If you’ve injured your anterior cruciate ligament (ACL), you’ll experience some telltale symptoms. There’s typically a popping sensation in your knee, followed quickly by pain and instability. And as with other sudden injuries, once you’ve had a chance to rest and ice your knee, it’s a good time to learn about your best treatment options.

ACL injuries can be treated both surgically and nonsurgically. The best option for you will depend on a number of factors. Keep reading to learn why treatment is necessary, what nonsurgical treatment involves and when to consider ACL surgery.

Types of ACL injuries are based on severity

An ACL injury can range from being somewhat overstretched but with a stable knee joint, to a partial tear or even completely tearing. A complete tear is when the ACL is broken or has pulled off the bone. The majority of complete tears cause instability in the knee, with rare exceptions.

Most ACL tears are partial or complete, and half also involve damage to other ligaments. The extent of the injury can be a deciding factor in determining what treatment is best for you, as fully torn ligaments cannot reattach themselves. However, nonsurgical treatment is generally the first recommendation for all ACL injuries in order to start the healing process and to prevent additional damage.

Treating a torn ACL without surgery requires physical therapy and rehabilitation

Partial and complete ACL tears require physical therapy and rehabilitation, either as a standalone treatment or as preparation for a potential surgery. Physical therapy for an ACL injury focuses on reducing pain and swelling, restoring the knee’s range of motion and strengthening the supporting muscles to increase stability.

If your knee is stable, you have no swelling or pain, and you aren’t trying to return to activities that involve sudden turns or changes in direction, nonsurgical treatment may be the right choice for you.

Without surgery, recovery time for an ACL injury can vary

How long it takes to recover from an ACL injury depends on a number of factors, such as:

  • The severity of the injury
  • Your pre-injury activity level
  • How closely you stick to your physical therapist’s rehabilitation plan

Physical therapy programs for ACL tears can last anywhere between 3-6 months, but it may take up to a year to reach your desired level of functionality.

The main risk of nonsurgical treatment is instability

While treating an ACL tear without surgery can be enough for certain people to return to their regular activities, one of the main risks of not getting surgery is instability, particularly if you have a complete tear. Since a tear won’t go away on its own, there’s no guarantee that you’ll be able to prevent your knee from buckling or giving out. Over time, this can start to damage the other ligaments in your knee, which can lead to other injuries and osteoarthritis in the joint.

When to consider ACL surgery

In general, treating an ACL tear without surgery is acceptable for people with no instability symptoms, no damage to other ligaments and a lower level of activity. ACL surgery is often strongly recommended for people with significant knee joint instability, as well as:

  • Athletes
  • Children and adolescents
  • People who engage in heavy manual labor or other intense activities

If you’ve torn your ACL, the best place to start is with an expert. A knee ligament injury specialist can assess your injury and make treatment recommendations based on your preferences and lifestyle.