Jul - ACL injury

ACL Injuries: Who Are at Risk?


Tears or ruptures of the ACL (anterior cruciate ligament) are very common.

So common that it affects approximately 250,000 individuals.

And that statistic is in the United States alone.

What are the likely causes?

Individuals who are engaged in sports are more prone to ACL injuries.

ACL injury can also often occur as a result of the following:

  • Pivoting
  • Single-leg landing
  • Direct trauma (common in contact sports)
  • Cutting
  • Twisting force (applied to the knee when the person lands on one foot)

An ACL injury can be very painful and most people will hear and experience a “pop” in the knee when it occurs.

This is followed by feelings of instability.

ACL injuries will not only make activities like walking down the stairs difficult but it will also hinder patients from engaging in athletic activities.

What are the risk factors?

While everyone can have ACL injuries, there are several factors that can put people at a higher risk.

Some of the most common risk factors include:


Compared to males, females are more prone to ACL injuries.


Majority of ACL tears often occur between the ages 15 to 45.

Oftentimes, this can be attributed to higher sports participation and an active lifestyle.

Single-leg cutting, pivoting, and landings

A huge percentage of ACL injuries (70 percent) can be attributed to sudden deceleration (i.e. cutting, landing on one leg, and pivoting).

Individuals who participate in sports like volleyball, tennis, lacrosse, football, and downhill skiing are more prone to ACL injuries.

Direct blow outside the leg or knee

ACL injuries from contact often result from direct blows to the knee when it is hyper-extended or slightly bent inward.

What are the common symptoms?

For those with acute ACL tears, one or more of the following symptoms will be present:

  • Deep knee pain
  • Swelling
  • Restricted range of motion (difficulty in straightening the affected area is also evident)
  • Instability (this can become noticeable when performing activities that put stress and strain on the affected area like walking down the stairs or pivoting)
  • Affected knee may feel warm to the touch (this can be attributed to likely bleeding within the joints of the knee)

Without proper medical attention, swelling and pain might eventually disappear on its own after several weeks but the instability will persist in most cases.

Patients with ACL injuries will also experience difficulty standing up from a sitting position and going downstairs.

What are the treatment options?

While surgery may sometimes be required, not everyone who develops an ACL injury will have to undergo one.

Certain factors like age, activity level, as well as other injuries will have to be taken into account before the doctor will decide if surgery is an option.

Active individuals who are involved in sports/activities that will not require sudden stops or turns (i.e. cycling and swimming) and those who do not experience any instability are likely candidates for non-invasive treatment alternatives.

Non-surgical treatments are often facilitated by a physical therapist.

The main goals would include maximizing strength, balance, and proprioception (body positioning).

What can patients expect during the recovery period?

For patients who will have surgery, post-operative rehabilitation will be needed to maximize long-term healing.

Primary focus will be on balance, proprioception, core strength, and range of motion.

Apart from physical therapy programs, home exercise programs might likely be prescribed.

Some surgeons might also recommend using no braces albeit there’s no evidence yet that will support its benefit.

In most cases, athletes can already engage in their chosen sport 6 to 12 months after the surgery.

However, only orthopedic surgeons are able to determine for sure when it will be truly safe to return to routine athletic activities.

Checking with an orthopedic surgeon is the recommended route as returning prematurely might put the ACL graft in serious risk.

For help with ACL injuries, please visit www.bjios.sg immediately.


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