ACL injuries or Knee ligament injuries are seen commonly by the best orthopedists in town, as these injuries often times occur in aggressive or elite level San Diego athletes that yearn to return to play.


Anterior Cruciate Ligament (ACL) injuries or simply ACL injuries happen to hundreds of thousands of people every year.  ACL  injuries usually end play and can be extraordinarily painful. Although debilitating, they are treatable. You just have to make sure you know how severe your injury is and what you can do to treat the problem.bruised-knee-contusion

ACL injuries are actually quite common among people who participate in high action cutting sports, such as:

  • Soccer
  • Football
  • Basketball
  • Lacrosse

Levels of Severity with ACL Injuries

There are three categories of injuries based on what kind of damage has been done to the ACL:

  1. Grade 1 ACL injuries: This is the easiest ACL injury to heal. A grade one ACL injury is the result of the ligament stretching slightly. It does not cause the knee joint to become unstable.
  2. Grade 2 ACL injuries: This grade of injury is in the middle, and the least common of all knee injuries. A grade two type of injury happens when the ligament stretches to the point where it is unstable. It is more commonly known as a partial tear.
  3. Grade 3 ACL injuries: This ACL injury is the most severe. A grade three injury is labeled when the ligament is completely torn in half. This can cause the knee to become extremely unstable. Severe knee pain and an almost impossible time walking are common symptoms.


At the end of the day, the grade doesn’t really matter.  To an orthopedist this injury boils down to those athletes that are able to compensate (ie, their knee is functionally stable) and those that can’t (ie, their knee is functionally unstable). Having a functionally stable knee means that that athlete is able to return to his/her level of customary play in cutting sports without the knee giving out.  Generally speaking, one third of athletes will be able to return to play despite their injury with little to no intervention; one third of athletes will be able to return to play after engaging in directed physical therapy without surgery; one third will require surgery in order to return to play due to continued knee instability despite physical therapy.

Treatments for ACL injuries

Non-Severe ACL Injuries

If you only have a mild injury, you can, usually, use physical therapy to treat your injuries. Your physical therapist will have you go through a series of exercises and motions to help you regain full control of your knee again. It can take some time to heal completely, depending on the injury type.

Since this is so common with sports athletes, there are specialists who work specifically with athletes. The goal is to help them get back into their sport of choice as quickly as possible.

Severe ACL Injuries (ie, unstable knee)

One third of the athletes will require surgery to regain a stable knee, despite having engaged in physical therapy.  With a physical examination and an MRI scan, a well-trained sports medicine surgeon can anticipate the need for treatment of various concomitant injuries: cartilage damage, meniscus tears, etc.  severe-acl-tear

ACL reconstruction can be done in a variety of ways.  First decision to be made is whether a patient chooses to use their own tissue or donor tissue to reconstruct the ligament.  If a patient chooses their own tissue, the options are bone-patellar tendon-bone, or hamstring tendon, or quadriceps tendon.  Although some surgeons may argue that one type of tissue is superior to the other, many studies have looked at this and there is little to no clinical difference.

If you have been told that you have an ACL tear or are concerned about a knee injury, contact our award winning sports medicine doctors at San Diego Orthopedic Surgery Clinic.



ACL tear can happen to proathletes or the teenage competitive soccer player scrimmaging in a Carlsbad park on a sunny  San Diego Sunday afternoon.Isaiah-Pead-acl-tear

Arguably the most volatile position in the NFL is the running back. Injuries, everyday wear and tear, and age can shorten the career of a running back. For Isaiah Pead, the end could be near. He was a top five running back in the 2012 NFL draft. He has been off and on injured, had some off-the-field issues, and has been overall underwhelming when he is available to play. Unfortunately for Pead, his career outlook just got even bleaker as he has suffered a season ending injury during a preseason kickoff return. Pead was running down field full speed when his feet got tangled and he went down. The result: an ACL Tear.  This knee ligament injury will stop you in your tracks.  Most athletes report hearing and feeling a pop and then they go down.acl-tear-san-diego

The ACL or anterior cruciate ligament connects the front of the shinbone (tibia) to the middle of the kneecap (patella). The main purpose of the ACL is to provide rotational stability and to prevent the shinbone from getting too far ahead of the thighbone (femur).

Sometimes ACL tear can occur as a result of direct contact with the knee, but more times than not, an ACL tear is a non-contact injury such as in the case of Isaiah Pead. The cause of this non-contact injury is often due to rapid direction changes, sudden stops and decelerations, as well as incorrect landing and pivoting. The symptoms of a ACL Tear include knee pain, knee swelling, knee discomfort, knee tenderness, and decreased range of motion in the knee.

