An ACL tear can make the knee feel unstable during cutting, pivoting, landing, or even everyday movement. Dr. Jonathan Gelber evaluates the injury, associated meniscus or cartilage damage, your activity goals, and the stability of your knee before recommending rehabilitation, reconstruction, or another appropriate plan.
What an ACL injury means for your knee
The anterior cruciate ligament helps control forward movement and rotation of the shin bone relative to the thigh bone. ACL injuries commonly occur during a sudden stop, direction change, awkward landing, or collision. Many tears are complete, but the symptoms and functional impact vary.
A pop, rapid swelling, loss of motion, difficulty bearing weight, or a knee that gives way should be evaluated. These symptoms can also occur with a meniscus tear, cartilage injury, fracture, or another ligament injury.
How ACL tears are diagnosed
Diagnosis begins with the injury history and a focused knee examination. Dr. Gelber evaluates swelling, motion, ligament stability, walking, and signs of associated injury.
X-rays may be used to look for a fracture or other bone injury. MRI can confirm an ACL tear and identify associated damage to the meniscus, cartilage, or other ligaments. The scan is interpreted together with the examination and your goals; an MRI finding alone does not determine treatment.
Treatment is based on stability and activity goals
There is no single treatment for every ACL tear. The decision depends on whether the knee gives way, the sports or work you want to return to, your age and skeletal maturity, the tear pattern, and whether the meniscus, cartilage, or other ligaments are injured.
Rehabilitation without reconstruction
A structured rehabilitation program may be reasonable when the knee is functionally stable, activity demands do not require frequent pivoting or cutting, and associated injuries do not require surgery. Treatment focuses on restoring motion, reducing swelling, rebuilding strength, and improving balance and movement control.
Some patients complete rehabilitation and function well without reconstruction. Repeated giving-way episodes warrant reassessment because they can place the meniscus and cartilage at risk.
ACL reconstruction
Reconstruction is often considered for active patients who want to return to pivoting or cutting activities, have persistent instability, or have important associated injuries. The torn ligament is generally replaced with a graft rather than simply stitched together.
When surgery is appropriate, the graft choice, timing, meniscus treatment, and rehabilitation plan are individualized. Learn more about arthroscopic knee surgery and how Dr. Gelber approaches tissue preservation.
Returning to sport is a process, not a date
Return to running, cutting, and sport should be based on recovery of motion, strength, movement quality, functional testing, and confidence—not the calendar alone. Rehabilitation progresses from swelling control and range of motion to strength, landing mechanics, change of direction, and sport-specific work.
For younger athletes, skeletal maturity and reinjury risk require additional planning. See our approach to adolescent sports injuries.
What to do after a new knee injury
Until the knee is evaluated, avoid pivoting or returning to sport on an unstable knee. Use support as needed if weight bearing is difficult, and seek urgent care for a visibly deformed knee, loss of circulation or sensation, an open injury, or pain that cannot be controlled.
An orthopedic evaluation can clarify whether the problem is an ACL tear, another source of knee pain, or a combined injury.
Build a plan around the activities you want to keep doing
Dr. Gelber is a board-certified orthopedic surgeon with fellowship training in sports medicine. He will review your knee stability, imaging, associated injuries, and goals, then explain the tradeoffs of rehabilitation and surgery in plain language.
Meet Dr. Jonathan Gelber or schedule an evaluation in Toluca Lake.
