acl tear in children

The ABCs of ACL Tears in Children: Prevention, Diagnosis, and Recovery

As proactive parents, it’s crucial to stay informed about your young athlete’s well-being, especially when it comes to their sports-related injuries. ACL (Anterior Cruciate Ligament) injuries in children are increasingly common. In this comprehensive guide, we’ll delve into the ABCs of ACL tears, including the knee’s anatomy, risk factors associated with these injuries, and the pivotal role that Physiotherapy plays in both prevention and post-surgical recovery. 

Anatomy of the Knee: The Foundation of Athletic Performance

Understanding the Knee Joint:

The knee is a remarkable but intricate joint comprising bones, ligaments, and tendons. This foundational understanding is important to comprehend how ACL injuries occur. The knee joint connects the thigh bone (femur) to the shinbone (tibia) and allows for a range of movements, including bending, straightening, and twisting. Ligaments are tough, fibrous bands that stabilise the joint, and the ACL is one of the most critical ligaments. It runs diagonally in the middle of the knee and prevents the tibia from sliding in front of the femur, providing stability during activities like running, jumping, and pivoting.

The Role of the ACL:

Your child’s ACL serves as a linchpin for knee stability during sports activities. It’s an essential component that helps maintain the knee’s structural integrity. ACL injuries often happen when there’s a sudden change in direction, deceleration, or a direct impact to the knee. These injuries can range from partial tears to complete ruptures, with the latter requiring surgical intervention in most cases. Understanding the mechanics of how ACL injuries occur is crucial in both prevention and post-injury management.

Risk Factors for ACL Tears: Know the Red Flags

Age and Gender

Why do children and adolescents face a higher risk of ACL tears and the gender-specific dynamics at play? Research indicates that young athletes between the ages of 14 and 18 are at the highest risk due to growth spurts and changes in muscle strength and coordination. Additionally, female athletes are more susceptible to ACL injuries than their male counterparts, often due to differences in anatomy, hormonal factors, and neuromuscular control.

Sports and Activities

There are certain sports and movements with elevated ACL tear risks. Sports like football, netball, rugby, and skiing involve frequent changes in direction and high-impact movements. This increases the chances of ACL tears as load and torque on the ligament is more frequent. Biomechanical factors, such as poor landing techniques, poor strength in the trunk and lower limbs, and limited neuromuscular control, can further heighten the risk.

Biomechanical Factors

Proper biomechanics are crucial in preventing ACL injuries. Training programs that focus on teaching athletes how to land, cut, and pivot safely can significantly reduce the risk. Biomechanical assessments with a Sport Therapist or Physiotherapist can help identify individual factors that may predispose your child to ACL tears, allowing for personalised preventive strategies.

ACL rehab

Preventing ACL Tears: The Role of Physiotherapy

Preventive Exercises

  • Specificity Matters: Sports Therapists and Physiotherapists can tailor exercises to your child’s sport, emphasising movements and muscle groups most relevant to their activities.

  • Proprioception Training: Physiotherapy includes drills to enhance your child’s proprioception (body awareness), crucial for reducing the risk of awkward landings and knee injuries.

  • Strength Training: Progressive strength exercises target key muscle groups around the knee, such as the quadriceps and hamstrings, to enhance stability and reduce the likelihood of ACL tears.

To avoid injury, we highly recommend seeing a Sports Therapist or Physiotherapist who can devise a specific training programme, tailored to your child’s specific strengths and weaknesses.

ACL physiotherapy

Injury Recovery and Return to Play: Guiding Your Child's Comeback

In the unfortunate event that your young athlete experiences an ACL tear, Physiotherapy becomes a crucial component of their journey back to peak performance. Here, we’ll explore how physiotherapy aids in the recovery process and helps your child safely return to their beloved sports activities.

1. Immediate Post-Injury Care

After an ACL tear, physiotherapy begins almost immediately, even before surgery in some cases. This initial phase focuses on managing pain, reducing swelling, and regaining knee mobility.

  • Pain Management: Physiotherapists employ various techniques, such as ice, manual therapy, and gentle exercises, to alleviate pain and discomfort.

  • Oedema (Swelling) Control: Swelling can hinder the recovery process. Physiotherapy interventions, like compression and cryotherapy, help manage oedema effectively.

  • Range of Motion: Maintaining or restoring normal knee range of motion is a primary goal during this phase to prevent joint movement restriction as the soft tissues heal.

2. Pre-Surgery Preparation

If surgery is required, physiotherapy plays a vital role in preparing your child both physically and mentally.

  • Prehabilitation: Strengthening exercises and conditioning routines are initiated to optimise the knee’s stability and muscle strength before surgery. This prehabilitation can improve surgical outcomes.

  • Educational Support: Physiotherapists provide information about the surgical procedure, expectations, and the importance of adhering to the rehabilitation plan.

3. Post-Surgical Rehabilitation

Following ACL reconstruction surgery, a comprehensive rehabilitation program overseen by a Physiotherapist is imperative.

  • Early Mobilisation: Gradual mobilisation exercises are introduced to ensure your child begins moving their knee as soon as possible without compromising the surgical site.

  • Strengthening and Stability: Physiotherapy focuses on rebuilding muscle strength, particularly in the quadriceps and hamstrings, while enhancing knee stability.

  • Functional Progression: Rehabilitation gradually advances to sport-specific activities, ensuring your child can safely return to their chosen sport.

4. Sports-Specific Rehab

As your child progresses through rehabilitation, the Physiotherapist tailors exercises to mimic the demands of their specific sport.

  • Sport-Specific Drills: These drills replicate the movements and challenges your child will encounter during practices and games.

  • Injury Prevention: Physiotherapists continue to emphasise injury prevention strategies to reduce the risk of future ACL tears.

5. Gradual Return to Play

Your child’s Physiotherapist collaborates with their sports coach to develop a safe and gradual return-to-play plan.

  • Monitoring Progress: Progress is closely monitored to ensure that your child’s knee can withstand the rigours of competitive sports.

  • Ongoing Support: Even after your child returns to play, physiotherapy provides ongoing support to maintain strength and prevent re-injury.


ACL injuries can be challenging, but with the right Sports Therapy or Physiotherapy guidance, your young athlete can recover and return to the sports they love. Therapists play a pivotal role in the journey, from immediate post-injury care to full recovery and beyond. By prioritising this, you can help your child regain their confidence, strength, and passion for the game.

Stay informed, stay proactive, and keep your young athlete on the path to victory, whether it’s in the prevention of injuries or the recovery from them!

If you want advice on ACL injuries, our expert Physiotherapists or Sports Therapists can help to get you back on your feet!

Book an Appointment today or give us a call on 01273 711 399 for some free advice.

DISCLAIMER: All content within this column is provided for general information only and should not substitute for the medical advice of your own doctor or any other health care professional. S57 Health & Wellbeing Clinic is not responsible or liable for any diagnosis made by a user based on the content of this site.