ACL Injuries in Children

Unfortunately, the number of ACL injuries in kids  (especially aged 10-14) is rising. This is likely due to increased participation in high-risk athletic activities, and a lack of early sport-specific training.

About the ACL

The ANTERIOR CRUCIATE L IGAMENT Arises from the lateral femoral condyle and inserts into the intercondyloid eminence of the tibia, blending into the medial meniscus (see below)

The ACL resists anterior tibial translation and is also a secondary restraint to knee hyperextension. Basically it holds your thigh bone on your leg bone!
It also prevents excessive rotation of the tibia during cutting and pivoting activities.

Mechanism of Injury

  • Commonly a non-contact injury where the athlete plants their foot on the ground to change directions, subsequently tearing and causing the knee to ”give way”
  • The ACL also can be torn if the knee is forcefully hyperextended while landing from a jump.
  • Although less common, contact ACL injuries can occur when an athlete is hit on the side of the knee with the foot planted on the ground. These injuries often involve more than one ligament.

So should kids have surgery or take a non-operative route?

ACL reconstruction in kids may be required when:

  1. The child has repairable associated injuries that require surgery (e.g., bucket-handle meniscus tear, repairable meniscal lesion or osteochondral defect)
  2. The child has recurrent, symptomatic knee giving way despite completing high-quality rehabilitation
  3. The child experiences unacceptable participation restrictions (i.e. an unacceptable modification of activity level to avoid knee giving way)

Non-surgical treatment is a viable and safe treatment option in skeletally immature patients who do not have associated injuries or major instability problems

So what now?

If your child has sustained an ACL injury, or acute knee injury, book in an appointment with one of our experienced physiotherapists who will guide your child through their comprehensive rehabilitation program. It is important that you as a parent come along to these appointments so we may involve you in their care, and we will all work together as a team, to get them back to their sporting goals.

Laura To

Physiotherapist and Pilates Instructor