ACL injury - Symptoms and causes (2024)

Print

Overview

ACL injury

ACL injury - Symptoms and causes (1)

ACL injury

The anterior cruciate ligament (ACL) is one of the key ligaments that help stabilize the knee joint. The ACL connects the thighbone (femur) to the shinbone (tibia). It's most commonly torn during sports that involve sudden stops and changes in direction — such as basketball, soccer, tennis and volleyball.

An ACL injury is a tear or sprain of the anterior cruciate (KROO-she-ate) ligament (ACL) — one of the strong bands of tissue that help connect your thigh bone (femur) to your shinbone (tibia). ACL injuries most commonly occur during sports that involve sudden stops or changes in direction, jumping and landing — such as soccer, basketball, football and downhill skiing.

Many people hear a pop or feel a "popping" sensation in the knee when an ACL injury occurs. Your knee may swell, feel unstable and become too painful to bear weight.

Depending on the severity of your ACL injury, treatment may include rest and rehabilitation exercises to help you regain strength and stability, or surgery to replace the torn ligament followed by rehabilitation. A proper training program may help reduce the risk of an ACL injury.

Symptoms

Signs and symptoms of an ACL injury usually include:

  • A loud pop or a "popping" sensation in the knee
  • Severe pain and inability to continue activity
  • Rapid swelling
  • Loss of range of motion
  • A feeling of instability or "giving way" with weight bearing

When to see a doctor

Seek immediate care if any injury to your knee causes signs or symptoms of an ACL injury. The knee joint is a complex structure of bones, ligaments, tendons and other tissues that work together. It's important to get a prompt and accurate diagnosis to determine the severity of the injury and get proper treatment.

Request an appointment

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Causes

Ligaments are strong bands of tissue that connect one bone to another. The ACL, one of two ligaments that cross in the middle of the knee, connects your thighbone to your shinbone and helps stabilize your knee joint.

ACL injuries often happen during sports and fitness activities that can put stress on the knee:

  • Suddenly slowing down and changing direction (cutting)
  • Pivoting with your foot firmly planted
  • Landing awkwardly from a jump
  • Stopping suddenly
  • Receiving a direct blow to the knee or having a collision, such as a football tackle

When the ligament is damaged, there is usually a partial or complete tear of the tissue. A mild injury may stretch the ligament but leave it intact.

Risk factors

There are a number of factors that increase your risk of an ACL injury, including:

  • Being female — possibly due to differences in anatomy, muscle strength and hormonal influences
  • Participating in certain sports, such as soccer, football, basketball, gymnastics and downhill skiing
  • Poor conditioning
  • Using faulty movement patterns, such as moving the knees inward during a squat
  • Wearing footwear that doesn't fit properly
  • Using poorly maintained sports equipment, such as ski bindings that aren't adjusted properly
  • Playing on artificial turf

Complications

People who experience an ACL injury have a higher risk of developing osteoarthritis in the knee. Arthritis may occur even if you have surgery to reconstruct the ligament.

Multiple factors likely influence the risk of arthritis, such as the severity of the original injury, the presence of related injuries in the knee joint or the level of activity after treatment.

Prevention

Proper training and exercise can help reduce the risk of ACL injury. A sports medicine physician, physical therapist, athletic trainer or other specialist in sports medicine can provide assessment, instruction and feedback that can help you reduce risks.

Programs to reduce ACL injury include:

  • Exercises to strengthen the core — including the hips, pelvis and lower abdomen — with a goal of training athletes to avoid moving the knee inward during a squat
  • Exercises that strengthen leg muscles, particularly hamstring exercises, to ensure an overall balance in leg muscle strength
  • Training and exercise emphasizing proper technique and knee position when jumping and landing from jumps
  • Training to improve technique when performing pivoting and cutting movements

Training to strengthen muscles of the legs, hips and core — as well as training to improve jumping and landing techniques and to prevent inward movement of the knee — may help to reduce the higher ACL injury risk in female athletes.

Gear

Wear footwear and padding that is appropriate for your sport to help prevent injury. If you downhill ski, make sure your ski bindings are adjusted correctly by a trained professional so that your skis will release appropriately if you fall.

Wearing a knee brace doesn't appear to prevent ACL injury or reduce the risk of recurring injury after surgery.

