Jock Doc

Pivoting injury to the knee is serious, most likely an ACL tear

Q. I am a 24-year-old recreational basketball player who three days ago was coming off a screen when I pivoted and my right knee gave out. I had severe pain and felt a pulling sensation. I could not get up and an ambulance took me to the emergency room. The doctor took X-rays, which showed no break. He said my knee was too swollen to examine and put me in a brace. He gave me crutches and told me to see an orthopedic surgeon. I have to wait a week for an appointment and wondered what I could have done to my knee and how soon till it gets better?

A. A pivoting injury to the knee without contact that results in severe pain with a pull or a popping sensation is usually an ACL tear. The ACL is an important ligament for knee stability. ACL injuries are rarely solitary and are associated with other knee disruptions 85 percent of the time (meniscal cartilage tears, MCL tears, LCL tears, PCL tears or bone contusions).

The orthopedic surgeon will likely order an MRI scan, which will help identify the soft tissue injuries that will not show on the X-ray. Usually these injuries are treated with bracing and physical therapy for a period of a few weeks followed by ACL surgery, if necessary. After surgery the athlete is out of competitive sports for at least six months.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send questions to