ACL Tear or Injury

The ACL is one of the four major ligaments in the knee. Ligaments are strong bands of tissue that connect bones and help stabilize joints. The ACL connects the thigh bone (femur) to the shin bone (tibia) and helps control the knee’s forward movement and rotation. When the ACL is injured, the knee can feel unstable or give out during activity. 

Types of ACL injuries: Sprains and tears

ACL injuries are classified as sprains or tears, and they are graded based on severity: 

• Grade 1 (mild sprain): The ligament is stretched but not torn. 
• Grade 2 (partial tear): The ligament is stretched and partially torn. 
• Grade 3 (complete tear): The ligament is torn in half or pulled away from the bone. 

What causes ACL tears? 

ACL injuries often happen during sports that involve sudden stops, jumps or quick changes in direction—like soccer, basketball, football, gymnastics or lacrosse. 

• Teen athletes have the highest rate of ACL injuries. 
• Female athletes are more likely to tear their ACL than males. 
• ACL tears can also happen from falls or twisting the knee during daily activities or work. 

Some people feel a sudden, sharp pain, while others have only mild discomfort. Common symptoms include: 

• A popping sound or feeling in the knee 
• Swelling within a few hours 
• Pain and tenderness along the joint 
• Difficulty walking or bearing weight 
• Loss of full range of motion 

If you think you’ve torn your ACL: 

1. Stop using the injured leg. 
2. Elevate it. 
3. Apply ice. 
4. Take over-the-counter pain relievers like ibuprofen. 

Make an appointment with a sports medicine or orthopedic specialist. Your provider will ask about your injury and examine your knee for signs of instability. They may order: 

• X-rays to rule out broken bones. 
• MRI scans to check the extent of ligament or soft tissue damage. 

Initial care usually includes rest, ice and sometimes a brace to stabilize the knee. Physical therapy may be recommended to improve range of motion and reduce swelling. 

Next steps depend on your lifestyle and goals: 

• Non-surgical treatment: If you’re not very active or are willing to avoid sports or high-impact activities, physical therapy and bracing may be enough. 
• Surgical treatment: If you want to return to sports or if your knee feels unstable, reconstructive surgery is often recommended. 

ACL reconstruction typically uses tissue from your own body (autograft), such as a portion of the patellar tendon, quadriceps or hamstring. In some cases, donor tissue (allograft) may be used, but this is less effective in younger or highly active people. 

After surgery, you’ll likely wear a knee brace and use crutches for about 3 to 4 weeks. Physical therapy usually begins soon after surgery to reduce swelling and restore movement. 

Your recovery timeline: 

• Most people take at least 6 months to heal. 
• Return to full activity and sports typically takes 8 to 9 months. 
• A knee brace may be recommended for up to 1 to 2 years during high-impact activities. 

Following your care team’s instructions and staying active in your rehab are key to a full recovery. 

Can an ACL tear come back?

The risk of tearing the new graft is low - about 5%. Staying fit, strengthening your muscles and following your rehab plan can help reduce the risk of reinjury. Factors like age, activity level and graft type also affect your risk. 

You can lower your risk of an ACL injury with the following strategies: 

• Strengthen your legs: Focus on the quadriceps, hamstrings and glutes. 
• Improve balance and flexibility: Stretch and do exercises that improve control and stability. 
• Use proper technique: Learn how to land from jumps and pivot safely. 
• Warm up and cool down: This helps your body prepare for movement and recover afterward. 
• Build up slowly: Don’t go from zero to full speed—gradually increase your workout intensity. 
• Listen to your body: Rest when needed and avoid pushing through pain. 

We’ll help you create the right plan to meet your athletic and fitness goals. 

An ACL tear can feel like a setback—but we’re here to help you move forward. Banner Health offers: 

• Expert orthopedic and sports medicine providers 
• Personalized treatment plans and support 
• Advanced surgical and non-surgical options 
• Physical therapy and rehab to help you return safely