ACL Tears: Causes, Symptoms, Diagnosis & Treatment from an Expert Austin ACL Surgeon

What are Anterior Cruciate Ligament (ACL) tears?

If you’re an athlete or active individual in Austin experiencing knee pain or instability after a sudden injury, you may be facing an anterior cruciate ligament (ACL) tear.

Inside your knee joint, you have two cruciate ligaments: the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). The anterior cruciate ligament crosses over the front of the PCL, forming an “X.” Together, these major ligaments, along with other structures such as the medial collateral ligament (MCL) and lateral collateral ligament (LCL), help maintain and control the back-and-forth motions of your knee and prevent the shin bone (tibia) from sliding in front of the thigh bone (femur). When the anterior cruciate ligament sustains injury and tears, it is known as an anterior cruciate ligament tear or torn ACL.

The ACL is one of the most common torn ligaments in the knee, often injured during sports involving abrupt directional changes, landing incorrectly from a jump, or hyperextension of the knee, like soccer and basketball, and can lead to significant knee instability requiring advanced musculoskeletal care and often arthroscopy with tissue graft reconstruction.

An injured anterior cruciate ligament is known as an ACL sprain, which often requires evaluation at a specialized clinic by an experienced Austin ACL surgeon. The severity of ACL injuries can vary and is measured according to the number of tears that occurred, often necessitating advanced imaging such as X-rays and MRI and a thorough rehabilitation program.

There are three grades of anterior cruciate ligament injuries, which reflect the extent of damage and guide treatment decisions, including whether to undergo ACL surgery or repair:

Grade 1 sprains – the ACL has sustained a minor degree of stretching or a partial tear, but can still keep the knee stabilized. This is considered a mild knee injury and may respond well to rest and physical therapy under attentive orthopedic care.
Grade 2 sprains – a partial ACL tear has occurred, causing the ligament to become weak and loose, which in many cases requires more focused orthopedic care and possibly a procedure to reconstruct the ligament.
Grade 3 sprains – a complete ACL tear has occurred, splitting the ligament in two and causing instability of the knee joint. A complete ACL rupture is a serious condition that often requires ACL reconstruction using either an autograft or allograft. This surgical procedure is typically done arthroscopically with anesthesia and followed by a structured rehabilitation protocol to ensure quality care and optimal recovery.

What causes the ACL to tear?

ACL injuries occur when the knee sustains trauma, typically during sports or related activities. Trauma to the knee can occur through a direct impact, such as a football tackle, or through a non-contact mechanism. Most ACL tears are the result of non-contact knee injuries, which occur when the body makes an awkward maneuver or movement. Most ACL injuries occur with these movements, often causing significant knee pain and requiring evaluation by a fellowship-trained Austin ACL specialist who specialize in knee injuries:

A quick change in direction
Coming to an abrupt stop
Decreasing speed while running
Making an incorrect landing

Female athletes are at an increased risk of ACL rupture due to anatomical and hormonal factors. Risk factors include differences in neuromuscular control, weaker hamstring muscles compared to quadriceps muscles, and hormonal influences that affect ligament laxity. ACL injuries can also be associated with damage to other knee ligaments, such as the medial collateral ligament (MCL), lateral collateral ligament (LCL), or the medial meniscus, especially when the injury occurs during sports.

These associated injuries can further affect knee stability and sometimes lead to knee osteoarthritis later in life, impacting long-term outcomes if not properly managed by a fellowship-trained surgeon in Austin, TX.

Injury prevention programs focusing on neuromuscular training and strengthening of the quadriceps tendon and hamstring muscles are essential to reduce the risk of ACL tears and secondary injury. Delaying ACL reconstruction surgery after injury may increase the risk of meniscus tears and damage to articular cartilage, emphasizing the importance of timely evaluation and treatment by experienced Austin ACL doctor, M. Tyrrell Burrus, MD, , who has helped thousands of patients in Austin and surrounding locations like Cedar Park, Georgetown, Marble Falls, and Round Rock. Dr. Burrus utilizes a structured, phase-based rehabilitation protocol that includes functional testing as part of the return-to-sport plan to ensure optimal recovery and minimize re-injury risk.

What are the common ACL tear symptoms?

Typically, the very first signs that you may have an ACL tear are a sudden “popping” sound in your knee and feeling as though your knee may buckle. This is often accompanied by severe pain and tenderness in the affected area, indicating injury to the soft tissues within the knee joint. Other signs and symptoms of a complete ACL tear may include:

Knee swelling within 24 hours of the anterior cruciate ligament tear, which is a common injury that causes inflammation and fluid buildup.
Feeling as though your knee is unstable or giving out, especially during physical activities or sports that require pivoting or sudden changes of direction.
A decreased or loss of knee range of motion in the injured knee, making it difficult to fully bend or straighten the joint.
Experiencing discomfort or difficulty bearing weight on the injured leg when walking or standing.

