Anterior Cruciate Ligament (ACL) Tear


The ACL is a very important ligament which is positioned deep inside the knee. It crosses the posterior cruciate ligament (PCL) to form a crucifix, hence the name “Cruciate”.





The ACL runs from the front of the tibia (shin bone) to the back of the femur (thigh bone), which makes it effective at stopping the tibia from sliding forwards underneath the femur and preventing the knee from bending backwards (hyper extending). It’s not surprising that a common way of damaging it is by receiving a heavy blow to the back of the shin bone when the foot is fixed.

The ligament doesn’t run parallel, but obliquely from the inside of the tibia (shin bone) to the outside of the femur (thigh bone). This means it’s able to protect the knee by resisting valgus stress (force pushing outside of the knee inwards), especially when the knee is flexed (bent). An excellent example of this type of injury can be seen in this video of Jimmy Bullard playing in the Premier League:

Not all ACL injuries involve physical contact, but they usually involve bent-knee-twisting type action and can be as simple as jumping off a step or pivoting, as seen in this video of Michael Owen:

When the ligament is ruptured, the patient often recalls hearing a ‘popping’ sound and may describe the knee giving way underneath them. This is commonly accompanied by an intense pain and very obvious rapid swelling of the joint – an indication of hemarthrosis (blood entering the joint capsule).

The diagnosis is confirmed via an MRI scan or arthroscopic examination (a camera inside the knee) by a medical consultant. In most cases, patients are offered specialist rehabilitation and strengthening exercises and this may be enough to support the knee, but if they wish to perform activities that involve twisting type actions, such as skiing, it’s advisable to have surgery. This is a very common and effective procedure, where they take a strip of the patient’s semitendinosus (hamstring) tendon or patella (tendon) and secure it to the joint to act as a new ACL. In rare cases of elite sportspeople, such as Michael Owen, they will use donor ligament from a cadaver (dead person).

(The list of conditions given above and subsequent explanations are intended as a general guide and should not be considered a replacement for a full medical examination. Furthermore, we do not purport to treat all the conditions listed. Should you wish to discuss any of these conditions with our chiropractors, please do not hesitate to phone the clinic on 020 7374 2272 or email

Our team of chiropractors and massage therapists are on hand to answer any questions you may have, so get in touch today via or on +44 (0)20 7374 2272.

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