Symptoms of a torn ACL

The anterior cruciate ligament, often called the ACL, is one of the primary stabilising structures in the knee. It connects your thigh bone (femur) to your shinbone (tibia), working together with other ligaments to maintain joint stability during various movements. ACL injuries are one of the most commonly reported kinds of knee injury, occuring in about 1 in every 3000 people.

This guide will delve into the symptoms associated with a torn ACL, offering you valuable information to recognize the signs, understand the injury, explore treatment options, and embark on the road to recovery.

Symptoms of a torn ACL

A torn ACL can lead to a range of symptoms that can vary in intensity depending on the severity of the injury. Recognising the symptoms of an ACL injury is crucial for seeking timely medical attention and appropriate treatment. Here are some common symptoms associated with a torn ACL.

Sharp and sudden pain

One of the most noticeable symptoms of a torn ACL is a sharp and sudden pain in the knee at the time of injury. This pain can be intense and may make it difficult to continue the activity. Some people report hearing a popping sound at the moment the ACL tears.

Swelling and inflammation

After the injury occurs, the knee joint may quickly swell due to inflammation. Swelling can be substantial, causing the knee to feel puffy and stiff. This accumulation of fluid is a response to the trauma and is an early sign of a potential ACL tear.

Instability and buckling

An ACL tear can lead to instability in the knee joint. Some people may feel as if the knee is giving way or buckling under them, especially when attempting to put weight on the affected leg. This instability can make walking, running and other activities challenging.

Limited range of motion

Torn ACLs can restrict the normal range of motion in the knee. You might find it difficult to fully extend or flex your knee, and attempting to do so could result in discomfort. Activities that involve bending the knee, like squatting or climbing stairs, might also be limited.

Difficulty bearing weight

Due to the instability and pain caused by a torn ACL, people often experience difficulty bearing weight on the affected leg. This can significantly impact mobility and day-to-day activities. Walking or standing may be uncomfortable or painful.

Bruising

In some cases, bruising can develop around the knee joint following a torn ACL. The bruising might appear several hours or days after the injury and is usually a result of blood vessels being damaged during the trauma.

Inability to return to activity

If you've torn your ACL, you might find it nearly impossible to resume the activity during which the injury occurred. Sports or physical activities that involve quick changes in direction, pivoting, or jumping may be particularly challenging. This means ACL injuries are particularly problematic for golfers, footballers and tennis players.

Progressive discomfort

While some symptoms of a torn ACL can be immediate and intense, others might develop more gradually. Some people may initially experience mild discomfort that worsens over time, especially if the injury isn't promptly diagnosed and treated.

Muscle weakness

Muscle weakness around the knee joint is common following a torn ACL. The quadriceps and hamstring muscles, which play a significant role in knee stability, can become weaker due to limited use and protective guarding.

Associated injuries

A torn ACL might occur in conjunction with other knee injuries. For example, damage to the medial collateral ligament (MCL) or meniscus can accompany an ACL tear. These additional injuries can contribute to a more complex clinical picture and require comprehensive evaluation.

Common causes of ACL injuries

Torn ACLs can result from various activities and situations that place excessive stress on the knee joint. Understanding the common causes can help you take preventive measures and reduce the risk of injury. Here are some scenarios that can lead to an ACL tear:

Sudden changes in direction

Abrupt changes in movement, such as pivoting, cutting, or quickly changing direction while running, can stress the ACL. These movements are common in sports like football, basketball, and tennis.

Non-contact twisting

Twisting your knee while your foot is firmly planted on the ground can cause the ACL to tear. This can occur when making a sudden turn or landing from a jump.

Deceleration and stopping

Coming to a sudden stop or decelerating rapidly while moving can strain the ACL. This often happens during sports that involve quick stops, such as skiing or downhill running.

Direct impact

A forceful impact or collision to the knee, especially from the front or the side, can lead to an ACL tear. Such impacts can occur during contact sports like football or rugby.

