Lower Back Pain in Sports: Causes, Risks, and Smart Prevention Tips

 ACL Injury Treatment Without Surgery

ACL Injury Treatment Without Surgery

A Comprehensive Guide to Non-Operative Healing & Recovery 🩺

Nonsurgical treatment for anterior cruciate ligament tears

Physicians at NYU Langone can recommend treatment options for anterior cruciate ligament (ACL) injuries, ranging from immediate strategies to reduce inflammation to physical therapy and ongoing efforts to strengthen and support the joint.

These treatments may be an option for people who do not want to undergo ACL reconstruction or reconstructive surgery, or for those who do not normally put too much stress on their knees from teleport or contact sports.

More Informatics 💡 Q&As From About ACL Injury Treatment Without Surgery.

Q.1: Can you fix your ACL without surgery?

Ans: A fully ruptured ACL typically will not mend naturally or reconnect absent a surgical procedure. The ligament fibers are usually too far apart to be completely reattached. In a non-surgical sense, however, "treatment" refers to the body's ability to compensate. Through a system of physical therapy, the muscles around the knees (quadriceps, hamstrings, calves) can be greatly strengthened. The support of these muscles can provide enough knee stability for most individuals to return to a normal, active lifestyle.

Q.2: Can I still ride with a torn ACL?

Ans: Indeed, typically it is still possible to walk even with a ruptured ACL. The ability to walk after an ACL injury often depends on the severity of the tear, the presence of other knee injuries, and the strength of the surrounding tissue. Initially, pain, stiffness, and discomfort may develop, making walking difficult or impossible. However, the initial acute symptoms resolve, and most individuals regain normal walking ability with the help of crutches or braces. High-impact activities, sudden standing, or pivoting movements are generally more difficult and pose a risk of re-injury.

Q.3: Who is the best surgeon for non-surgical ACL surgery? 

Ans: The best candidates for non-surgical ACL repair are usually those with unilateral ACL tears, have demanding lifestyles that do not involve professional football sports, and have low career expectations. People who are fine with a broken back, and those who are serious about an intense and long-lasting physical therapy program, also make strong athletes. It should be checked by your doctor to ensure it is appropriate for your coat size and individual goals.

Q.4: What is the main goal of physical therapy in the event of an ACL tear without surgery? 

Ans: The main goal of physical therapy for a torn ACL without surgery is to restore knee stability and function by strengthening the muscles surrounding the tendon. The focus is on building quadriceps and hamstring strength to compensate for ligament injuries. The treatment also improves range of motion, balance, and proprioception (the sense of the body’s position in space), allowing patients to move safely daily and return to certain sports.

Q.5: How long does non-surgical ACL rehab take? 

Ans: Nonsurgical ACL reconstruction typically involves a long-term commitment, often lasting 6 to 12 months or more. The initial stage centers on decreasing rigidity and regaining mobility, succeeded by gradual reinforcement of the quadriceps and hamstrings. Functional training, including balance and agility exercises, is gradually introduced. Time depends on individual conditions, medical commitments, and specific functional goals such as returning to specific activities.

Q.6: Can I play sports with an ACL tear without surgery? 

Ans: Return to sport from an ACL tear without non-surgical treatment depends on the demands of the sport and the condition of the individual knee. Low-impact sports like biking, swimming, or rowing can do more. However, in high-impact, pivoting, or cutting sports (e.g., football, basketball, skiing) there is an increased risk of reinjury and further damage to the knee without ACL reconstruction. A thorough evaluation by a physical therapist and physician is necessary to determine safe participation.

Q.7: What are the risks of choosing non-surgical ACL surgery? 

Ans: The primary risk of choosing nonsurgical ACL treatment is chronic knee instability, which can lead to recurrent “stepping” episodes. These episodes of instability cause further damage to other structures of the knee, such as the menisci (cartilage) or other ligaments, resulting in the early onset of osteoarthritis. Although non-surgical methods limit the risks of surgery, effective management of these risks requires significant lifestyle changes and strict adherence to rehabilitation.

Q.8: What is the role of bracing in non-surgical ACL treatment? 

Ans: Bone splinting has an adjunctive role in the nonoperative treatment of ACL injuries, especially in the early stages of recovery or when returning to specific activities. A functional ankle brace provides posterior stability, reducing episodes of “stepping” and providing a sense of security. However, fat does not replace strong muscles. The first step is often completing a comprehensive physical therapy program, not replacing essential training for long-term stability.

Q.9: How is a partial ACL tear medically different from a complete tear? 

Ans: Unilateral ACL tears often have greater success with nonoperative treatment than complete tears. With some tears, some ligament fibers are left intact, which inherently provides stability. Treatment continues through physical therapy to strengthen the surrounding muscles to maximize knee function and prevent dislocation until complete recovery. Although there are non-surgical options for true tears, the inherent discomfort is much greater, and the approach is often highly dependent on the extent of the procedure and commitment to tensile strengthening.

Q.10: Can non-surgical ACL treatment prevent future arthritis? 

Ans: Unfortunately, no surgical or non-surgical treatment of the ACL can guarantee that you will not develop knee arthritis in the future. ACL injury, regardless of treatment, alters the biomechanics of the knee joint. However, non-surgical treatment, especially if instability persists, can lead to more frequent knee “displacement,” further damaging the meniscus and cartilage, and increasing the risk and severity of osteoarthritis over time. Maintaining knee stability is important.