Anterior Cruciate Ligament (ACL)
What is the Anterior Cruciate Ligament (ACL)?
A ligament is a band of connective tissue that connects two bones together and provides stability to the joint such as the knee joint. The ACL is a ligament that connects the upper leg bone (the femur) to the lower leg bone (the tibia). The PCL and the ACL are two ligaments inside the knee joint that create a “X” to connect the femur to the tibia. The ACL is in front of the PCL and prevents forward motion of the lower leg bone relative to the upper leg bone and provides rotational stability to the knee joint as well.
How is the ACL injured?
During sports is when the ACL is typically injured (for example soccer, football, basketball, lacrosse) that require quick changes in direction, landing from a jump incorrectly, stopping suddenly, or with direct contact or collisions, with falls in daily life, or trauma to the knee. You can sprain the ligament or tear the ligament.
Typically when the ACL tears you will feel or hear a “pop”. Symptoms of a torn ACL may include the knee “giving out” or “buckling”, swelling, bruising, loss of mobility of the knee (ie difficulty straightening or bending the knee), difficulty walking, instability with going downstairs or stepping off a curb.
Diagnosis of a torn ACL can be concluded with examination by a physician, orthopedic, athletic trainer, and/or physical therapist. Confirmation can be done with imaging such as an MRI, which is ordered by your physician.
Non-Surgical vs. Surgical Treatment
The ACL cannot heal without surgical repair if it tears, however not everyone may opt to perform surgery. If you are an athlete, live a very active lifestyle, have a rigorous job, or do not want to be limited with exercise you may opt for surgery to repair the ACL. If you only want to get back to doing daily activities, you may opt to not perform surgery. In this case, your physician may recommend a brace-Team Elite Care ( is the largest distributor in AZ with custom fitting) to provide stability to the knee.
An orthopedic surgeon can perform surgery to repair the ACL by use of a cadaver (allograft) or by use of your own hamstring tendon or patellar tendon (autograft).
Physical Therapy is important for both surgical and non-surgical options to improve pain, swelling, mobility and strength to support the knee for return to activities of daily living, work, or sports.
The Fischer Institute clinicians successfully treat ACL sprains and tears by improving pain, swelling, mobility and strengthening of the core, hips and legs in order to improve function and return to desired activities such as work, daily activities, exercise, or sports.
- ASTYM Therapy
- Dry needling
- Soft tissue massage
- Joint mobilizationsExercise and recovery
- Zuni body weight unloading treadmill (to safely progress loading and return to running)
- Blood flow restriction (BFR) therapy
- Game ready (ice water compression for swelling and recovery)
- Normatec Recovery (for swelling and recovery)
By: Ashley Church, PT, DPT,ACE,CPT