If a knee injury has occurred, an orthopedic physician will compare the structures of your injured and your non-injured knee and in most cases this is sufficient enough to diagnose ligament tears. However, the doctor will sometimes schedule an x-ray and an MRI in order to dismiss potential confounding problems, to validate the diagnosis, and to determine the degree of the injury.

Treatment for an ACL tear is dependent upon the severity of the injury. Grade I sprains involves overly stretched but still in tact. Grade I sprains typically require keeping the weight off the affected leg. Once the swelling has subsided, a physical therapy regimen will be prescribed. These exercises are meant to strengthen the leg muscles that support the ACL. Grade II sprains involves the ACL being stretched to the point that it has become loose. Grade II sprains are a little trickier to handle because they may or may not require surgery depending on lifestyle of the patient. The non-surgical approach is similar to that of grade I sprain but generally this is a longer process since these sprains are more severe. The surgical approach involves the rebuilding of the ligament via a tissue graft followed by rest and physical therapy. Grade III sprains occur when the ligament has been completely split into two pieces. In grade III sprains, surgery is required to rebuild the ligament. The recovery time for ACL surgery is often six to nine months. The prognosis for surgical recovery is positive and many athletes are able to return to their respective sport at near pre-injury form.ACL-Tear-Grades

As for Isaiah Pead, there is a very good chance he will make a full recovery, but considering his career thus far, it is doubtful he will ever become the player we once thought he could be. Then again, sometimes a player needs to hit rock bottom before they can really begin to understand what it takes to make it, maybe this, will be his wakeup call.

If you have been told you have an ACL tear or are suffering from knee pain, contact our top sports medicine specialists at Orthopedic Surgery San Diego to obtain a consult and be treated they way you deserve!




Many of our Carlsbad and North County San Diego competitive soccer players sustain ACL tear every year.  Even though, sports medicine specialists take measures to prevent such devastating knee injuries, a twisting injury to the knee suffered by the Arizona Cardinals’ Darnell Dockett is just the latest ACL tear to sideline a professional athlete.acl-tear

ESPN reported that Dockett, a defensive tackle, damaged the knee when his foot caught in the turf during training camp in Tempe, Ariz. Following an examination, doctors scheduled Dockett for surgery. Just a few days earlier, Rams quarterback Sam Bradford sustained an ACL tear  as a result of a hard hit by a defensive lineman. Both players are out for the season.  The risk of sustaining such knee injuries and other ligament tears are somewhat preventable with proper core strengthening.  acl-tear-knee-injury

ACL is short for anterior cruciate ligament, connective tissue that extends from beneath the femur (thigh bone) to the top of the tibia (the large bone in the lower leg). The smallest of the four main ligaments in the knee, it stabilizes the knee for rotational movements. The ACL enables a person to make fast “cuts” while running. It is rarely stressed during activities like jogging that do not involve sudden stops, twists or turns.

ACL tear and sprains were once referred to as “trick knees.” They occur frequently in football, basketball, soccer and tennis because of the pressure and repetitive stress that athletes put on their knees. Most of the 250,000 to 300,000 ACL tear injuries reported in the United States each year involve people who play sports. The odds of an athlete spraining or tearing an ACL reportedly is about 1,000 to 1.

ACL Tear Types:

A Grade 1 ACL tear features a ligament that has been stretched too far. It does not usually prevent normal use of the knee. A Grade 2 sprain results from the ligament being stretched to the point that it is loose. This condition also is called a partial tear. The most serious ACL tear injury, a Grade 3 sprain, is a complete tear, in which the ligament is severed and the knee becomes unstable.acl-tear-grades

The ways that Dockett and Bradford hurt their knees were typical. ACL tears result from changing direction too quickly or stopping suddenly, landing wrong on the knee after jumping, and the blunt-force trauma of a blow to the joint or a collision. When an ACL tear occurs, the person might hear a popping sound in the knee. The joint gives out and quickly becomes inflamed. This causes a great deal of pain, as well as loss of mobility and range of motion.

While a mild sprain sometimes heals without surgery, an ACL tear must be repaired for a patient to regain full use of the knee. It is not possible to merely stitch back together the two pieces of a severed ligament. Orthopedic surgeons reconstruct ACLs by grafting tissue from the patellar tendon (with attaches the kneecap to the shine bone), the hamstring tendons (in the back of the thigh) or the quadriceps tendon (which runs from the kneecap to the thigh). Tissues from cadavers also are used.

The arthroscopic procedure requires only small incisions in the skin. Surgeons insert miniature instruments, which they manipulate to graft the tissues. Patients experience less pain, and recover more quickly, than they would if more invasive surgery were needed. Sometimes, ACL injuries happen in conjunction with damage to other ligaments or cartilage. That can necessitate more extensive surgical procedures.  You don’t have to live with the knee pain and instability.  Contact our Orthopedic Surgery San Diego Sports Medicine specialists to help you regain your mobility and be the best athlete you can be.


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