ACL Injuries and Surgery

This page has been designed to provide you with the right information about anterior cruciate ligament (ACL) injuries.

If you have had, or are planning to have, an ACL surgery (commonly known as an ACL reconstruction), you can jump straight to the right information about this by clicking the link below.

Go to ACL Surgery page

What is an anterior cruciate ligament and what does it do?

The anterior cruciate ligament (ACL) is one of a number of ligaments inside your knee. Its main job is to connect your femur (thigh) to your tibia (shin). It is an extremely strong ligament and works to help stabilise and support your knee with twisting movements and forwards movement of the shin.

How does it get injured?

Injuring an ACL is not an easy thing to do as it is very strong. If you are unfortunate enough to have injured your ACL, it is normally down to a combination of movements coming together, and a force being applied to the knee that will put stress on the ligament and may injure it. As we’ve said, it is not easy to injure your ACL and most injuries are associated with sports like football, rugby or skiing.

What is the best way to manage an ACL injury in the early stages?

Firstly, try not to worry.

Follow the new way of managing acute (early) muscle and joint injuries using the POLICE principle.

This means looking after the injured body part by stopping playing or taking some weight off it.

This means working the body part within what is comfortable. This would include walking on it or moving it as much or as far as is comfortable/ manageable.

Ice can act as a good distraction and therefore is good as pain relief in the early stages of an injury.

Applying a Tubigrip or bandaging the area may help with the swelling in the early stages. It will also reassure you that the body part feels suitably supported.

Gravity can help with fluid drainage and as such can help with swelling, as long as your heel is above the height of your knee.

What are the symptoms of an ACL injury?

The most typical symptoms when someone has injured their ACL is sudden pain, a ‘popping sound’, rapid swelling and difficulty taking weight on the leg. Once the initial symptoms of the injury calm down, often the main complaint becomes a feeling of looseness or wobbliness in the knee, which may cause giving way or the feeling of it.

How is an ACL injury diagnosed?

Normally, a physiotherapist or doctor’s suspicions might be raised about a possible ACL injury by simply asking certain questions. A physical examination where the ACL is tested can help reduce or increase any suspicions about an ACL injury. An MRI is needed to confirm if the ACL has been injured.

Can an ACL recover by itself?

No, unfortunately it cannot.

Can I improve my knee without surgery?

Yes, you can. It is not essential for you to undergo surgery to improve your knee. By working hard on your leg strength with the support of a physiotherapist, you can find that your symptoms can improve. However, if you are looking to return to sport or a job that requires you to move fast, turn or react quickly, it is likely that you may have to consider surgery if the strengthening doesn’t help enough.

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Ok, what should I be doing?

We’ve pulled together a programme of exercises that are often really useful for trying to help you improve your leg strength. These are shown below. Click on the gym programme to download a pre-filled programme for yourself.

When should I start something like this?

Well, it is worth allowing your knee to calm down first, which might take several weeks, but you can consider starting work on your knee as soon as you feel confident.

Exercise tip:

You should aim to complete the exercises (as many or as few as you want to) about 3 to 4 times a week.

Each exercise should be completed between 8-12 times (or repetitions) for 3 to 4 sets. Make sure you have about 1 minute's rest in between each set.

In order to change your muscles, you need to challenge them. In other words, you should really feel the effort with each set of exercises and should really not be able to do more than 12 each time around.