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ACL stands for Anterior Cruciate Ligament. It is a key ligament in the knee. The ACL runs diagonally in the middle of the knee. It helps keep the tibia from sliding forward and provides rotational support in the knee. ACL is commonly known since injuries to this area of the knee happen in many beloved sports.

Mechanism of Injury

ACL tears mostly occur in sports where there are sudden stops and changes in direction, such as basketball, volleyball, and football. ACL tears are more likely to happen in females than in males. Although, we do not know the exact reason why this is, some researchers believe it is due to differences in training, muscle balance, and neuromuscular control. Others believe it is due to anatomical differences like the size of the pelvis or the ligaments being weaker due to high levels of estrogen. It is important to remember that about half of all ACL injuries occur with damage to other structures like the meniscus and other ligaments. Partial tears are rare in the ACL, most tears are either full tears or almost full tears.


At the time of injury, it is common to hear a “popping” sound in the knee. Patients with ACL tears will also experience pain with swelling within 24 hours. They will also experience a loss in their range of motion as well as discomfort while walking. There will also be pain in the joint line and a feeling of the knee “giving out”.


If a patient has a full ACL tear, they will have surgery to fix the injured ligament. After surgery, the patient will begin Physical Therapy. The return to play and normal function can take anywhere between 6-12 months. The recovery time depends on many factors like age, gender, activity level before surgery, and the patient themselves as each patient is unique.

What to expect from Physical Therapy

Physical Therapy will begin post-surgery with regaining range of motion in the knee and focusing on isometric exercises to strengthen muscles that are important for knee stability. The therapist is likely to focus a lot of strengthening on the hamstrings since this group of muscles aid the ACL in preventing forward sliding of the tibia. With time, the patient will transition to harder exercises, slowly working up to sport-specific exercises. Under the therapist and surgeon direction, they will eventually be cleared to go back to normal physical activities. Special braces for the knee are important during this time and the surgeon and therapist will help you know what you need and when to use it. The step of Physical Therapy after an ACL tear is crucial in returning to normal. At Pick PT Physical Therapy our therapist have extensive experience in treating ACL tears. Our clinics are set up specifically for individuals or athletes with ACL tears.