves, it may stretch, partly tear or completely tear.

Two treatments are available, depending on the injury’s severity and your activity level. With either treatment option, walking may be limited for a while.

“Although walking is sometimes possible with a torn ACL, it’s best to seek treatment,” says Stephen Silver, M.D., chief of Sports Medicine at Hackensack University Medical Center. “By resting your knee and following your doctor’s orders, you should avoid further injury.”

How to Tell If You Have an ACL Tear or Injury

Athletes who run, jump and pivot quickly may risk injuring their ACL. Non-athletes may also tear this ligament if they twist their knee while in motion.

Ligaments aren’t designed to stretch, so yours may tear if your knee twists wrong. Your ACL helps stabilize your knee, so walking may be harder after the injury.

“You may have limited range of motion, if you can walk after your injury,” Dr. Silver says. “Many people feel that their knee will buckle, so they don’t try walking. However, after an ACL injury, I encourage straight walking, no pivots or turns, as long as pain and swelling are tolerable.”

Most people who tear their ACL experience some or all of these symptoms:

• A popping noise, which is the sound of the ligament tearing
• Instability, feeling like the knee will give out if you bear weight on it
• Swelling, because burst blood vessels bleed into the joint, making it appear swollen
• Pain, which may arise suddenly and typically increases as the knee swells
• Loss of range of motion, making it hard to move the knee as usual
  
  

What to Do For a Suspected ACL Injury

After you tear your ACL, stay off of your leg, and ice your knee. Also, elevate the injury and wrap your knee (compress it with a bandage).

“Doctors call this RICE – rest, ice, compression and elevation,” Dr. Silver says. “If you begin RICE therapy early, you may minimize the swelling.”

Make an appointment with a doctor to check out your knee. Before your appointment, stay off of your feet, avoiding walking and other activities.

How an ACL Tear is Treated

There are two treatments for ACL tears: Some people have the ligament surgically repaired. Other people wear a knee brace and get physical therapy.

The treatment that your doctor recommends for you will be based on:

• How badly the ACL is injured. Is it stretched but still attached, partially torn or completely torn?
• How active you are. Are you a competitive athlete, a “weekend warrior” or someone who’s more sedentary?
• How old you are. Are you a child, adolescent, young adult or older adult?

“If a child isn’t finished growing yet, doctors often delay ACL surgery,” Dr. Silver says. “That’s because it’s possible to damage a child’s growth plate during an ACL repair.”

If you have surgery, doctors will use a tendon to reconstruct your torn ACL. You’ll need to use crutches at first, limiting your weight-bearing and walking.

Within a week of surgery, you’ll start physical therapy. You’ll gradually be able to walk, and by 3 months, you may jog.

Bracing and physical therapy is less invasive, but it’s not ideal for very active individuals. If you only participate in low-impact exercise, it may be a good solution.

“Talk with your doctor about the pros and cons of surgery versus physical therapy,” Dr. Silver says. “Just keep in mind, if you’re very active and don’t choose surgery, you’re more at risk for re-injuring your knee.”

If your doctor doesn’t recommend surgery:

• Wearing a knee brace when you’re physically active may provide enough support
• Physical therapy should help strengthen your knee muscles, to help you function well
  
  

You may begin walking in your brace within a week of starting physical therapy. Over time, you should be able to walk longer distances, but you shouldn’t run.

Next Steps & Resources:

• Meet our source: Stephen Silver, M.D.
• To make an appointment with Dr. Silver, or a doctor near you, call 800-822-8905 or visit our website. 
• Learn more about our orthopedic care.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.