Anterior Cruciate Ligament

Advanced care for ACL tears and knee injuries in young athletes.

What is an ACL injury?

An anterior cruciate ligament (ACL) injury is a tear or sprain of the ACL, the strong band of tissue that connects the thigh bone (femur) to the shinbone (tibia) and stabilizes the knee joint. ACL tears commonly occur in sports involving sudden stops, quick changes in direction or jumping. High school female athletes are at the highest risk for ACL injuries.

Signs and symptoms of an ACL tear

If you experience an ACL tear, 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 an ACL tear?

Common causes of an anterior cruciate ligament tear 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

ACL treatment

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

However, non-surgical treatment is rarely recommended for young athletes due to the high risk of reinjury and further knee damage, such as meniscus tears or early-onset arthritis.

Surgical treatment

ACL reconstruction surgery is often required for athletes who want to return to running, cutting and pivoting sports. The ACL cannot heal on its own, so the procedure involves reconstructing the ligament using a graft. At Connecticut Children’s, we offer a variety of ACL 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

Rehabilitation after ACL reconstruction takes 9 to 12 months, involving:

  • Physical therapy to restore strength, mobility and stability
  • Progressive return-to-sport protocols to prevent reinjury
  • ACL injury prevention exercises to improve knee mechanic

Innovative treatment: the BEAR implant 

Connecticut Children’s is the first in Connecticut to offer the Bridge-Enhanced ACL Repair (BEAR) Implant, a minimally invasive alternative to traditional ACL reconstruction. This option is designed for select patients—typically children, teens and young adults with complete, midsubstance ACL tears who are treated soon after injury and meet specific clinical criteria.

Unlike conventional surgery, the BEAR Implant:

  • Uses a patient’s own blood to help the torn ACL heal naturally
  • Eliminates the need for grafts from another part of the body
  • Maintains 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.

Expert care for growing athletes

Connecticut Children’s sports medicine specialists provide advanced ACL treatments and personalized rehabilitation plans for young athletes. With same-day appointments 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.