ACL Injuries and Treatments

An overview of the anterior cruciate ligament, or ACL.

Some of the most common injuries we see in Sports Medicine are sprains or tears to the anterior cruciate ligament, or ACL.

What is the ACL?

The anterior cruciate ligament is one of four ligaments found in the knee and is crucial in many pivoting and jumping sports. The ACL prevents the shin from slipping toward the thigh bone, and provides rotational stability to the knee. An ACL injury means the major support system in the knee is no longer functioning.

Injuries to the ACL

When the ACL tears, the athlete usually hears a pop and senses a looseness in the knee. Pain may not be felt immediately, but swelling often becomes apparent within the first few hours following the injury.

Most ACL tears occur without physical contact. Usually, a tear occurs when the knee twists or suddenly straightens while body weight is on the leg. Other common causes of ACL tear can include:

  • Rapid direction change
  • Sudden stops in motion
  • Slowing down while running
  • An incorrect landing from a jump
  • Direct contact or collision, like a tackle in football


Often, surgery is required to regain knee stability. Complete tears must be surgically reconstructed to avoid further injury. ACL reconstruction is typically performed as outpatient surgery, and the athlete usually begins physical therapy a few days after surgery. Recovery from an ACL reconstruction surgery can take anywhere between six and 12 months including therapy and training.

Physical therapy is an important step in rehabilitation for an ACL injury. While rare, loss of motion can occur after ACL reconstruction surgery. Some patients may require pre-op physical therapy to help with swelling and range of motion restoration. We also recommend several weeks of post-op therapy.

Patients typically return to school or sedentary jobs in one week. However, heavy labor occupations will most likely require two to four months of recovery. Remember, each patient is different and progresses with their recovery at varying rates.

Before returning to sports activities, Nebraska Orthopaedic Hospital recommends athletes complete the Functional Athletic Sport Testing (F.A.S.T.) program. The F.A.S.T. program was designed to assess an athlete’s readiness to return to higher level activities like running, agility activities, jumping, hopping and cutting. This program allows the entire care team, including the surgeon, physical therapists and general practitioners to work together to monitor a patient’s progress.

To learn more about ACL injuries or Nebraska Orthopaedic Hospital’s sports medicine program, visit

Dr. Ryan Arnold is a Board Certified orthopaedic surgeon specializing in Sports Medicine and Cartilage Reconstruction. He has extensive experience in ACL reconstruction and ACL revision, multi-ligament reconstruction, meniscal repair, and patella dislocations and stabilization procedure. In addition to clinic hours, Dr. Arnold serves as Team Physician for several Omaha area sports teams, including the University of Nebraska – Omaha Mavericks, Omaha Lancers Hockey Team and Omaha Beef Indoor Football Team.

ACL Injuries and Treatments

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