ACL Tears in High School Athletes: A Guide for Long Island Parents
An ACL tear is one of the most serious knee injuries a high school athlete can suffer, but with the right care, most young athletes can return to the sports they love. On Long Island, where lacrosse, soccer, basketball, and football fill fields and gyms nearly year-round, parents often face this injury with little warning.
This guide explains what an ACL tear is, how to recognize one, what treatment and recovery usually involve, and what families can do to lower the risk.
What is the ACL, and how does it tear?
The anterior cruciate ligament (ACL) is one of four major ligaments that hold the knee together. It runs diagonally through the middle of the knee, connecting the thighbone to the shinbone. Its main job is to keep the shinbone from sliding forward and to stabilize the knee during twisting and pivoting.
Most ACL tears in young athletes happen without any contact from another player. Common causes include:
Planting a foot and suddenly changing direction
Stopping quickly from a sprint
Landing awkwardly from a jump, especially with the knee caving inward
A direct blow to the knee, such as a tackle or collision
Tears can be partial or complete. A complete tear means the ligament has split into two pieces and cannot heal on its own.
Which high school athletes are most at risk?
Athletes in sports with cutting, pivoting, and jumping face the highest risk. On Long Island, that includes:
Lacrosse
Soccer
Basketball
Football
Volleyball and gymnastics
Girls face a notably higher risk of ACL tears than boys in the same sports. Researchers point to differences in anatomy, hormones, and the way many athletes land and pivot. The good news is that movement patterns can be trained, which is why prevention programs make a real difference (see below).
Signs of an ACL tear
Many athletes remember the moment clearly. Watch for these signs after a knee injury:
A "pop" heard or felt at the time of injury.
Swelling that appears within a few hours
Pain, often severe enough to stop play right away
A feeling that the knee is loose, unstable, or "gives way"
Trouble fully bending or straightening the knee.
Some athletes feel well enough to walk within a day or two, and the swelling may go down. That does not mean the ligament has healed. A knee that keeps giving way still needs to be checked.
What to do right after the injury
If your child hurts a knee and you suspect an ACL tear:
Keep them out of the game or practice. Playing on an unstable knee can cause more damage.
Rest the knee, apply ice wrapped in a cloth, and keep the leg elevated to control swelling.
Use crutches if walking is painful or the knee feels unstable.
Schedule an evaluation with an orthopedic specialist, ideally within a week or two.
Seek urgent care if the knee looks deformed, you can't bear any weight, or you have numbness, coldness, or a color change in the foot.
How an ACL tear is diagnosed
An orthopedic specialist usually starts with a physical exam, gently moving the knee to test its stability compared with the uninjured side. X-rays may be taken to check for broken bones. An MRI typically confirms the ACL tear and looks for other injuries that often happen at the same time, such as a torn meniscus (the knee's cartilage cushion) or damage to other ligaments.
Treatment options
Treatment depends on the severity of the tear, the athlete's age and growth, and their goals for returning to sport.
Non-surgical treatment. Some partial tears, and some athletes who do not plan to return to cutting and pivoting sports, can be managed with physical therapy and bracing. Therapy focuses on strengthening the muscles around the knee to improve stability.
ACL reconstruction surgery. For a complete tear in an athlete who wants to return to sports like lacrosse, soccer, or basketball, surgery is usually recommended. In ACL reconstruction, surgeons replace the torn ligament with a tissue graft, typically through minimally invasive arthroscopic surgery. Leaving a complete tear untreated in an active teen raises the risk of further damage, especially to the meniscus.
Growth plates. Younger athletes who are still growing have open growth plates near the knee. Surgeons use techniques designed to protect these growth plates, so a teen's evaluation should account for their stage of growth.
Recovery and returning to sports
Returning to competitive sports after ACL reconstruction usually takes 9 to 12 months. Every athlete's timeline is different, but recovery generally moves through these stages:
First weeks: control swelling, regain full knee straightening, and walk without crutches.
First few months: rebuilding strength and balance with physical therapy, then light jogging once cleared.
Middle months: sport-specific drills such as cutting, jumping, and landing practice.
Return to play: clearance based on strength, stability, and movement testing, not just time since surgery.
Rushing back is one of the biggest risks. Young athletes who return too early face a higher chance of tearing the same ACL again or injuring the other knee. For parents, that can mean missing part or all of a season, which is hard, but it protects the knee for years to come.
Can ACL tears be prevented?
Not every ACL tear can be prevented, but research shows that injury-prevention training can meaningfully lower the risk. These programs, often done as a 15- to 20-minute warm-up, teach athletes to move in ways that protect the knee. They typically include:
Landing softly with knees bent and aligned over the toes, not caving inward
Strengthening the hips, hamstrings, and core
Balance and agility drills
Practicing safe cutting and pivoting technique
Well-known examples include the FIFA 11+ warm-up and the PEP program. Parents can ask coaches and athletic trainers whether their team uses one, especially for lacrosse, soccer, and basketball. Getting enough rest between seasons and avoiding year-round overload in a single sport can also help.
About Dr. Richard Savino
Dr. Richard M. Savino is a board-certified orthopedic surgeon and Chief of Orthopedic Surgery at NYU Langone Hospital–Suffolk. He completed a fellowship in Sports Medicine and Shoulder Surgery at Johns Hopkins University, where he served as a team physician for the Baltimore Orioles and the Johns Hopkins University athletic department. He has also served as a physician for the U.S. Open at Bethpage and Shinnecock Hills.
Dr. Savino also understands knee injuries from the patient's side: his interest in orthopedics grew after he tore his ACL in high school. He performs knee, shoulder, and hip arthroscopy to diagnose and treat joint injuries.
Savino Orthopedics has two Long Island offices:
Stony Brook: 2500 Nesconset Hwy, Building 20-A, Stony Brook, NY 11790 · 631-675-9193
Hauppauge: 517 Route 111, 3rd Floor, Suite 3B, Hauppauge, NY 11788
To schedule an evaluation for a knee injury, request a consultation.
This article is for general educational purposes and is not a substitute for a medical evaluation. If you think your child has injured their knee, contact a medical professional.
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