ACL Tear

Table of Contents

    What Is an ACL?

    Your Anterior Cruciate Ligament (ACL) is located in your knee. While we often refer to our knees as if they are one simple body part, it is an incredibly complex mechanism. Let's take a closer look at your knee anatomy to give you a better idea of where exactly this ligament is located in your knee.

    The femur (thighbone), tibia (shinbone), and patella (kneecap) are the three bones that come together to form the knee joint. The kneecap is positioned in front of the joint to offer a level of protection.

    Ligaments join one bone to another bone. In your knee, there are four primary ligaments. They function as sturdy ropes to hold the bones together and maintain the stability of your knee. You have collateral ligaments and cruciate ligaments in your knee.

    Cruciate Ligaments

    Cruciate ligaments are located inside your knee joint. Your anterior cruciate ligament and posterior cruciate ligament (PCL) cross over one another to form an X. Your knee's ability to move from front to back smoothly is enabled by these cruciate ligaments.

    The middle of the knee is where the anterior cruciate ligament is located diagonally. It gives rotational stability to the knee and prevents the tibia from sliding out in front of the femur. The PCL prevents the shinbone from going too far backward. It is far less likely to be injured and is stronger than the ACL.

    Collateral Ligaments

    In addition to your cruciate ligaments, your everyday movement is made possible by your collateral ligaments. You can find these collateral ligaments on the sides of your knee. On the inside, there is the medial collateral ligament (MCL), and on the outside, there is the lateral collateral ligament (LCL). Your knee's side-to-side motion is restrained by these two ligaments, and they support your knee against unnatural movement.

    What Are the Types of ACL Injuries?

    acl tear diagram

    Image Credit: Cleveland Clinic

    • Grade 1 sprain: The ligament has only minor damage, and you can still maintain stability in your knee joint.
    • Grade 2 sprain: Your knee ligament has been stretched to the point of partial tear.
    • Grade 3 sprain: Your knee joint is unstable and your ligament is completely torn. In other words, it has split into two pieces.

    It is worth noting that complete or nearly complete tears are the most common injuries so it is not unusual to find that you have the most severe grade of the sprain.

    ACL tears are often confused with torn meniscus. To confirm your diagnosis of a particular grade of sprain and see if you have any other type of knee injury, your doctor might call for an X-ray or MRI of your knee and provide the best plan of treatment for you.

    Visit our torn meniscus treatment page for more information on the causes, diagnosis and treatment options at Ray of Health.

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    Where Should I Go to Get ACL Tear Treatment in Singapore?

    If you are dealing with chronic knee pain, you may have a knee injury. Whether you are a serious athlete or just happened to move the wrong way one day, you might have torn or sprained your ACL. As soon as you start dealing with knee pain, it’s essential to look into the diagnosis and proper ACL tear treatment.

    While proper knee treatment can help you get rid of pain even in the most severe cases, it is essential to note that these injuries won’t heal on their own.

    Looking to get treatment for ACL tear in Singapore? We are ready to help! The orthopaedic doctor here at Ray of Health will diagnose your issue and create a customised treatment plan to get you feeling like your own self again. We also offer other orthopaedic treatment plans for knee arthritis and rotator cuff tears.

    Why suffer in pain for another day? Reach out to us online, email us at, call +65 6235 8781, or chat with us on WhatsApp at +65 8028 4572.

    How Are ACL Tears Treated?

    The first step in ACL treatment is rehabilitative therapy lasting. Over the course of several weeks, you will learn exercises from a physical therapist that you can do at home. You may also need to use crutches for a while to avoid putting weight on your knee while wearing a brace to keep it stable.

    Rehabilitative therapy will work to reduce swelling and pain while helping you regain the full range of motion in your knee and build up your muscles. If your injury is minor and your lifestyle isn’t too hard on your knees, physical therapy may be enough for you.

    Is Surgery Needed?

    Each injury is different and there is not one standard treatment that you can expect in every single case. Generally speaking, however, there are a few reasons why your doctor may say that ACL tear surgery is essential.

    Your doctor might advise surgery for a torn ACL in the following conditions:

    • You're an athlete, especially if your sport requires pivoting, cutting, or jumping
    • Your knee's fibrous cartilage and/or additional ligaments are also damaged
    • Your knee is buckling on a regular basis

    What Is ACL Surgery?

