How To Check Your ACL - Top 3 Signs You Have An ACL Tear

Anterior cruciate ligament (ACL) tears are a common injury to the knee, especially among athletes. How can you tell if you have torn ACL or not? Today I wanted to share three easy tests I use as a physical therapist to assess the integrity of your ligament and tell whether or not you may have a tear.

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The four major ligaments that stabilize your knee joint are the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL) and lateral collateral ligament (LCL). These ligaments each serve to stabilize and support the knee in different directions.

What is the ACL?

The anterior cruciate ligament (ACL) is one of four major ligaments that hold your knee together. The ACL attaches from the front of your tibia to the back of your femur and is key in providing stability to the knee. Specifically the ACL limits the motion of forward translation (forward "sliding") of the tibia on the femur. It also serves to limit rotation of the tibia on the femur.

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How do you injure your ACL?

Most injuries to the ACL are actually non-contact; no trauma from an outside force is involved. ACL injuries are typically sustained when your foot is planted and then you try to cut laterally or rotate. These motions apply maximum stress to the ACL and, with sufficiently high forces, can cause it to rupture. Another common cause is a blow/trauma to the outside of the knee when the foot is planted.

What are the signs of an ACL injury?

The most common signs of an ACL injury are
- Hearing or feeling a "pop" in your knee
- Joint effusion (swelling in the knee)
- Bruising (depending on the severity of the rupture)
- Joint tenderness
- Instability (feeling like your knee could "give way" while standing, walking, going up/down stairs, etc).

How can I check my ACL to see if it's injured?

If you suspect you may have an ACL injury, you should go get it assessed by a medical professional (either a physical therapist or orthopedic doctor). These individuals are extensively trained in performing tests and measure to assess whether or not your ACL has been compromised.

There are three tests you can perform at home with the help of a friend or family member that will give you a better idea as to whether or not your ACL has been injured.

1. History - one of the major predictors of ACL injury is the history of the injury. As mentioned previously, ACL injuries are typically accompanied by a "pop" that is either heard or felt, swelling, bruising, joint tenderness, and instability. These injuries are often traumatic in nature and happen suddenly as opposed to gradually over time.

2. How to perform Lachman's Test
- Lay the subject on his/her back with his/her knee slightly bent (20 degrees).
- Stabilize the person's femur with one hand and pull the tibia forward with the other.
- If the ACL is intact, you should feel a "catch" at the end limiting forward motion of the tibia on the femur.

3. How to perform an Anterior Drawer Test.
- Lay the subject on his/her back with his/her knee bent to 90 degrees.
- Sit lightly on the person's foot and wrap your fingers around to the back of his/her knee.
- Pull the tibia forward towards you to assess how much motion there is.
- If the ACL is intact, there should be very little motion with a "firm" end feel.
- If there is an ACL injury, there might be excessive motion and an "empty" end feel (no catch limiting forwards translation.

If any of these tests are positive, chances are you've injured your ACL. The next step would be to go see a physical therapist or orthopedic doctor/surgeon to discuss your injury and your options. Please don't hesitate in taking this important next step!

If you have any questions or comments about any of the information presented in this post please feel free to leave them in a comment to this post down below. I'll get to them as soon as I can.

CHECK OUT MORE GREAT VIDEOS FROM TONE AND TIGHTEN:

[PHanomaly]

Excellent info, easy to understand, and 6:47, great close-up, which most youtube videos dont do, making it unclear what they are actually demonstrating! Thank you!!

[nikhiljaiswal]

Great job! Need to learn this for medical school lol! Thanks once again.

[vladmalyk]

Thank u so much for this video I had an MRI already done and been told my ASL was torn but I wanted to double check and this helps alot

[jacekratajczyk]

I wish, our doctors would know those methods. I have torn ACL in 1996. Reconstruction made in 2004. Before reconstruction they were always sure, that ACL is OK. After reconstruction the same. In fact, the ACL graft was torn again in May 2005 and during 14 years and tones of consultation they assured me that everything is fine :)

[LycanPaw]

Recently suffered a twisted knee during my soccer game. Planted my foot, and twisted. Didn't hear the *pop*, but felt bone and bone friction. Great swelling and immobility, of course. Took about 2 weeks to calm that down with anti-inflammatory. The doc did both tests and said "a bit of a give on the ACL". A few days later, my Physio did the same tests and more. Didn't notice any tear and passed all my ACL/MCL and LCL tests (except bending of the knee in full, really painful and not as flexible). 3 weeks after the first incident, I balanced on the leg trying to kick the ball (helping the team warm up), and the twist happened again. This time a lot more pain, down the outside of my shin to the outside of my ankle. Lasted 2 days. X-ray the following day indicated no bone damage and no torn ligament was suspected again. Swelling wasn't as bad. 3 weeks after that, when the knee felt good again, again another twist under the same circumstance (think I'd learn, right??). This time, the twist didn't cause a lot of pain, and it felt a lot less give. Swelling a bit, but nothing significant. Throughout this whole thing (today is 1 week from last incident), I've been able to jog and even sprint. All forward motions are good. Still afraid of sideways and backwards movement. Stairs are good too. Squatting isn't good, still. Swelling behind my knee noticed after doing my knee-strengthening routines. RICE does help. EVERYONE: get a reliable knee brace, don't baby your knee and do your knee strength routines. Take anti-inflammatory and ice it/rest it (RICE). The toughest part of the recovery is to gain trust in your knee again. Took me an entire season (didn't play) to regain trust in my ankle after a really bad sprain with interior bleeding (no surgery needed). Take your time. A sprained knee (which is most likely what I have, still waiting for an MRI) takes between 4-8 weeks, and then rehab. Everyone thinks I've "cracked" or partially torn my ACL. Something that heals by itself.


