What Happens to Knee Stability After an ACL Tear?

The ACL is a key ligament inside the knee, functioning like sturdy cables that keep a suspension bridge firm and stable. When you ski, it helps control your knee’s movements during sharp turns, sudden stops and uneven terrain, ensuring your knee doesn’t wobble or twist unnaturally.

If the ACL is torn, this vital stabilising function is lost. Think about removing one of the suspension bridge’s main cables—the structure becomes shaky and less able to hold weight. Similarly, a torn ACL might cause your knee to feel unstable or occasionally ‘give way’, making everyday movements and skiing both risky. This happens because the knee’s natural biomechanics—the way bones and muscles interact—are altered.

Orthopaedic experts such as Professor Paul Lee, with vast experience in knee injuries and rehabilitation, highlight that an ACL rupture upsets the delicate balance within the joint. This can result in immediate difficulties and also increase wear on other parts of the knee over time. That’s why professional diagnosis and assessment after injury are essential in planning the safest way back to skiing.

Assessing Protective Gear and ACL Knee Braces: Facts vs Myths

After an ACL injury, many skiers consider knee braces or other protective gear to safeguard their recovery. Knee braces are popular because many believe they prevent the knee from moving too far forward or backward, reducing the chance of another injury.

The reality, however, is more complex. Braces can offer helpful sensory feedback, improving your awareness of knee position, and provide some external support. Yet, they do not fully stop the tibia bone from moving forward or backward in the absence of a healthy ACL. Research supported by experts at MSK Doctors confirms that knee braces are useful tools but not foolproof solutions.

It’s important to remember that no brace can replace the natural stability provided by a healthy ACL or the muscle strength gained through proper rehabilitation. Protective equipment should complement, not replace, tailored medical care and physiotherapy.

Rehabilitation Protocols and Decision Factors for Returning to Skiing

Recovering from an ACL tear and aiming to ski again involves a carefully planned rehabilitation process. This includes reducing swelling, regaining joint movement, rebuilding strength, and eventually reintroducing functional activities. The whole process often takes six months to a year, sometimes longer, varying by individual case.

Several factors influence when—or whether—you should return to skiing. These include your age, prior fitness, the injury’s severity, and also your mental readiness. Elite athletes like Lindsey Vonn benefit from top-tier rehabilitation, allowing them to return to competition, but recreational skiers face different challenges balancing everyday life and resource access.

Recent studies demonstrate the benefits of advanced rehab methods. For example, a programme using electric stimulation “significantly developed the working muscles, achieving normal activity levels” after an ACL tear (Kzar & Kadhim, 2020). Another detailed case study reported “improvements in knee function, strength, range of motion and overall performance” with a structured physiotherapy regime (Singh et al., 2024).

Age also plays a role in future injury risk. Research confirms that “patients who undergo ACL reconstruction at a young age are at increased risk of rupturing either the reconstructed graft or the opposite knee’s ACL” (Ifran et al., 2020). This makes personalised rehabilitation plans and ongoing support essential for young, active skiers.

Successful recovery relies on a multidisciplinary team, including physiotherapists, orthopaedic specialists and psychological support. Experts like Professor Paul Lee and the MSK Doctors team exemplify the integrated care required to tailor rehabilitation to each unique individual.

Reducing Re-Injury Risk: Practical Tips and Psychological Barriers

Preventing a second ACL injury involves more than just physical effort. Targeted strength training—especially exercises focused on key muscle groups around the knee—can improve joint stability. Adjusting skiing technique, such as making controlled turns and avoiding risky slopes, is also important.

Adjunct therapies can speed recovery. For instance, one study noted their aim “to identify the effect of electric stimulation on rehabilitating knee joint muscles” (Kzar & Kadhim, 2020). Similarly, combining physiotherapy methods like range-of-motion exercises and muscle mobilisation improves outcomes: “Physical therapy combined with mobilisation and home exercises positively impacts meniscus rehabilitation” (Singh et al., 2024).

Addressing mental challenges is equally vital. Fear of reinjury can slow progress or cause hesitation on the slopes. Gradual confidence-building—and ongoing support from medical teams—helps patients overcome these barriers.

Furthermore, it’s crucial not to overlook the uninjured knee. Experts advise that “patients should be counselled not to neglect rehabilitation of the contralateral knee during the immediate and return-to-sport phases” (Ifran et al., 2020).

Regular follow-up and monitoring ensure the knee remains strong and stable as you get back to skiing safely.

Conclusion and Disclaimer

Skiing again after an ACL tear is achievable, but it requires careful planning, dedicated rehabilitation, and realistic expectations. Protective gear helps, but it cannot substitute personalised medical advice and comprehensive rehab.

Every recovery journey is unique, influenced by factors such as injury severity, fitness level, and mental readiness. Consulting qualified healthcare professionals to develop a tailored return-to-sport plan is vital.

With the right preparation and support, you can return to the slopes with confidence and safety.

For individual medical advice, please consult a qualified healthcare professional.

References

• Kzar, F. H., & Kadhim, M. J. (2020). The effect of increasing rehabilitation program using electric stimulation on rehabilitating knee joint working muscles due to ACL tear in athletes. Journal of Physical Education, 32(3), 14-18. https://doi.org/10.37359/jope.v32(3)2020.1012
• Ifran, N. N., Mok, Y. R., & Krishna, L. (2020). Tear rates of the ipsilateral ACL graft and the contralateral native ACL are similar following ACL reconstruction. The Journal of Knee Surgery, 35(03), 308-311. https://doi.org/10.1055/s-0040-1713861
• Singh, D., Aryan, A., Amit, A., & Arfat, M. (2024). Effect of physiotherapy rehabilitation exercises on patient with ACL mucoid degeneration with medial meniscus bucket handle tear: A case study. Salt Journal of Scientific Research in Healthcare, 55-59. https://doi.org/10.56735/saltjsrh.ms2404025559