Should You Walk on a Torn ACL?

The two major ligaments in your knee are your anterior cruciate ligament (ACL) and your posterior cruciate ligament (PCL).

These strong bands of tissue:

• cross in the middle of your knee
• connect your femur (thighbone) and tibia (shinbone)
• stabilize your knee joint, preventing excessive forward and backward movement

The ACL is more prone to injury than the PCL.

The immediate signs of an ACL injury may be:

• pain, which is often severe and typically severe enough to discontinue the activity you were doing before the injury
• feelings that your kneecap or bones are grinding
• rapid swelling
• knee deformity
• bruising around the knee
• range of motion loss
• instability, which makes your knee feel loose, like it might buckle if you put weight on it

Some people feel a “popping” sensation or even hear a “pop” when an ACL injury occurs.

If you injure your knee, the first step is to reduce pain and swelling. As soon as possible after the injury:

• put ice on your knee
• lie down and raise your knee above the level of your heart
• take a pain reliever, such as ibuprofen (if necessary)

After taking immediate action for pain and swelling reduction, make an appointment with your healthcare provider. They’ll develop a treatment plan that takes into account your:

• current physical condition
• age
• medical history
• injury’s severity

According to the American Academy of Orthopaedic Surgeons (AAOS), ACL injuries are graded from mild to severe on a three-step system:

• Grade I. This is a mild injury — microscopic tears. Your healthcare provider may recommend rehabilitative therapy, which usually includes a program of physical therapy (PT) and exercise. It may also require mobility aids, such as using crutches, wearing a knee brace, or using a combination of mobility aids. After reducing swelling and pain, PT focuses on strengthening muscles and restoring range of motion.
• Grade II. This is a moderate injury — partial tear. According to Johns Hopkins Medicine, Grade II ACL injuries are rare. They’re commonly treated similarly to either a Grade I or II injury based on the specific case.
• Grade III. This is a severe injury – complete tear. If you’re active in sports or have a strenuous job that includes climbing, jumping, or pivoting, your healthcare provider will most likely suggest surgical reconstruction. Following surgery, physical therapy can help restore strength, range of motion, and balance.

According to the AAOS, the majority of ACL injuries are Grade III.

For a mild ACL injury, your healthcare provider may prescribe a brace or another mobility device, such as crutches or a cane, to help you walk.

The time it takes for you to recover for unassisted, stable walking will depend on the nature of the injury and your response to rehabilitative therapy.

Following surgery, there’s no set amount of time for a full recovery. According to the Cleveland Clinic, formal physical therapy can start in the first week following surgery.

If you’re an athlete, sport-specific activities, such as jumping, may be added to the program after 12 to 16 weeks. Athletes who respond well to therapy can often return to normal activity within 6 to 9 months following surgery.

The Mayo Clinic indicates that up to one-third of athletes will have another ACL tear within 2 years following surgery. They suggest that the risk for re-injury may be reduced with a longer recovery time.

ACL injuries commonly occur during physical activities that put stress on your knees, such as sports.

A mild injury may only stretch the ACL. A more severe injury can result in a partial or complete tear.

Actions that can trigger an ACL injury include:

• firmly planting your foot and pivoting
• suddenly changing direction or stopping
• cutting (changing direction after suddenly slowing down)
• jumping and landing awkwardly
• hyperextension (when the knee straightens out more than it should)
• a collision or direct blow that causes your knee and the rest of your leg to move away from each other

Typically, an ACL injury is not the result of direct contact.

Factors that increase your risk of injuring your ACL include:

• participation in certain sports, such as basketball, football, gymnastics, soccer, and downhill skiing
• playing on artificial turf
• lack of physical conditioning
• improper equipment, such as shoes that don’t fit or ski bindings that aren’t appropriately adjusted

According to the Mayo Clinic, females are more likely to experience ACL injuries than males. It’s thought that this may be due to hormonal influences and differences in muscle strength and anatomy.

You shouldn’t walk on a torn ACL too soon after you’ve experienced an injury. It might make the injury more painful and cause further damage.

If you suspect that you’ve torn your ACL, see a healthcare provider for proper diagnosis of your injury.

If it’s a mild injury, your healthcare provider might clear you to walk on it without assistive devices, such as crutches, a brace or cane, following rehabilitative therapy.

If you’ve experienced a severe injury, you’ll most likely need surgical repair followed by PT.

Based on your progress, your healthcare provider will let you know when it’s OK to walk without a brace or other mobility devices, such as crutches or a cane.