ACL (Anterior cruciate ligament) Injury

One of the most common ways people hurt their knees is by injuring their ACL (anterior cruciate ligament). This is one of the bands of tissue that holds the bones together within your Knee. It also helps to keep your Knee stable. You can stretch or tear your ACL if you make a sudden movement or quick, sharp turn when you’re running  or jumping. It’s often painful, and can make it hard to walk or put pressure on the injured leg.


Many people hear a popping noise in their knee when they get hurt. But it doesn’t happen to everyone. More common symptoms include:

Pain: If you have a minor injury, you may not feel pain. You may feel sore along your knee’s joint line. Some people have trouble standing or putting pressure on the hurt leg.

Swelling: This is most likely to happen during the first 24 hours. You can reduce swelling by putting ice on your knee and elevating (raising) your leg by propping it up on a pillow.

Trouble Walking: If you’re able to put pressure on your hurt leg, you may notice that it’s harder than normal to walk. Some people find that the knee joint feels looser than it should.

Less range of motion:  After you damage your ACL, it’s very likely that you won’t be able to bend and flex your knee like you normally would.


Ligaments are strong bands of tissue that connect one bone to another. The ACL, one of two ligaments that cross in the middle of the knee, connects your thighbone to your shinbone and helps stabilize your knee joint.

ACL injuries often happen during sports and fitness activities that can put stress on the knee:

  • Suddenly slowing down and changing direction (cutting)
  • Pivoting with your foot firmly planted
  • Landing awkwardly from a jump
  • Stopping suddenly
  • Receiving a direct blow to the knee or having a collision, such as a football tackle

When the ligament is damaged, there is usually a partial or complete tear of the tissue. A mild injury may stretch the ligament but leave it intact.

Grades of Injury:

An ACL injury is classified as a grade I, II, or III sprain.

Grade I Sprain

    • The fibers of the ligament are stretched, but there is no tear.
    • There is a little tenderness and swelling.
    • The knee does not feel unstable or give out during activity.
    • No increased laxity and there is a firm end feel.

Grade II Sprain

    • The fibers of the ligament are partially torn or incomplete tear with hemorrhage.
    • There is a little tenderness and moderate swelling with some loss of function.
    • The joint may feel unstable or give out during activity.
    • Increased anterior translation yet there is still a firm end point.
    • Painful and pain increase with Lachman’s and anterior drawer stress tests.

Grade III Sprain

    • The fibers of the ligament are completely torn (ruptured); the ligament itself is torn completely into two parts.
    • There is tenderness, but limited pain, especially when compared to the seriousness of the injury.
    • There may be a little swelling or a lot of swelling.
    • The ligament cannot control knee movements. The knee feels unstable or gives out at certain times.
    • There is also rotational instability as indicated by a positive pivot shift test.
    • No end point is evident.
    • Haemarthrosis occurs within 1-2 hours.

An ACL avulsion occurs when the ACL is torn away from either the femur or the tibia. This type of injury is more common in children than adults. The term anterior cruciate deficient knee refers to a grade III sprain in which there is a complete tear of the ACL. It is generally accepted that a torn ACL will not heal.

Radiological Diagnosis: After complete Physical examination or Physical test we can also doing X-ray, Ultra sonogram and MRI for confirmation.  


It depends on how badly you’ve been hurt. Here are some of the options your doctor may give you:

 First aid:If your injury is minor, you may only need to put ice on your knee, elevate your leg, and stay off your feet for a while. You can reduce swelling by wrapping an ace bandage around your knee. Crutches can help to keep weight off your knee.

 Medication: Anti-inflammatory drugs can help to reduce swelling and pain. Your doctor may suggest over-the-counter medications or prescribe something stronger. For intense pain, your doctor may inject your knee with steroid medication.

Knee Brace: Some people with a damaged ACL can get by with wearing a brace on their knee when they run or play sports. It provides extra support.

Physical Therapy: For Physical Therapy you should consult with your Physiotherapist. He/She will decide your Physiotherapy according to assessment.

Surgery: Your doctor may tell you that you need this if your ACL is torn badly, if your knee gives way when you’re walking, or if you’re an athlete. A surgeon will remove the damaged ACL and replace it with tissue to help a new ligament grow in its place. With physical therapy, people who have surgery can often play sports again within 12 months.

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