Landing incorrectly

Landing awkwardly after a jump, especially with your knee extended and foot planted unevenly, can stress the ACL. This is common in sports that require jumping and landing, like gymnastics and volleyball.

Hyperextension

Overextending the knee joint, which means straightening it beyond its natural range of motion, can put strain on the ACL. Hyperextension can occur during various activities, including falling or missteps.

Lack of proper conditioning

Inadequate conditioning of the muscles around the knee joint can lead to decreased stability and increase the risk of ACL injuries. Weak muscles are less effective at supporting the joint during sudden movements.

Previous ACL injuries

If you have previously torn your ACL and have not fully recovered or rehabilitated, you may be more prone to tear your ACL again. A recent study of college athletes in the United States found that of all reported ACL injuries, 11% were recurrent.

By being aware of the common causes and risk factors associated with ACL injuries, you can make informed decisions about your physical activities and take steps to protect your knee health.

An orthopaedic consultant or physiotherapist can provide you with personalised guidance on injury prevention and maintaining the wellbeing of your knee joint.

Diagnosing a torn ACL

Diagnosing whether your ACL is torn requires a careful assessment to determine the extent of the injury. Orthopaedic consultants employ various techniques to accurately diagnose this common knee injury. By understanding the diagnostic process, you can gain insights into your condition and make informed decisions about treatment.

Physical examination

During the physical examination, your consultant will assess your knee's range of motion, stability, and overall condition. They may perform specific tests that help determine the integrity of your ACL.

Imaging tests

An MRI (magnetic resonance imaging) scan is a valuable tool for diagnosing a torn ACL. It provides detailed images of the soft tissues within the knee joint, allowing the physician to visualise the extent of the injury.

Treatment options for a torn ACL

The severity of the ACL injury and your overall health will influence the treatment plan recommended by your healthcare provider. Here are some common approaches:

Non-surgical treatment

• Rest and rehabilitation: For partial tears or less severe injuries, rest, ice, compression, and elevation (RICE) can help reduce swelling and pain. Physiotherapy with a trained physiotherapist is essential to regain strength, stability, and range of motion in your knee
• Bracing: Wearing a knee brace can provide support and stability to the injured knee during the healing process. Your healthcare provider may recommend a specific type of brace based on the severity of the tear

Surgical treatment

• ACL reconstruction: For a complete tear, surgical intervention is often required, especially for people who wish to return to high-demand activities. During ACL surgery, the torn ligament is replaced with a graft, usually taken from the patient's own hamstring or patellar tendon or from a donor
• Rehabilitation post-surgery: After ACL reconstruction, a thorough rehabilitation program guided by a physiotherapist is crucial. The program focuses on regaining strength, flexibility, and stability while gradually reintroducing weight-bearing activities

Recovering from a torn ACL

Recovery from a torn ACL involves a combination of rest, rehabilitation, and patience. The timeline for recovery varies, but it's important to follow your consultant and physiotherapist’s recommendations to ensure a successful outcome. A thorough rehabilitation program can significantly impact your recovery and help prevent future injuries.

• Recovery advice for footballers after ACL surgery

Preventing future ACL injuries

Once you've experienced a torn ACL, you may become more susceptible to future injuries. Here are some preventive measures to consider:

• Proper conditioning: Engage in targeted exercises that improve the strength and stability of the muscles around your knee joint. This can help reduce the risk of ACL injuries during physical activities
• Technique training: If you participate in sports that involve sudden movements and changes in direction, proper technique and form are crucial. Work with a coach to refine your movements and reduce unnecessary strain on your knees

Recognising the symptoms of a torn ACL is essential for seeking timely medical attention and beginning the journey towards recovery. Whether you opt for non-surgical methods or undergo ACL reconstruction surgery, remember that rehabilitation and patience play vital roles in your healing process. Prioritise your knee health, and consult a healthcare professional for personalised guidance on managing a torn ACL effectively.

Call us or book online to speak to one of our orthopaedic consultants if you think you’ve torn your ACL, and discuss whether one of our treatment and management options is right for you.