PS: Second hardest thing is to not play, when you are the manager/player of the team :(

[okorpheus]

So I had an injury to my knee several years ago. I had an MRI and was told it indicated a torn ACL. When I went to an Orthopedic surgeon, he evaluated me doing tests that I remember much being like this video and said he felt it was just a badly strained muscle and should heal with rest. It did get mostly better, but I will occasionally have some instability. In particular, if I take a step backwards and my heel on the side of the injury lands on something where my foot doesn't come all the way down, my knee will almost always shift and give. Should I have this reevaluated? If it was an ACL tear and has been left for several years, are there even repair options that could be considered?

[jaxondakota]

Great video, thank you! 👍 my only question is how can you prevent an acl injury and how

[Chris-gvll]

I came so unbelievably close to tearing it yesterday, I got extremely lucky

[sciencesquadbynikita]

Awesome explanation sir
Love from India🙏

[DeanoSauruzRex]

I twisted my knee on artificial turf around a month and a half ago and didn't allow it to fully heal, I'm inpatient and a month without football (soccer for Americans) with my team is just out of the question (It's bad I know)
In the past I have recovered from rolled ankles and ligament damage fairly quickly and because this was the first time in 25+ years of football that I had twisted my knee I was totally un-educated in the rehabilitation side. I gave my self 3 weeks off and immediately started rehab, at'least what I assumed was good for it, icing, elevation, compression when needed and light walking/jogging in the pool.

I went back way too early and was very weak on my knee but each week i could feel it getting stronger. The last 2 weeks my knee has felt totally fine/normal. I would use KT tape for a peace of mind and mild stability but 3 days ago twisted the knee on the exact same pitch, exact some patch and at almost the exact same game time (spooky) . So, the firs t time I did it there was no pop, no bruising but a small amount of swelling. The second time was the same, no pop, no bruising and a small amount of swelling. I know i have twisted my knee bad because it hurt like a son of a bitch for a good 1 minute and i removed my self from the game immediately...however I am not seeing/feeling the major symptoms of an ACL tear. I hurts across the back of the knee and just underneath the knee cap. Am I very lucky in that i may have just hyper extended it and not recovered enough? Fortunately its the last game of the season and I get to sit off it for 6 months.

I'm 33 years old and the thought of possibly giving up football on the weekend is daunting and quite frankly has brought me down to my lowest since the second Injury.
Its uncomfortable, bending my knee past 45' degrees is painful but i don't feel the "grinding" symptom or an inability to put weight on it...I can't stand on one leg with it fine.

[LycanPaw]

Family doctor referred me to a specialist. I went to the hospital where a specialist saw me. Then he referred me to a surgeon who was running a physio clinic. Saw the surgeon at his clinic and then I went under the knife. One day surgery, in and out. Next day I was doing squats using my couch for assistance. Entire thing happening in Mississauga, ON, Canada. Dr. DiPasquale. An emerging top orthopedic in North America. I got lucky. Real lucky to have him. I went to my own physio clinic closer to home, but had regular visits at the hospital where in 10mins he told me I'm the fastest recovery he's seen. 4months I was running straight. 6 months I was able to play with brace. 8months I could've taken it off, my I was too afraid. At 9months or so, I damaged it and forced to play without it. No issues

[soham]

Can you please upload a video about partial acl tear exercises ?

[jimmyreinstein]

Can you do a video on the other knee ligaments and IT band tests?

[anneennaanne]

Thank you for this! I have Mild ACL according to my MRI result. 😢

[howardconder]

Thanks.. I still play soccer and had a bad tackle 9 months ago and still suffering. MRI shows some tares to MCL and Meniscus. I developed a cyst and had it lanced and injections followed but after a couple of months the pain came back and I am not sure what to do next. Do I have an op or what?

[wamikavashistha]

I once had a ligament tear 12 years back in my high school but didn't get any physiotherapy afterwards.. now I have gained much weight and on the same knee I experience pain. I have swelling on the right side of my left knee, I have so many sitting hours I experience pain when I lay my legs down for longer hours... Is there a solution to this?

[axhadriano]

I can feel the pain and I’m not even hurt oooof!!!

[cjbrown]

After I hit my knee on the airbag, it had been swelling for 3 months with no pain.
At first it was only painful when I put pressure on it to get in bed. The swelling is outside the knee cap on the inner side

[isnagtowin]

I have a knee injury and trying to see if it’s an ACL injurie so I’m trying to do these test. How do bend that knee to that position when your hurt

[mariahargrove]

I was having a lot of pain in the back of my knee, I had no swelling I did not hear a pop my knee was stable, I was not able to bend without pain and walking was painful as well. I went to my doctor he advised me to get a MRI, I did and was told I had a tier in the ACL. I went and had surgery to replace it with a donor I been going to therapy for
(3 months) now, my knee is still swollen, the other complaint I have is that the knee is still stiff, even though I go to therapy 3 times a week, and I stretch and also doing light workouts. Way is that? Is the stiffness normal it never feels better. I also have issues now with my feet (plantar fasciitis) I was told my doctors (two of them) why did that happen? I never had that problem before, until after the ACL surgery.
Please give me your option of that I am experiencing.
FYI I am woman in her mid 50.