Getting back on your feet after an anterior cruciate ligament (ACL) injury may require physical therapy alone or in combination with knee surgery. Duke knee specialists combine the latest advances in ACL surgery with the knowledge and expertise of knee-specific physical therapists. We know you want to return to your sport or exercise routine as soon as possible, and we do our best to help you achieve your goal safely.
When to Seek Treatment
Your knee relies on four major ligaments to keep it stable.
- The ACL and the posterior cruciate ligament (PCL) are in the center of your knee. The ACL stabilizes the knee from sliding forward while the PCL stabilizes the knee from backward movement.
- The medial collateral ligament (MCL) controls stability of the inner (medial) knee while the lateral collateral ligament (LCL) controls stability of the outer (lateral) knee.
When to Make an Appointment
A popping sensation and sound with knee swelling during physical activity should prompt early medical attention; there's a good chance you’ve torn your ACL or had another knee injury.
Visit Duke Orthopaedics Urgent Care
Our convenient orthopaedic urgent care clinic is open seven days a week. Get fast service with no long waits and no unnecessary exposure to illness. No appointment is needed; walk-ins are welcome.
Duke Health orthopaedic clinics are located throughout the Triangle. In-person and virtual appointments are available.
Do You Need ACL Surgery?
Age and Activity Level
When the anterior cruciate ligament (ACL) is torn or stretched out of shape, it leads to knee instability. This will feel like your knee is buckling or giving way, particularly with activities that involve pivoting or cutting. If you’re older, sedentary, and engage in mostly straight-line activities like cycling or jogging, physical therapy may be all you need. Younger people who want to remain active or return to jumping, cutting, or twisting activities will benefit from ACL reconstruction surgery combined with physical therapy before and after surgery.
Thorough Exam Determines Extent of Injury
A thorough examination, including X-rays and MRI, will determine if you suffered a knee ligament or another knee injury. If it’s an isolated MCL, PCL, or LCL ligament injury, knee surgery may not be necessary. Our experience shows that when these injuries occur in isolation, they can heal on their own better and faster with knee bracing, early motion, physical therapy, and anti-inflammatory medication. When these injuries are combined with an ACL injury, reconstruction surgery may be recommended.
Physical Therapy for ACL Injuries
In many cases, you can receive physical therapy, injury treatment, and follow-up care all at one convenient location.
Before Your ACL Surgery
You will start knee-specific physical therapy immediately. Physical "prehab" prepares your knee for ACL surgery and ensures you have a faster recovery. If you’ve torn your MCL, PCL, or LCL, it may be all you need to heal the ligament.
After Your ACL Surgery
After surgery, your physical therapists work on strength and conditioning of your knee. Functional movement screening, developed at Duke, gives your doctor objective measurements of your recovery and helps him or her determine when you can safely return to your normal activities. This minimizes the risk of re-injury.
Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our orthopaedics program is nationally ranked, and the highest ranked program in North Carolina, according to U.S. News & World Report for 2021–2022.
Why Choose Duke
A Team of Knee Specialists
Duke knee specialists include primary care sports medicine specialists, orthopaedic physician assistants, ACL surgeons, and physical therapists who specialize in knee injuries associated with specific sports. We understand how pivoting and sudden stops and starts lead to torn ACLs, and how to strengthen your knee to minimize your risk of re-injury.
You Benefit from Our Ongoing Research and Innovation
- Duke Orthopaedics pioneered several surgical breakthroughs, including novel fracture repairs and advanced surgical techniques.
- Our surgical success is based on decades of ongoing Duke research.
- We use sophisticated tools to study patient outcomes, measure surgical success, and fine-tune our techniques to ensure you have the most options and experience the best outcome.
Our Large Surgical Volumes Result in Better Outcomes
You can view our surgical volume for each specialty on our providers' profile pages.
The Right Graft for Your Injury
ACL surgeons use donor tissue or your own quadriceps, patella tendon, or hamstring tendons to reconstruct your ACL. Our knee surgeons rely on extensive Duke research and years of experience performing these surgeries when recommending which graft will work best for you. Graft recommendations take into consideration the type of athlete you are, your age, and previous injuries. Our goal is to recommend a graft that minimizes your pain and maximizes your recovery and performance after ACL reconstruction surgery.