The anterior cruciate ligament or ACL plays a critical role in the strength and stability of the knee. Chances are you’ve heard of a professional athlete or two who has suffered an ACL tear and needed reconstructive surgery before they could get back on the field to play at full strength.

Though for the average person who doesn’t have a highly trained and experienced sports medicine specialist waiting on the sidelines trying to determine the extent of an ACL tear can be a little more challenging. Especially in the case of a partial ACL tear which might not offer up such severe and overt symptoms.

If you have recently suffered a knee injury and you are trying to determine the best course of action, it might help to take a look at the ACL and some of the more common symptoms of a problem. If anything it will help you better understand your treatment options and whether or not surgery is required.

What Is The ACL?

The ACL is the largest ligament in your knee. It plays a critical role in connecting the upper thigh bone, (Femur) to the lower leg bones. This large ligament helps stabilize the knee, while also helping transfer the force of walking from the lower extremities to the pelvis. When the ACL is damaged it can cause severe knee instability that can cause increased strain and damage to the surrounding ligaments, tendons, muscles, and related connective tissues.

What Are Common Causes Of An ACL Tear?

The anterior cruciate ligament transfers a significant amount of force between the lower and upper legs. While it is very strong some things can partially or completely tear the ACL. It is most often related to sports or suffering an awkward fall. Some of the more common movements that can cause an ACL tear include:

  • Suddenly slowing down and changing direction
  • Pivoting your body with your foot firmly planted
  • Landing awkwardly from a jump
  • Landing awkwardly from an accidental fall
  • Stopping suddenly

What Are The Symptoms Of An ACL Tear?

The anterior cruciate ligament holds a lot of tension and transfers a lot of force. This also means that when it is partially or completely torn the symptoms are often pronounced. This includes things like:

  • A loud pop or popping sensation in your knee
  • Severe pain
  • The inability to walk without pain
  • Rapid swelling
  • Significant decrease in the range of motion
  • A feeling of instability when trying to bear weight

How Is An ACL Tear Diagnosed?

Early diagnosis of an ACL injury is important. Pain and swelling can make later diagnoses unnecessarily uncomfortable and can delay the treatment process.

The Lachman test tends to be the most accurate test for detecting an ACL tear. This starts with a physician performing a mechanical exam to assess discomfort and range of motion while also assessing the stability of the joint. This might also indicate potential injury to other ligaments or other structures of the knee.

At that point, your physician will likely refer you for an MRI. This magnetic resonance test allows the physician to closely examine the internal structure of the ACL and surrounding structures to develop a customized treatment plan. This could reveal a sprain, strain, a partial or complete tear of the ACL.

Can A Torn ACL Heal On Its Own?

A complete tear of the ACL cannot heal on its own. A partial tear of the ACL might be addressed with physical therapy and might be the preferred treatment plan if the tear is minor and you are not an athlete or your career doesn’t involve a lot of physical labor.

How Is A Partial ACL Tear Treated?

In the case of a minor ACL tear, it might be possible for rest and an extensive course of physical therapy might be sufficient for restoring a fully functional level of strength and structural integrity to the injured ACL. This might also include anti-inflammatory medications and prescription pain medications to facilitate the rehabilitation process.

In the case of a more significant tear or a complete tear of the ACL may require surgical intervention. In many of these cases, a total ACL reconstruction is called for. This is even more likely to be the case if other structures or ligaments were also injured when the ACL was torn.

How Is An ACL Tear Treated?

Surgical treatment for a significant or complete tear of the ACL is typically scheduled after the swelling has gone down in the affected surrounding tissues. The surgical reconstruction typically calls for full sedation and it usually requires an overnight stay in a hospital for observation.

The ACL reconstruction procedure involves completely removing the remnants of the torn ligament and replacing it with a band of tissue that will connect muscle to bone. The grafted tendon can be taken from another part of your knee or it can be sampled from a cadaver, deceased donor.

If other structures in the knee or other ligaments have been injured, they can also be addressed during the same procedure.

How Long Does It Take To Heal After A Total ACL Reconstruction?

The rehabilitation and healing process after an ACL reconstruction can be a lengthy one. Especially if you are an athlete or you have a labor-intensive career. Physical therapy starts early and can take 6 to 9 months or longer before you are fully cleared to full activity.

Most people start to walk unassisted within 2 to 4 weeks after the ACL reconstruction surgery. Though this is only for short periods of time. Around 10 to 12 weeks your physical therapist will clear you for brisk walking, which will gradually work up to light jogging. This phase usually involves increased plyometric exercise to boost the overall strength of the reconstructed ACL as well as improve the range of motion.

Complete recovery after ACL reconstruction usually takes 6 to 12 months. A longer timetable might be needed for athletes or individuals who have labor-intensive jobs. Your physical therapist will be able to guide you through the process.