I suffered a torn ACL in the same knee on two different occasions. I tore my ACL the first time playing football in high school. I played the entire season with it torn and had it repaired in the off-season. I tore the reconstructed ACL in the same knee 10 years later.
I have yet to have the ACL repaired after the second complete tear. In my current state, I happily play multiple sports, engage in intense physical activity, and believe that I have managed to find a balance of rehabilitation and therapeutic mechanisms that allow me to function at 99% of my ability without an ACL in my right knee.
Below, I’ll share information about my first ACL injury and reconstructive surgery, my second ACL injury, and my experiences competing in sporting activities without it on both occasions.
How did you tear your ACL?
The first time I tore my ACL I was in high school. It was a non-contact injury during a football scrimmage in the summer. I planted on my right leg to make a tackle and my knee popped and buckled. My knee felt loose immediately after the injury.
I did not have a lot of pain after the injury, so I practiced the rest of the day with the team without restriction. The next morning, I woke up and my knee was considerably swollen and tender. I was certain I had sustained some form of significant knee injury.
I went to a doctor, had an MRI, and confirmed the ACL was torn. This is the only way to confirm a torn ACL!
Could the doctors tell it was torn without an MRI?
Even the best orthopedic doctors cannot tell if your ACL is torn without an MRI. They can do the standard test where they move your knee back and forth, but on 3 different occasions in my life, I have had doctors check this and be WRONG (twice telling me it was torn when it wasn’t, and once telling me it wasn’t when it was).
If you think you’ve sustained an ACL surgery, you must get an MRI to know for sure. Meniscus and other significant knee injuries can often mimic torn ACL symptoms.
You decided to play football without an ACL?
Yes. This was in 2004. Even now, this is considered a controversial decision.
The surgical options at the time were about as good as they were now. We now know much more about recovery after the surgery and pre-habbing the injury, but our surgical interventions today are the same as they were 10 years ago (when we are talking about complete ACL tears).
At the time, I had actually started practicing and doing strength and conditioning again before we got the MRI results back. After my swelling subsided, I still felt pretty unstable on the knee, but didn’t think I would be able to do all the things I was doing if my ACL had been torn.
When we got the MRI back, I was surprised to find it was actually torn. I felt as though I could play football and I didn’t want to miss a year because of the injury.
Luckily I convinced my parents it wasn’t crazy. The doctor actually thought my knee was extraordinarily stable for someone with a torn ACL.
What was it like playing a season with no ACL?
I was very young at the time and did very little rehab and preparation for playing a sport with no ACL. As with most young teenage boys, my diet wasn’t very good either. I was just young and athletic.
Fortunately for me, my lack of preparedness didn’t stop me from excelling that season. I finished the year as an All-State, All-Conference, and All-Area player.
I had 3-4 instances during actual games in which my knee buckled or gave out. These almost always happened without contact when I was backpedaling. In practice, it happened on several other occasions.
I was happy with my decision to play the year with the ACL torn at that time. I played very well even though I was admittedly not at 100% of my potential.
At the end of the season, I opted for the surgery so that I could recover in time for the next year.
Why did you opt for surgery after 1 year?
I recognized that I was having stability issues. I felt that at 16-17 years old, it was probably responsible to have the ACL repaired. I was concerned about stability being an issue that could progressively get worse.
Where you happy with that decision in retrospect?
Yes. At that time, I was not physically developed enough to live life without an ACL. I did not know how to strengthen my knee or body to live life – or compete in a sport – without my ACL.
Even though I would tear it again in 10 years, I believe that the process of playing without it, repairing it, and then rehabbing it and strengthening it, led me to my ability to successfully function without it now.
What type of ACL graft did you do?
I did a patella graft. There is a lot of debate about this now. Even great orthopedic doctors disagree; based on results within their practice.
Some research says the patella is stronger. However, recovery is longer, because your patella has to recover as well. There are a lot of doctors that argue that, with proper rehab and attention, a cadaver graft is just as strong.
The evidence on hamstring grafts makes me nervous if you’re an athlete. Too many long-term hamstring problems have been documented.
Ultimately, I opted to never go through any of them again, so take my advice with a grain of salt, but I would do a cadaver graft if I had to do it again.
I’ve heard about stem cells for partial tears. Apparently, there is some good research on this, but it is still pretty new, and you need a partially intact ACL to be a candidate.
So, then you tore the repaired ACL, right?
I tore it 11-12 years after the original tear. The graft lasted a long time. During that 11 year period, I focused a lot on single-leg exercises to keep both of my knees healthy (as apparently the statistical chance of an ACL injury goes way up if you’ve already had one before).
