What treatment, recovery from an ACL tear in skiing looks like

Q. I am an active 30-year-old woman who was skiing last week out West and fell. I felt a pop in my knee when I twisted. The ski patrol brought me down the mountain in a sled. At the emergency room, they diagnosed that I tore my ACL. The doctor gave me a brace, crutches, and told me to see an orthopedic surgeon when I returned to Miami. The doctor felt that I would probably need surgery. What is an ACL tear, are there non-surgical options and how long till I can return to normal?

A. There are four main ligaments that maintain stability of the knee. The MCL and LCL are important for side-to-side stability. These ligaments, when torn, have a good micro circulation and can usually heal non-surgically in a brace.

The ACL and PCL are ligaments that cross deep inside the knee joint. They are important for maintaining stability during pivoting motions. When torn, these ligaments usually cannot heal as they have a poor blood supply.

In a young active person, surgery is usually recommended to make a new ACL. Post-op care requires at least six months to regain range of motion, muscle strength and allow the healing process to commence long enough to decrease the risk of re-injury.

The orthopedic surgeon will likely order an MRI to confirm the diagnosis and assess any other damage to the knee such as a cartilage tear. I recommend to skiers that they get their legs in shape prior to a ski trip.

And to further decrease the risk of injury, have your bindings properly adjusted so they release when stressed. Finally, stop stopping skiing when tired.

Dr. Harlan Selesnick is team physician of the Miami Heat and Inter Miami. Send your questions to HarlanS@baptisthealth.net