Symptoms

Damage in the ACL can range from a minor tear to a full rupture. Symptoms will vary by the degree of injury to the ACL, but may include:

• Pain
• Popping noise when injury occurs
• Swelling in the knee within 24 hours
• Loss of full range of motion
• Instability—a wobbly feeling that will make it difficult to stand or walk

These symptoms are usually good indicators of an ACL injury but doctors will usually x-ray the knee to rule out a fracture to the bone. The doctor will also examine your knee to see if there is instability. If a definitive diagnosis is still unclear, an MRI scan may be ordered. This scan can provide detailed pictures of the interior of the knee. In other cases, an arthroscopic exam of the knee may be performed. The doctor will insert tiny cameras into your knee. The cameras will show any damage inside the knee joint.

Treatment

If you do suffer a torn ACL, your treatment will depend on your age, activity requirements, and the extent of your injury. Here are the most common treatments:

Surgical treatment involves repairing and rebuilding the ligament. In the past, this surgery required opening the knee to reconstruct the ACL. It was performed with success, but the rehabilitation process was slow. Today, doctors most often perform surgery arthroscopically utilizing small incisions. It can lead to a faster recovery. Here is what to expect during surgery:

• Small incisions are made around the knee.
• Small surgical tools are inserted through the incisions. The tools will remove the torn ends of the ACL.
• The ACL will be replaced by a graft. The graft may be taken from patellar tendon (the one that attaches the kneecap to the tibia) or some of the hamstring tendons. The graft is attached to both the lower leg bone and the thigh bone.

This procedure is very effective because it uses your own tissue and allows the knee to retain its normal range of motion. The knee can heal back to its original degree of strength with a low risk of infection or graft rupture. The reconstruction usually lasts a lifetime, but repeat tears can occur with sufficient stress.

This type of surgery may require an overnight stay at most, but in many cases, you can leave the hospital the same day.

Prevention

The best way to do this is to strengthen the muscles surrounding the knee, specifically the hamstrings and quadriceps. The reason? These two sets of muscles are crucial in giving a skier the ability to regain balance and control (such as catching an edge during a snowplow). This will help you to prevent the twisting and hyperextension of the knee that can cause the ACL to tear. The hamstrings also control forward motion of the shin bone on the thigh bone, so strength in this muscle group is essential.

Strength training is one important way to help prevent injury. Here are some others:

• Ski under control
• Bend your hips or knees when landing from a jump
• Warm up before exercising

Strengthening the leg muscles is particularly beneficial in the months prior to the start of ski season. Consider consulting a sports physician or trainer to try out other exercises and stretches designed to strengthen your knees and the rest of your body. These can improve your performance and lower your risk of injury.