Athletes and ACL Injury: How to Get Back to Your Sport
Athletes and ACL Injury: How to Get Back to Your Sport
An injured anterior cruciate ligament (ACL) is a common sports injury—especially in athletes who run, jump, cut, or pivot. Many people describe the moment the injury happens the same way: a sudden pop, sharp pain, and a knee that swells quickly.
But a torn ACL doesn’t always mean the end of your season. With the right care, most athletes return to their sport.
What the ACL Does—and How It Gets Injured
The ACL works like a rope that connects the thigh bone (femur) to the shin bone (tibia). Its main job is to keep the knee stable, especially during rotation.
When athletes jump, change direction, or twist suddenly, that rope can become:
- Frayed but still connected (partial tear or high‑grade sprain): The ligament is damaged but still doing its job.
- Not connected (complete tear): The ligament can’t stabilize the knee.
Travis Maak, MD, an orthopedic surgeon and sports medicine specialist at University of Utah Health, works with patients by feeling how the knee moves. If the ligament still gives a rope-like resistance, it’s connected. If not, it’s a complete tear.
Your Steps to Recovery
Not everyone with an ACL tear needs surgery right away. In fact, many people do well with the right rehab. Whether or not you choose surgery, early treatment focuses on getting the knee working again.
Treatment includes:
- Regaining motion: Physical therapy helps the knee fully straighten and fully bend. The goal is to match the uninjured knee.
- Reactivating the muscles: A swollen knee shuts down the quadriceps muscle—it’s a reflex. When this happens, the knee can feel unstable, and walking becomes difficult. Therapy helps the quads and glutes fire normally again.
- Building strength: Once swelling improves and the muscles “wake up,” most people can walk, jog, or even run. This usually happens four to six weeks after injury.
Many athletes are surprised that the knee can feel normal again—even without an ACL.
Deciding Whether ACL Surgery is Right for You
One of the biggest questions athletes ask is, “Do I need surgery?”
Maak says the answer depends more on your age, activity level, and goals—not just your MRI.
Deciding whether to get ACL surgery can depend on:
- Age
- How often the knee shifts
- Your lifestyle, profession, and personal needs
- Risk of injuring the meniscus
Research shows that two‑thirds of athletes who return to high‑demand sports without ACL reconstruction end up needing surgery later. Meanwhile, some athletes continue to compete without an ACL. This depends on how the body moves and what the sport demands.
“It’s a rotation ligament,” Maak says. “If your sport requires rotation, it’s far more dangerous to play without an ACL.”
When ACL Reconstruction Helps
If you decide surgery is the best option, ACL reconstruction can help restore stability and reduce the chance of long-term knee damage.
The goal of ACL reconstruction is to protect the knee from repeated episodes of “giving out” that could damage the medial meniscus or cartilage—causing tears and long-term damage.
There are other risks if you don’t repair the ACL, including:
- You may not be able to safely perform certain activities.
- You can further injure other parts of the knee and body.
“ACL surgery isn’t about fixing something as an emergency—it’s about preventing a cascade of future knee problems,” Maak says.
How University of Utah Health Helps Athletes Recover
One of the biggest challenges in ACL care is knowing when someone is truly ready to return to their sport.
“It isn’t as simple as strength tests or how confident someone feels,” Maak says. “Subtle issues—like a weak quad or an imbalance between legs—can increase the chance of tearing the ACL again.”
University of Utah Health is on the cutting edge of managing ACL injuries. The Clinical Outcomes in Orthopaedic Research (COOR) Program, led by Stephan Bodkin, PhD, studies how people move before and after an ACL injury—and after ACL reconstruction.
The COOR program gives surgeons, physical therapists, and athletes:
- Clear data on movement patterns
- Insight into muscle strength and symmetry
- Evidence to support (or delay) a return-to-sport decision
The COOR program helps providers and athletes make safer, evidence‑based decisions about returning to play—especially for sports that require cutting and pivoting.
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