    During surgery for reconstruction, the surgeon will replace the damaged ligament with a section of the tendon. This tissue then binds your muscle to your bone and functions like a ligament. This kind of replacement is called “graft.” This replacement tendon might come from a donor or a piece of tendon from another part of your knee.

    After your surgery, you will continue with rehabilitation therapy. This reconstruction combined with diligent rehabilitation can give your knee the same stability and functionality that it had previously.

    What Is the Recovery Time?

    Each knee injury has a different recovery time. Your exact recovery time will depend on its severity as well as how quickly you treat the issue and how diligent you are in following the physical therapy.

    On the quicker side of things, a minor sprain heals with rest, ice therapy, and over-the-counter pain medication in approximately one to two weeks. ACL tear surgery recovery time is often nine months, though athletes can go back to their sport in as little as six months. It is important to be aware though that even with the best ACL tear therapy and treatment plan, you may find that it takes up to a year to feel back to your old self again.

    When Is It an Emergency?

    People often ask us how to know if an ACL injury is an emergency. While each case is a bit different, they are usually not an emergency. You will want to get off your feet immediately and make a doctor’s appointment, but it is usually not necessary to rush in for emergency care.

    It is essential to note, however, that they can be accompanied by other serious knee injuries. If you have any of the following symptoms, you'll need to see a doctor urgently:

    • An intense knee pain
    • You can’t move your knee or put any weight on it
    • Your knee is very swollen or disfigured
    • Very high temperature
    • Redness or heat from your knee

    Can an ACL Tear Heal on its Own?

    Full ACL tears are not self-healing. These tears almost always require surgical intervention, usually through the minimally invasive procedure called arthroscopy. Surgery may be necessary for even partial ACL tears if other ligaments, tendons, or your kneecap is also injured.

    Ultimately, each case is different and requires its own treatment. Your doctor may recommend physical therapy,  surgery, or a combination of both. If your tear is minor, you may only need rest and simple home treatments but it’s crucial to have your knee checked before looking for home remedies.

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    Frequently-Asked Questions About ACL Tears in Singapore

    Causes of ACL Tears

    ACL Tears are common and can happen in a wide range of situations. More often than not, however, they occur during sports. For example, when you have your foot firmly planted on the ground and you are suddenly hit by someone or something. This might also happen when you abruptly change directions or land from a jump, which might also lead to ankle injuries. While this is a common sports injuries, they may happen at any time.

    Here is a complete look at its causes:

    • Stopping abruptly
    • Direct blows to the knee or collisions
    • Slowing down abruptly
    • Awkward landings from a jump
    • Changing direction abruptly
    • Overextension of the knee joint
    • Pivots with the foot firmly planted

    If you are also experiencing pain in your ankles, perhaps it is time to visit our orthopaedic doctors for ankle injury treatment.

    Who Is Most Likely to Get It?

    Did you know that female athletes are two to eight times more likely than male athletes to have an injury? Since a female pelvis is wider than a male pelvis, there is a difference in the structure of the leg. This changes the thigh bone, tibia, and femur bones in a woman’s body in a way that causes more stress on the soft tissues.

    As women have less testosterone, they also have less muscle density as well as more laxity in their joints and ligaments, which can increase the odds of a tear.

    How to Know If You Have a Torn ACL?

    There are five common movements that we often find that cause ACL tears. These include the collisions and hard impacts that happen during sports; changing directions quickly; stopping suddenly; jumping and then landing badly; and slowly moving suddenly. If your knee pain came on shortly after one of these actions, it is essential to look for other signs. Here are some common symptoms of a torn ACL:

    • Swelling later in the day
    • Knee pain that gets worse when you put weight on it
    • Loss of full range of motion
    • Knee tenderness
    • Weakness in your knee when walking

    Other knee injuries include damage to knee cartilage or another ligament. For that reason, it is crucial to have a healthcare professional check your knee.

    We also recommend doing warm-up and stretches before sports to improve mobility and prevent muscle cramps

    How Can You Tell If Your ACL Is Torn or Sprained?

    We often talk about two different types of injuries: tears and sprains. When your ACL is stretched out but not torn, it is a sprain. When the knee ligament is torn, it is known as a tear. Within the spectrum of tears, there are full and partial tears.

