What is an ACL injury?
An anterior cruciate ligament (ACL) injury is one of the most common knee injuries in young athletes. It can happen during sports that involve jumping, pivoting, cutting or sudden stops, such as soccer, basketball, football and lacrosse.
At Connecticut Children’s, our sports medicine specialists treat these tears and other knee injuries in children and teens. We offer nonsurgical care, advanced surgical options and personalized rehabilitation plans to help athletes recover safely.
Think Your Child May Have Torn Their ACL?
Early evaluation can help prevent more damage to the knee. Our pediatric sports medicine team offers expert diagnosis, imaging when needed, and treatment plans designed for growing athletes.
Signs and symptoms of an ACL tear
If you experience a torn ligament, you may notice:
- A “pop” sound or sensation in the knee at the time of injury
- Swelling within hours of the injury
- Instability or buckling when trying to stand or walk
- Pain when putting weight on the affected leg
What causes this type of injury?
Common causes of this knee injury include:
- Sports involving pivoting, cutting or sudden stops (e.g., soccer, basketball, football)
- Landing awkwardly from a jump, causing the knee to buckle inward
- Direct impact to the knee from a collision or fall
Treatment for the tear
Non-surgical treatment
Initial treatment focuses on reducing swelling and restoring knee mobility. Rehabilitation includes:
- Icing, compression and elevation to control swelling
- Physical therapy to regain strength and range of motion
- Bracing and activity modification to stabilize the knee
Surgery is often the best option for young athletes. Without it, the knee is more likely to be injured again, which can lead to more damage, including tears in the meniscus (the knee's shock absorber) or arthritis later in life.
Surgical treatment
Reconstruction surgery is a common treatment for athletes who want to return to their sport. The ACL cannot heal on its own, so orthopedic surgeons reconstruct the ligament using a graft. At Connecticut Children’s, we offer a variety of graft options, including:
- Quadriceps tendon graft – A preferred option, supported by ongoing research
- Bone-patellar tendon-bone graft – Common in high-demand athletes
- Hamstring graft – Another option for select patients
- Iliotibial (IT) band technique – A specialized approach for young children with open growth plates
Recovery after ACL surgery
Recovery can take 9 to 12 months, and involves:
- Physical therapy to restore strength, mobility and stability
- A return-to-sport plan to prevent additional injury
- Injury prevention exercises to improve the area around the knee
Innovative treatment: the BEAR implant
Connecticut Children's is the first in Connecticut to offer the Bridge-Enhanced ACL Repair (BEAR) Implant. This newer procedure can repair the torn area instead of replacing it in some children, teens and young adults. It is an option for certain patients with a complete tear who are treated soon after the injury and meet specific medical guidelines.
Unlike conventional surgery, the BEAR Implant:
- Uses a patient’s own blood to help the torn area heal naturally
- Eliminates the need for grafts from another part of the body
- Keeps the ACL’s original attachments to the femur and tibia
This groundbreaking treatment helps promote natural healing and faster recovery.
FAQs: common ACL injury questions
Without treatment, an ACL tear can lead to:
- Chronic knee instability, increasing the risk of falls and further injuries
- Damage to the meniscus and other knee structures
- Early arthritis due to abnormal joint movement
For young athletes and active individuals, ACL surgery is often recommended to restore stability and function.
Yes, many people can walk immediately after an ACL tear, but the knee may feel unstable or give out. Walking with an untreated ACL injury increases the risk of further damage, such as meniscus tears.
Key exercises after ACL surgery include:
- Heel slides and quad sets (early recovery)
- Straight leg raises to maintain muscle strength
- Balance and agility drills (later recovery)
- Sport-specific training before returning to competition
- Sleep on your back with a pillow under the ankle for support, so that the limb is elevated but not bent
- Avoid sleeping on the surgical side to reduce discomfort
- Use ice packs before bed to minimize swelling
Most athletes return to sports in 9 to 12 months, depending on:
- Strength and stability testing
- Clearance from a sports medicine specialist
- Completion of sport-specific rehab
Returning too soon increases the risk of reinjury, but following a structured return-to-play protocol can help.
ACL Surgery or Physical Therapy?
Every knee injury is different. Our experts explain when surgery may be recommended, when rehabilitation is appropriate and what families can expect during recovery.
Read the GuideExpert care for growing athletes
Connecticut Children’s sports medicine specialists provide advanced treatments and personalized rehabilitation plans for young athletes with injured knees. With same-day appointments available for recent injuries and leading-edge surgical techniques, we help athletes recover safely and return to peak performance.
Schedule an appointment today. Call 860.837.9220 to learn more about our ACL treatment options.