Anterior Cruciate Ligament (ACL) Tear in Children: Care Instructions

Overview

An anterior cruciate ligament (ACL) tear is a tear in a knee ligament that connects the thighbone (femur) with the shinbone (tibia). The ACL helps keep the knee stable.

An ACL can tear when a child plants their foot and then pushes off, changes direction, or twists. An ACL can also tear if a child falls or gets hit in the knee. Sometimes the ACL is partly torn. Other times it is completely torn.

ACL tears often happen while playing sports like soccer or football. Injuries like those from a car crash, stepping in a hole, or jumping or falling from a height can also cause an ACL tear.

Treatment depends on your child’s age and how severe the injury is. Treatment may include limiting activities, like sports. It may also include a brace, physical therapy, or surgery. If surgery is needed, the doctor may wait until your child stops growing and their bones are mature.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and contact your doctor if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

How can you care for your child at home?

  • Make sure your child follows the doctor’s directions for wearing a brace or using crutches. If your doctor recommends an elastic bandage, sleeve, or other type of support for your child's knee, make sure your child wears it as directed.
  • Be sure your child rests and protects the knee as directed.
  • Put ice or a cold pack on the area for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when your child is awake). Put a thin cloth between the ice and your child’s skin.
  • Prop up the sore area on a pillow when you ice it or anytime your child sits or lies down during the next 3 days. Try to keep it above the level of the heart. This will help reduce swelling.
  • Give your child acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) as directed. Be safe with medicines. Read and follow all instructions on the label. Do not give aspirin to children and teens. It has been linked to Reye syndrome, a rare but serious illness.
  • Make sure your child follows the doctor's instructions about activity while healing. If your child can do mild exercise, slowly increase their activity.
  • Have your child follow the doctor's or physical therapist's directions for strength exercises.

When should you call for help?

Contact your doctor now or seek immediate medical care if:

  • Your child has increasing or severe pain.
  • Your child has increased swelling in their knee.
  • Your child's leg or foot is cool or pale or changes color.
  • Your child has tingling, weakness, or numbness in their toes.

Watch closely for changes in your child’s health, and be sure to contact your doctor if:

  • Your child has a problem with their splint or brace.
  • Your child is not getting better as expected.
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