These ACL tear symptoms often prompt patients to seek evaluation by a sports medicine physician or physical therapist, who can perform a thorough physical examination and may recommend magnetic resonance imaging (MRI) to confirm the diagnosis and assess the extent of damage to the ACL and other knee ligaments, such as the medial collateral ligament and lateral collateral ligament.

Consultation with a fellowship-trained Austin ACL surgeon specializing in sports medicine is recommended to discuss surgical options, including arthroscopic ACL reconstruction using allograft or autograft tissue. Early diagnosis and treatment by skilled physicians improve patient satisfaction and long-term knee stability.

How do I know if I have an ACL tear?

If you are experiencing any of the above symptoms or believe you have an ACL tear, an evaluation by an experienced medical professional or a sports medicine physician can help determine the cause of your symptoms.

To help diagnose an ACL tear, your surgeon in Austin will begin by going over your medical history and symptoms. Next, your ACL tears doctor will perform a physical examination to help assess the injured knee against the non-injured knee. A pivot shift test, anterior drawer test, or other manual exams may be used to assess knee laxity and rotational stability, which are key in determining if the ligament is hurt.

These tests help evaluate whether the anterior cruciate ligament is intact or if there is a partial ACL tear or complete ACL rupture. Early diagnosis by knowledgeable providers is essential to guide treatment options, which may include anterior cruciate ligament surgery, such as ACL reconstruction using a quadriceps tendon autograft or patellar tendon graft, especially for active patients seeking to restore knee stability and function.

ACL reconstruction is typically performed arthroscopically as a minimally invasive procedure by a board-certified surgeon with a great bedside manner. Recovery usually takes 6–9 months, with rehabilitation following a structured, phase-based protocol. Most patients start bearing weight immediately after ACL surgery and begin active range-of-motion exercises within days post-surgery.

How is a torn ACL treated?

If you are suffering from an ACL tear, a common type of anterior cruciate ligament injury affecting the knee joint, there are both surgical and nonsurgical treatment options available to manage pain and restore function. While the anterior cruciate ligament cannot heal on its own after a complete tear without ACL reconstruction, some patients, particularly older individuals or those with low-activity lifestyles, may benefit from conservative, nonsurgical approaches.

At our practice, we prioritize nonsurgical services initially to help manage symptoms, support healing of partial ACL injuries, restore mobility, alleviate pain, and prevent further progression of damage to the ACL and other knee ligaments, such as the posterior cruciate ligament and collateral ligaments. Our board-certified and fellowship-trained Austin ACL doctor carefully evaluates each person to determine the best treatment plan based on their specialties and individual needs.

Nonsurgical treatment options for anterior cruciate ligament injuries may include:

Use of a knee brace to support and stabilize the knee joint
Crutches to prevent further injury and reduce weight bearing on the injured leg
Physical therapy and targeted exercises designed to restore knee function, improve leg strength, and enhance stability by strengthening surrounding muscles like the quadriceps and hamstring muscles. Rehabilitation follows a structured, phase-based protocol and includes functional testing as part of the return-to-sport plan, which is helpful for effective ACL recovery.

For athletes and active individuals aiming to return to sports, surgeons often recommend anterior cruciate ligament reconstruction surgery. ACL reconstruction surgery typically involves arthroscopic surgery, a minimally invasive technique using small incisions, that replaces the torn ACL with a graft, allowing for faster recovery and improved knee stability following a complete ACL tear. Additional therapies, such as platelet-rich plasma therapy, may be used to promote healing, reduce pain, and support rehabilitation after ACL surgery. Dr. Burrus provides clear explanations for his surgical recommendations and alternative treatment options.

Consultation with a fellowship-trained Austin ACL surgeon specializing in sports medicine is recommended to discuss surgical options and surgeon revision rates to ensure quality outcomes. Recovery usually takes 6–9 months, with many patients returning to light exercise in 4–6 weeks.

Schedule a Consultation With an Austin ACL Surgeon, Considered One of the Best ACL Tear Doctors in Austin, TX

M. Tyrrell Burrus, MD, is an experienced fellowship-trained surgeon practicing at an academic medical center in Texas, specializing in anterior cruciate ligament injuries and anterior cruciate ligament reconstruction surgery. He is dedicated to providing high-quality, specialized, and holistic care to restore knee stability, whether your ACL is intact or requires anterior cruciate ligament reconstruction surgery, using minimally invasive arthroscopic techniques and personalized graft selection for optimal outcomes.

Early evaluation by a skilled Austin ACL specialist is crucial to prevent further injury and reduce the risk of second ACL injuries or complications involving other knee ligaments, such as the medial collateral ligament or lateral collateral ligament. Dr. Burrus maintains a high surgical volume, which is associated with improved patient satisfaction rates and lower re-tear rates, and works closely with specialized sports physical therapists for effective ACL recovery.

Call (512) 324-9170 or fill out the form on this page to schedule a visit with a sports medicine physician and physical therapist team committed to guiding you through your ACL treatment and rehabilitation journey, ensuring the best outcomes for the next generation of active patients.