The Mayo Clinic experience and patient stories

Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care like they've never experienced. See the stories of satisfied Mayo Clinic patients.

  1. After knee replacement, Jennifer Budd conquers four marathons ... and countingJennifer Budd's biggest accomplishment is also her biggest heartbreak. Jen, an MRI scanning technician at Mayo Clinic in Florida, started running in 2009 to get into shape and to reduce stress. Soon, running progressed into a passion, not just for her but also for her family. By 2013, she had completed eight half-marathons. But she'd also had two knee surgeries — an ACL surgery and a meniscus repair. The surgeries didn't slow her down —…

By Mayo Clinic Staff

Request an appointment

Dec. 01, 2022

Print

  1. AskMayoExpert. Anterior cruciate ligament (ACL) injury.Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
  2. Papadakis MA, et al., eds. Sports medicine & outpatient orthopedics. In: Current Medical Diagnosis & Treatment 2019. 58th ed. New York, N.Y.: McGraw-Hill Education; 2019. https://accessmedicine.mhmedical.com. Accessed Nov. 13, 2018.
  3. Friedberg RP. Anterior cruciate ligament injury. https://www.uptodate.com/contents/search. Accessed Nov. 13, 2018.
  4. Anterior cruciate ligament (ACL) injuries. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/anterior-cruciate-ligament-acl-injuries/. Accessed Nov. 13, 2018.
  5. Ellman MB, et al. Return to play following anterior cruciate ligament reconstruction. Journal of the American Academy of Orthopaedic Surgeons. 2015;23:283.
  6. DeLee JC, et al. Injury prevention. In: DeLee & Drez's Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. https://www.clinicalkey.com. Accessed Nov. 21, 2018.
  7. Laskowski ER (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 24, 2018.
  8. Paterno MV, et al. Incidence of second ACL injuries 2 years after primary ACL reconstruction and return to sport. American Journal of Sports Medicine. 2014;42:1567.

ACL injury

Advertisem*nt

Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.

Advertising & Sponsorship

CON-20155226

  • ACL injury
ACL injury - Symptoms and causes (2024)

FAQs

ACL injury - Symptoms and causes? ›

The most common mechanism is that of a sudden pivoting or cutting maneuver during sporting activity, which is commonly seen in football, basketball and soccer. The ligament can also tear due to work injuries or automobile accidents. At the time of the injury, a “pop” or “snap” can sometimes be felt or heard.

What are the main causes of ACL injuries? ›

The most common mechanism is that of a sudden pivoting or cutting maneuver during sporting activity, which is commonly seen in football, basketball and soccer. The ligament can also tear due to work injuries or automobile accidents. At the time of the injury, a “pop” or “snap” can sometimes be felt or heard.

What are the 2 main symptoms of a torn ACL? ›

What are the symptoms of an ACL tear? Common symptoms of a torn ACL include a popping sound at the time of injury, knee pain, swelling and knee instability.

How to tell if an ACL is torn or sprained? ›

Chances are you have an ACL tear if you heard a loud pop in your knee when you were injured, followed by swelling, pain, and knee instability. Symptoms of an ACL Tear: Severe pain. Rapid swelling.

What triggers ACL? ›

Anterior cruciate ligament (ACL) injuries may occur from coming to a quick stop with a directional change while running, pivoting, landing, or overextending the joint in either direction. The ligaments which attach the upper leg bone (femur) to the large lower leg bone (tibia) create a hinge joint called the knee.

Can you still walk with a torn ACL? ›

With ACL tears, walking is possible but can be painful. The patient should be able to walk in a straight line but will be unable to make sudden turns or pivot. A knee brace can help stabilize the knee, but with ACL tears, surgery is almost always required.

Can you bend your knee with a torn ACL? ›

If you're able to put pressure on your hurt leg, you may notice that it's harder than normal to walk. Some people find that the knee joint feels looser than it should. Less range of motion. After you damage your ACL, it's very likely that you won't be able to bend and flex your knee like you normally would.

What can be mistaken for an ACL injury? ›

It can be easy to confuse the two injuries, as both a torn ACL and a torn MCL exhibits similar symptoms, including: swelling, inflammation, extreme pain and possible bruising. The main difference between an ACL tear and an MCL tear is that an ACL tear will have a distinctive popping sound, while an MCL tear will not.

