The first step after sustaining an ACL injury is to have a physical examination. During the exam, the orthopedic surgeon will discuss the injury and your symptoms with you. Additionally, they will ask about your sport, previous knee injuries, and medical history. During the examination of the ACL, the physician will also examine the structures surrounding the knee, such as the MCL, since injuries to the other structures are common. Your physician will order x-rays and run tests in order to fully understand the injury.

Immediately following the injury, it's important to reduce swelling and control pain. You can do this by resting, icing, compressing, and elevating the area. In addition, your surgeon may also recommend Acetaminophen (Tylenol) or an anti-inflammatory like Ibuprofen (Motrin or Advil) or Naproxen (Aleve). Once the swelling has decreased, you should begin moving the knee. In order to prepare for surgery, it is essential to try to regain motion (especially extension or straightening). 

An ACL that is completely torn cannot be healed without surgery. Some ACL tears are partial tears, meaning that a part remains intact. In these cases, surgery may not be necessary. Usually, a brace is worn, and the patient receives physical therapy to regain movement and strength.

Most ACL injuries require surgery. Surgery is performed through small incisions or "portals" using an arthroscope (a small camera). The surgeon will also examine other structures inside the knee. In the event of a meniscus tear, the damaged segment may need to be repaired or "cleaned up" by trimming. Then, the torn ACL is “reconstructed” or replaced. A graft will be used to reconstruct the torn ligament. The graft is inserted into tunnels or sockets drilled in the bone where the ACL normally runs and then "fixed" with screws or metal buttons.

Post-surgery, your surgeon may recommend crutches or a brace immediately. Next, physical therapy (PT) begins. This is where we come into play! PT aims to reduce swelling, regain range of motion and flexibility, strengthen the muscles around the knee, improve balance, and ultimately prevent further injury. During the final phase of rehabilitation, patients are often given exercises that simulate their sport. An athlete is usually able to return to sport in about 8-12 months. A number of tests will be required before you're released by your surgeon and PT. Balance, strength, and range of motion will all be assessed during these tests.