Dr. Ginsberg: Hello. My name is Dr. Claudia Ginsberg. I am a primary care sports medicine specialist at Tri-County Orthopedics, where I've been practicing since 2003. The ACL is a ligament inside the knee that helps with the rotational stability of the knee. Athletes that are involved in sports that involve quick changes of direction, or sudden decelerations, are at highest risk for ACL tearing.
Most athletes, when they tear their ACL, will experience a sudden pain in their knee while they change direction or decelerate. Some patients will hear a pop. Most patients will have swelling in their knee within a matter of hours.
We diagnose an ACL tear first with a careful history, then with a thorough physical exam. Usually we have a suspicion that the ACL is torn based on certain special physical exam findings. We usually obtain further imaging, like X-rays, and even then, an MRI to further confirm the suspected diagnosis.
MRI will also help us to see if there are other injuries in the knee that are often associated with ACL tears, such as meniscus tears, bone bruises, and even tiny fractures.
Many patients who tear their ACL will elect to have surgery to reconstruct the ligament. This is especially true for athletes that participate in sports that involve a lot of torquing, twisting, and quick changes of direction.
Some patients who are less physically active or who participate in sports that are more linear will choose to not have their ACL reconstructed. When choosing conservative treatments for the ACL, we usually recommend a good program of physical therapy for stretching and strengthening of the lower extremities, as well as a brace to help stabilize the knees during sports.
It's important that one has a careful discussion of both conservative and surgical treatment options with your physician to help make sure you choose the treatment option that's appropriate for you.
There have been a number of recent medical studies that show that it actually is possible to decrease the rate of ACL injuries with a specific exercise program. These programs involve a combination of strength training, flexibility training, and balance training. Some are available on the Web. You can also look into these programs through a local exercise facility or physical therapy facility.
It's important that you discuss with your healthcare provider your specific goals and activities that you enjoy so that together you can make a decision about whether ACL reconstruction is appropriate for you or whether conservative treatments are a reasonable option.