How do I know if I tore my ACL or meniscus? ›

ACL tears are often associated with a popping sound, immediate swelling, and a feeling of instability. MCL tears commonly cause knee pain and tenderness along the inner side of the knee. Meniscus tears may produce a popping sensation, locking or catching of the knee, and difficulty straightening the leg.

What does damaged ACL feel like? ›

Symptoms of an ACL injury

You could experience grinding feelings of your bones or kneecap. Another sign is not being able to put weight on your leg. People with a mild ACL injury might feel like their knee is unstable, or like it might “give out” when they are using it.

How can I check myself for a torn ACL? ›

Seven Self-Administering Tests to Know If You've Torn Your ACL
  1. Listen for a Popping sound. If you tore your ACL your knee will pop. ...
  2. Observe a Joint Shift. Compare your injured knee with your healthy knee. ...
  3. Walk. A torn ACL will inhibit your ability to walk. ...
  4. Swelling. ...
  5. Evaluate Pain. ...
  6. Unable to Bend Knee. ...
  7. Weak Leg Muscles.
May 29, 2011

Can a torn ACL heal on its own? ›

A torn ACL can't heal on its own, but it's possible to live with it (especially if you have a low-grade tear). But if you're an athlete or want to return to physical activity, you'll need surgery to repair your ACL. Most people choose to have an ACL tear surgically repaired.

Where is ACL pain located? ›

An injury to your anterior cruciate ligament is usually accompanied by a "popping" noise and a feeling that your knee gives out from under you. Other signs and symptoms of an ACL injury include: Pain on the outside and back of the knee.

How can I fix my ACL naturally? ›

To treat a minor ACL tear, your doctor may suggest that you:
  1. Apply ice to the knee a few times a day.
  2. Prop the knee above the level of your heart.
  3. Compress the knee with a bandage or wrap.
  4. Reduce or stop activity for several weeks.

What are the symptoms of a torn MCL? ›

The most noticeable MCL tear symptom is pain on the inside of your knee directly over the ligament. You may also hear and feel a “popping” sensation in your knee at the time of injury. Other common symptoms include bruising, knee instability, swelling, and the inability to hold your weight.

What is the most common cause of ACL injury? ›

Sports injuries are the most common causes of ACL tears, however, the ACL can be injured during any trauma, such as during a car accident, falling off a ladder, or missing a step on a staircase.

How is the ACL most commonly injured? ›

History: One of the most common knee injuries is an ACL sprain or tear. Typically, injury occurs during activity/sports participation that involves sudden changes in the direction of movement, abrupt stopping or slowing down while running, or jumping and abnormal landing.

Who is most likely to get an ACL injury? ›

Know the Risk Factors

Anatomy: Women generally have wider hips compared to men and are often more knocked-kneed, which means their knees tend to tilt inward. This alignment alters the knee joint, increasing the risk of ACL injuries during movements such as jumping, pivoting and landing.

What activities cause ACL tear? ›

The ACL connects the thighbone (femur) to the shinbone (tibia). It's most commonly torn during sports that involve sudden stops and changes in direction — such as basketball, soccer, tennis and volleyball.

What increases the risk of an ACL tear? ›

Engaging in certain sports or activities significantly increases the risk of ACL tears. Sports involving sudden changes in direction, deceleration, or landing from jumps, such as soccer, basketball, volleyball, skiing, and football, pose a higher risk.

Top Articles
Latest Posts
Article information

Author: Dr. Pierre Goyette

Last Updated:

Views: 6245

Rating: 5 / 5 (70 voted)

Reviews: 93% of readers found this page helpful

Author information

Name: Dr. Pierre Goyette

Birthday: 1998-01-29

Address: Apt. 611 3357 Yong Plain, West Audra, IL 70053

Phone: +5819954278378

Job: Construction Director

Hobby: Embroidery, Creative writing, Shopping, Driving, Stand-up comedy, Coffee roasting, Scrapbooking

Introduction: My name is Dr. Pierre Goyette, I am a enchanting, powerful, jolly, rich, graceful, colorful, zany person who loves writing and wants to share my knowledge and understanding with you.