A Tale of Two Moments: Varying Experiences With Torn ACL Symptoms

Christopher C. Dodson, MD January 23rd, 2015

With between 70,000 and 80,000 incidents reported annually in the U.S., it’s no wonder anterior cruciate ligament injuries have become one of the most recognizable - and most dreaded - knee injuries. Though they do often occur in the context of impact sports, a tear to the ACL can happen to anyone during a variety of different movements, including pivoting, sudden stopping or twisting, and jumping.

Torn ACL symptoms can look similar to other knee ligament injuries and, in fact, sometimes occur in conjunction with associated injuries within the knee joint (for example, a torn meniscus). While a quick pivoting motion during a high-intensity sport such as soccer, basketball or football is a more common setting for this type of injury, ACL tears can occur during simple, non-athletic activity as well.

The two stories below indicate the different possible settings, while also highlighting the similarities that are often found in symptoms and treatments of ACL injury cases.
A Soccer Story: Torn ACL Symptoms On the Field of Play
Mike was a junior in college, playing competitive soccer and loving the experience of being a student-athlete. He had finally broken into the starting lineup and had even been named team captain. It was shaping up to be Mike’s best season yet and one for the team history books when they made it into the national tournament and found themselves competing for the championship.
But during that final game, something unexpected happened. As he dribbled the ball through the midfield, past several defenders on his way to the goal, Mike cut sharply back and forth to weave in and out of the opposing players. 
The cheers of the crowd were abruptly silenced, though, when he suddenly buckled to the ground. Those familiar with common torn ACL symptoms were not surprised to later hear Mike report that the injury had been accompanied by an audible “popping” noise.
In addition to immediate pain, Mike also experienced swelling in his knee and found that he was unable to even leave the field without the support of his coach and athletic trainer, who had run out to assist him. On the sidelines, the trainer suggested that the injury appeared to be a torn ACL and later that diagnosis would be confirmed by a sports medicine physician.
A Busy Morning: It’s No Time for an ACL Injury
Nicole, a busy mother of three and a working professional, was on her way out the door on a cold, January morning. After packing the kids’ bags with lunch for the day, cleaning up spilled cereal and searching the entire house for her keys, she finally thought she was ready to go.
Already running a few minutes behind, Nicole was disappointed to step out and find her car totally covered in heavy frost from the cold night. She ran back inside, grabbed a scraper and quickly started on her way down the driveway to her car. As she stepped out onto the frosty pavement, her leg slipped sideways out from under her and she fell to the ground.
Nicole felt sudden, intense pain. She tried to readjust her body’s position and realized she could barely move her right leg, which felt immobilized at the knee. When a neighbor saw her and came over to help, Nicole also discovered that she was unable to put any weight on the injured knee
A missed day of work and an MRI later, an orthopedic physician confirmed for Nicole that what she had experienced that morning were torn ACL symptoms.
Treatment & the Path to Recovery
For Mike, the diagnosis was obvious through a physical exam. During Nicole’s visit, she had an x-ray performed as well to make sure that no bones were broken. In both cases, the diagnosis turned out to be the same: a grade three anterior cruciate ligament sprain. Mike’s ACL was a near complete tear, while Nicole’s was literally torn in half.
In neither of these cases would the knee have healed on it’s own or could the ligament have been stitched back together. Both Mike and Nicole required arthroscopic knee surgery, during which the damaged ACL was removed and a new ligament was threaded through the joint. Mike’s new ligament was grafted from his patellar tendon, while Nicole’s was taken from her hamstring tendon.
Ten weeks after surgery, Mike was back to light running and Nicole was working with a physical therapist to regain strength and range of motion. Both of these stories have happy endings because both patients received quality, timely care and committed themselves to the proper recovery. 

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