    It can be difficult to gauge the difference between a tear and a sprain without testing. Generally speaking, your pain level will go up with each grade of injury, but the level of severity is not always immediately obvious. For this reason, it is essential to have a doctor fully assess your knee pain.

    How Is an ACL Injury Diagnosed?

    Your doctor will take a closer look at your knee during a physical examination and compare both injured and uninjured knees for tenderness and swelling. Your doctor will move your knee into several different positions for them to evaluate the joint’s range of motion and general health.

    A physical examination is often sufficient to make the diagnosis, but sometimes other tests are necessary to check for other possible causes and to fully assess the severity of your knee injury. The test your doctor chooses will be based on the specifics of your injury and will be one of the following:

    • X-rays: To check for a possible broken knee, X-rays may be required. It’s important to note that soft tissues like tendons and ligaments aren’t visible on X-rays so another check may be needed to pinpoint injuries.
    • MRI test: Magnetic resonance imaging (MRI) uses strong radio waves and magnetic field to create images of your body's tissues. An MRI can show the full extent of a tear and check for cartilage damage and any other kind of knee tissue deterioration.
    • Ultrasound: Using sound waves to see internal structures, an ultrasound is able to detect injuries in the tendons, muscles, and ligaments of your knee.

    Check out our guide on the differences between X-rays, MRI scans and CT scans.

    How to Treat It at Home?

    While it is essential to see a doctor for an examination, there are some at-home treatments that you can use before you get to the doctor’s office.

    For immediate pain relief and to reduce swelling, look to the RICE method. Here’s what to do:

    • Rest: Resting helps you heal and prevents the problem from getting worse (and, remember, ACL tears rarely heal on their own and will get worse without treatment).
    • Ice: During the first couple of days, try to ice your knee once every two hours for around 20 minutes at a time.
    • Compression: Your knee should be wrapped in an elastic bandage to keep down the swelling.
    • Elevation: Lie down with your knee raised on pillows as often as possible.

    How Can I Reduce the Risk of an ACL Injury?

    While ACL injuries are incredibly common, there is a range of steps that you can take to reduce your odds of a tear or sprain. Let’s look at a few of the top tips that you can follow to prevent injuries.

    • Exercise consistently: By maintaining the muscles around your knees in good shape and flexibility with a regular exercise programme, you can avoid a lot of injuries. Exercise keeps us in shape, enhances our balance, builds muscles, and makes us more conscious of our bodies. When you are exercising outdoors, remember to stay hydrated to avoid heat injuries.
    • Pay attention to your movements: Your joints and ligaments are put under a great deal of stress when you land a jump on stiff legs. Your risk of injury rises as a result of the ACL's increased force absorption. By bending at the knees and hips as you turn, you can lessen this stress. Knee bending also lines them up with your feet. Your core, glutes, quadriceps, and hamstrings are therefore working in tandem when you land to provide stability and prevent the ACL from taking the full force of the impact.
    • Rest when you’re tired: When you're tired, it's more difficult to keep your form in check. Making sure you get enough sleep and being aware of when to call it a day when it comes to exercising can help you avoid suffering an injury. Pushing yourself past your physical limits can also lead to muscle fatigue, which affects your muscles' capacity to produce force. Numerous factors, such as obesity, ageing, and intense exercise, can lead to muscle weakness.
    • Build up your leg muscles: Your legs are able to bend and straighten thanks to your quadriceps and hamstring muscles. These muscles are found on the front and back of your thighs, respectively, and play a major role in preventing knee injuries. Exercises like a Romanian deadlift are some of the best prevention exercises you can do.
    • Having a solid foundation is equally important: Your body moves more smoothly when you exercise your core. Additionally, it aids in gaining control over bodily motion. As you support your weight with your arms or forearms, the basic plank is an effective exercise that tones your core, as well as your arms, shoulders, back, glutes, and legs.

    About the Author

    Dr. James - Orthopaedic Surgeon in Singapore

    Dr James Tan C H

    Dr James Tan is a highly skilled surgeon who has more than 10 years of experience in sports surgery and exercise medicine. Apart from partnering the industry to pioneer advanced and proven treatment techniques, Dr Tan has treated athletes from the Singapore National Teams and professional footballers from the Singapore Premier League and the Young Lions. He is a member of the elite Asian Shoulder and Elbow Group and a founding member of the Singapore Shoulder and Elbow Surgery Society.