If you asked every person this question, it would likely get a massive variation in answers: How painful is an ACL tear?

Well, the facts are in.

An ACL tear is a common injury that causes agonizing pain, swelling, and difficulty bearing weight on the affected leg.

The good news is that a full recovery is likely with correct diagnosis and treatment.

How painful is an ACL tear?

In this article we’ll explore the symptoms of ACL tears, methods for diagnosis, treatment options for an ACL tear and risk factors associated with the injury.

Lastly, I’ll provide tips where I can from my experience of tearing both ACLs in my knees – which will hopefully help you if you’re recovering from an ACL injury right now.

What is an ACL tear?

An ACL tear is a well-known knee injury that can be extremely painful and debilitating.

It’s most anticipated to see ACL tears in athletes and sportspeople.

ACL tears occur when the knee joint’s anterior cruciate ligament (ACL) either partially tears or rips in half. 

The ACL is one of four main ligaments that provide stability to the knee, running diagonally across the center of the knee joint connecting the thigh bone to the shinbone.

When the ACL tears, either fully or partially, it causes sharp, intense pain, swelling, instability, and difficulty standing on the injured leg.

ACL tears range in severity from mild to severe.

To explain this further – a complete tear of the ACL ligament is called ‘severe,’ whereby a minor tear on the surface of the ligament (meaning the ligament remains intact) is what we’d call a ‘mild’ tear.

It’s down to the healthcare team to ‘grade’ the ACL injury to provide appropriate treatment.


Symptoms & Diagnosis of an ACL tear

A typical sign of an ACL tear is a ‘popping sound’ when you change direction or suddenly stop while playing sports or other activities such as running, jumping, or pivoting.

Other symptoms include intense pain throughout your lower leg and instability in the knee joint.

There may too be rapid swelling around your knee joint and signs of bruising, perhaps with skin discoloration.

Healthcare providers should perform a physical examination and additional tests, such as magnetic resonance imaging (MRI) and ultrasound imaging, to accurately diagnose an ACL tear, helping plan for optimized treatment and recovery.

Treatment Options

Depending on the mechanism and type of injury, treatment options differ.

You may require conservative treatment for a milder ACL injury in milder cases.

Treatments that come under the conservative approach include:

  • Rest
  • Knee brace
  • Ice therapy
  • Physical therapy
  • Stretching
  • Leg bandages and casts

The other end of the extreme in the case of a more serious (severe) ACL tear (meaning a complete rip of the ACL), may include an “ACL Reconstruction.’

A reconstruction involves making small incisions to replace the torn ligament with fresh tissue from another body part, such as your patellar tendon or hamstring tendon.

These treatment types are two ends of a spectrum, and in truth, most ACL injuries are treatable somewhere in the middle, by combining surgery and physical therapy as an example.

With either option, ensure you seek out experience from an orthopedic surgeon specializing in sports medicine and/or a physical therapist with experience working with athletes.

This is so you can get back on track quickly and maximize quality-of-life outcomes post-injury.

Risk factors for ACL tears

An ACL tear is a widespread knee injury. However, certain people may be more susceptible to it than others.

Risk factors for an ACL tear include age, BMI, previous history of ACL injury, weak hip muscles, decreased flexibility, and contact sports or activities with rapid changes in direction or high-impact movements.

Also, ill-fitting shoes with inadequate ankle support could contribute to leg instability, increasing the risk of an ACL tear.

Therefore, reducing the probability of suffering from an ACL tear is critical.

Try and take preventative measures – such as engaging in exercises targeting your gluteal and thigh muscles and stretching sessions designed to improve overall flexibility.

In addition, pay attention to what you wear when partaking in physical activity.

Ensure you have appropriate footwear for the task – making you less likely to suffer injury due to instability.

Lastly and most importantly, avoid contact sports where possible helps decrease your likelihood of suffering from an ACL tear significantly.

But, being an athlete myself, I understand how difficult this is when you find a sport you love!


Tips For Recovery

Regarding ACL recovery, the best course of action is to consult a physical therapist and/or healthcare provider with knowledge about the ACL and knee joint in the first instance.

They’ll create a bespoke rehabilitation plan for you that targets your needs and abilities.

It’s imperative to start slowly with stretching and strengthening exercises and low-impact activities like biking, swimming, and walking.

These should be done at a comfortable pace and gradually increased depending on how you feel.

Staying active while following the doctor’s recommendations is key for a full recovery.

As is looking after your mental health, which I can certainly help you with. Check out my book on the subject of ACL injury and mental health here.

Activities such as yoga or Pilates also help improve flexibility and range of motion, while running on flat surfaces or treadmills helps build strength in the legs without putting too much strain on the knee joint.

And (this may sound obvious) but avoiding activities involving sharp turns or sudden stops (such as basketball) is essential to reduce the risk of further injury.

Using a knee brace during sports will provide additional stability and support for your knee joint as well as a mental reminder that you are supported and do not need to favor the previously injured joint.

Finally, regenerative medicine treatments such as platelet-rich plasma (PRP) therapy may benefit those suffering from an ACL tear who wish to explore less invasive treatments for their injury.

PRP therapy delivers concentrated doses of growth hormone factors directly into injured soft tissues to promote accelerated healing.

(Your healthcare provider should be able to provide more information to you on the subject of PRP and if you are a good candidate for this type of treatment.)

By following these tips and consulting with medical professionals throughout the recovery process from an ACL tear, individuals have the best chance at recovering and enjoying an active lifestyle once again.

I hope you found this read insightful. Do check out more posts of mine here to read more about knee health.

About the Author

Hi there! I’m Dr. Keagen Hadley, OTD, OTR/L. Straight out of the University of Mary, I’m all about blending my know-how in knee health, well-being, and medical technology. As a licensed occupational therapy doc, I’m here to translate complex concepts into clear, actionable insights – whether it’s knee care or groundbreaking healthcare tech.

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