Physical therapy can help in prevention and rehabilitation of ACL injuries

Knee injuries to the anterior cruciate ligament (ACL) is unfortunately common during sports activities. The ACL is a thick band of tissue in the center of the knee joint that connects the backside of your thigh bone (femur) to the front of the shin bone (tibia).

The main purpose of the ACL is to prevent the tibia from moving too far forward under the femur and to stabilize the knee during twisting movements. If the tibia moves too far forward, the ACL can be strained and/or ruptured.

When an ACL injury occurs you may feel the knee give way and hear a loud “pop.” Swelling occurs shortly after injury due to damaged blood vessels. Later symptoms include feeling unstable (knee buckling) and difficulty with tasks like walking downhill, quick stopping and pivoting.

Pain typically subsides in two-to-four weeks, but instability remains which is what prompts people to seek physical therapy.

ACL injuries can occur in any sport that involves planting and pivoting. An injury to the ACL is typically caused by a non-contact injury, such as a sudden deceleration, pivoting with the foot planted or hyperextending the knee. Some ACL injuries are due to contact, such as a forceful blow to the outside of the knee when your foot is on the ground.

Initial conservative treatment for an ACL injury includes strategies to decrease pain, reduce swelling and regain normal joint range of motion.

Rehabilitation then progresses to strengthening the hamstrings and quadriceps in addition to strengthening the abdominal and hip muscles in all directions.

Returning to the sport can typically take around eight weeks in non-operative cases. If you require surgery to repair your ACL, post-surgical treatment typically takes up to four-to-six months and return to the field on a competitive level can take up to one year. A brace is often recommended for at least one year after surgical reconstruction to protect the knee joint.

Research shows females are at a higher risk for ACL tears than males. Studies indicate differences in control of hip muscles, core strength and leg strength as factors that put someone at risk for injury.

Injury prevention screening is warranted to identify athletes at risk for injury and to optimize core control, functional strength, speed and agility. An ounce of prevention is worth a pound of cure when it comes to preventing ACL injury.

The number one risk factor for an ACL tear is previous injury to the area. It is crucial to identify and properly treat all elements contributing to risk for ACL injury. The earlier you screen for risk factors and the earlier you seek care when injury occurs the better your long-term outcomes will be.

Long-term instability can lead to abnormal wear and tear on the knee and cause early arthritis. So if you’re feeling symptoms of instability or have experienced an injury to the ACL, contact your local physical therapist for a thorough examination.

Maximizing motor control and strength patterns throughout your core and legs will ensure you perform at your best for years to come.

Article by Jenna Stones, DPT. Jenna is a physical therapist and movement specialist at CORE Strategies Physical Therapy, Sport Performance & Medical Fitness in Overland Park.  The CORE team specializes in rehabilitation and performance training for clients of all ages and activity levels.  To learn more about CORE’s sport specific programs visit  Contact Jenna at

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