The twisting of the knee during quick stops and starts, turning, cutting, or awkward landing can adversely affect the function and stability of the anterior cruciate ligament (ACL).  A combination of twisting forces places added stress on this ligament, which can result in a tear. This injury can happen with or without direct contact with another player. 

Recent studies have found adolescent female athletes are 1.5 times more likely than their male counterparts to experience an ACL tear during sport. Athletes participating in soccer, basketball, lacrosse, and football are considered at a higher risk of suffering an ACL injury.


The ACL is one of several ligaments that help connect the thigh bone (femur) to the shin bone (tibia). Its primary functions are to keep the shin bone from sliding too far forward and to provide stability to the knee. When overstretched, a partial tear or full tear (rupture) of the ACL can occur.


  • Frequent or sudden change in direction
  • Quick deceleration combined with a change in direction
  • A combination of pivoting and twisting of the knee during play
  • A direct blow or collision with an opposing player
  • Variations in bone structure and joint alignment
  • Strength and flexibility imbalances
  • Faulty landing techniques when jumping or hopping


  • A “pop” sensation and/or noise 
  • Sudden onset of pain
  • Difficulty walking or putting weight on the injured leg
  • Instability upon standing on the injured leg 
  • Difficulty straightening the knee
  • Swelling of the knee joint


  • Initial Treatment
    • Elevate the injured leg for up to 20 minutes to help reduce swelling
    • Ice the knee for 10-20 minutes, 3-5x per day to reduce pain and swelling
  • Diagnosis and Professional Treatment
    • An accurate diagnosis of an ACL injury includes a combination of a physical exam by a physician, an x-ray, and an MRI
    • Surgery and rehabilitation are often required to ensure a full recovery of functionality and the ability to return to play


ACL injuries are one of the most feared among athletes due to their ability to shorten or even end an athlete’s season in matter of seconds. However, steps can be taken to help prevent these injuries, such as:

  • Utilizing proper techniques and mechanics when running, sprinting, and landing
  • Incorporating the FIFA 11+ program into your regular training sessions and pre-game prep
  • Participating in a strength and conditioning program specially designed for your sport


Click here to learn more about our Sports Medicine specialty and for a list of our Sports Medicine physicians. If you have questions or want to learn more ways to stay healthy, active and strong, consider connecting with one of our Certified Athletic Trainers through our Sports Medicine Hotline

Sources: STOP Sports InjuriesThe American Journal of Sports Medicine