An injury to the anterior cruciate ligament (ACL) is one of the most common and often complex knee injuries, particularly among athletes and active individuals. Traditionally, ACL tears were almost always treated with surgery, but recent research and evolving clinical practice have shown that conservative (non-surgical) management can be a viable option for many patients. So how do you know which path is right for you?
Understanding the ACL and the Injury
The ACL is a key stabilizing ligament in the knee, helping to control rotational movement and prevent the tibia from sliding too far forward. Injuries typically occur through sudden stops, changes in direction, or direct trauma—common in sports like football, skiing, basketball, and soccer.
Symptoms of an ACL tear may include a popping sound, swelling, instability, and pain. Diagnosis is usually confirmed via clinical testing and MRI.
Conservative Management: What It Involves
Conservative (non-surgical) treatment focuses on restoring function through physiotherapy, strength training, and activity modification. It’s best suited for:
- Individuals with partial ACL tears
- Those with lower activity demands
- Older adults or patients with medical conditions that increase surgical risks
- People who don’t experience instability in the knee
Rehabilitation typically includes:
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- Strengthening surrounding muscles (especially the hamstrings and quadriceps)
- Improving neuromuscular control and proprioception
- Gradual return to activity with or without a brace
Pro
- Avoids surgical risks and recovery time
- Less downtime from work or life responsibilities
- May be sufficient for non-athletes or low-impact lifestyles
Cons:
- Risk of ongoing instability, especially during pivoting movements
- Potential for long-term joint wear or secondary injuries if the knee remains unstable
Surgical Intervention: What It Involves
ACL reconstruction surgery involves replacing the torn ligament with a graft (typically taken from the hamstring, patellar tendon, or a donor). Surgery is often recommended for:
- Athletes or highly active individuals
- Those with complete tears and knee instability
- Patients who haven’t responded well to conservative care
Post-surgery, a structured rehabilitation program is essential, typically lasting 6 to 12 months, focusing on:
- Regaining range of motion
- Progressive strength and stability exercises
- Sport-specific drills and gradual return to activity
Pros:
- Provides greater stability for high-demand activities
- Reduces risk of further joint damage in unstable knees
- Often preferred for younger, athletic patients
Cons:
Making the Right Choice
Choosing between conservative and surgical treatment depends on your personal goals, activity level, degree of injury, and overall knee stability. A thorough assessment by an experienced physiotherapist and orthopedic specialist is key.
At Body and Mind Physiotherapy, we work closely with patients to determine the best course of action—whether that’s supporting a full recovery through targeted physiotherapy or guiding them through pre- and post-operative rehabilitation. No matter the path, our goal is to help you return to confident, pain-free movement.
Need help deciding what’s best for your ACL injury?
Book a consultation with our team today and take the first step toward a stronger recovery.