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I made my legs very very strong in that time period and it was one of the best decisions I ever made. I used mainly resistance bands and single-leg movements. This is the way to go based on my experience.
How did you tear your repaired ACL?
I do Brazilian Jiu Jitsu and tore it during practice. I started doing jiu jitsu immediately after football was over. So, I’d been doing it for over a decade when I tore it. Unfortunately, I tore it doing a rather benign activity. I certainly had done more strenuous things with it than the exact position that caused it to tear again.
Did you know immediately that it had torn again?
No, and neither did the doctors.
I decided to have it checked out since there was a tiny bit of swelling after the injury. The doctors did the standard movement test and felt that I did not have enough laxity in the knee (which was a good thing) to warrant a torn ACL diagnosis.
I opted to do the MRI anyway since they said it might be good to check my meniscus due to the swelling I noticed. Sure enough, the ACL was gone!
How did it feel after it was torn the second time?
After the injury, it was sore and a little swollen at first. I had a small amount of instability, but nothing like my first ACL tear.
The doctors agreed with me. They said they had never seen a knee with such strength and lack of laxity without an ACL. However, they were concerned about my ability to compete and practice jiu jitsu long term without an ACL.
Ultimately, I opted to continue my very active lifestyle without an ACL to see how things went.
What did the doctors recommend in place of ACL surgery?
While the doctors were a bit skeptical that I would be satisfied without having the ACL repaired, they agreed that my stability and confidence in the knee’s strength might allow me to get along fine.
They suggested I complete a full ACL rehab protocol (the kind they have people do as ACL prehab now). They also suggested these collagen supplements and a regiment of stretches that would keep my hamstrings, hip flexors, and quadriceps limber.
I did the exercises and stretches every day for 8 months, and still do them multiple times a week.
How did you fare with the ACL rehab and stretching?
Fantastic. I was back to all of my normal activities immediately. I felt a little unstable and unsure at first. I often wore a Bauerfiend brace during strenuous activities and jiu jitsu training at first to help with the lack of confidence in the knees’ ability to hold together.
After 6 months, I had shed the brace. I only had 2 incidents in that time period where the knee really bothered me.
After 1 year of strict rehab and stretching, I literally feel EXACTLY the same as I did with the repaired ACL.
Were you happy that you elected to avoid ACL surgery?
Yes! 4 months after tearing it the second time, I took 3rd in the Brazilian Jiu jitsu European Championships. I would have never been able to do that if I would have been laid up with surgery.
Additionally, the long-term prognosis on a knee after a second ACL surgical intervention isn’t sunshine and rainbows. It is really common that people tear them a third time or face terrible arthritis in the future (although this is possible no matter what you do in these circumstances).
What brace is best for someone without an ACL?
When I had initially torn my ACL and played through the entire football season without it, I wore a heavy-duty Donjoy ACL brace.
This is commonly what you see NFL offensive linemen wearing as a preventative measure. While this was OK for playing football, it was terrible for all other activities. These heavy-duty braces provide a lot of stability but almost no functional mobility.
That said, if you plan to play football or another contact support without an ACL. This is by far the one that is most recommended by most major orthopedic doctors.
After my second tear and life without an ACL, I chose to wear a small sleeve brace for the first year. It provided just enough protection to get me comfortable. After a year I was comfortable and my leg was strong enough without a brace to need it anymore.
In fact, I recommend shredding the brace as soon as you can. learning to cope without it is key to living life without an ACL.
However, the best knee brace I have ever worn hands down was this new Bauerfeind brace. It never slipped, provided a tight sense of stability, and gave me 100% of my normal mobility.
I have heard from tons of non-ACL-having people through this blog, and all of them that have tried this brace had the exact same feedback… best brace ever.
It’s a little pricey but worth it.
What do you recommend to those reading this?
If you, or someone you know, is considering playing a sport or living life without an ACL, I want you to know that it is entirely possible to play just about any sport without one. It is possible to compete at a high level successfully without an ACL. I am sure of this.
However, there are many who have tried and failed. There are a lot of people that have not had my experiences. I cannot speak to their adherence to the rehab or stretching either. There is likely some level of genetics that have aided me in this process.
But, keep in mind, after my first surgery I made my legs very strong to prevent future injuries. This is why I believe that I am able to function now without one.
The core thing that most athletes without ACLs have in common is a strict exercise, nutrition, and stretching plan. I know several other athletes without ACLs and they all do single-leg exercises and stretch everyday.
These are some supplements that I believe have helped to some degree (not any kind of affiliate link, just a list of some broad supplements that I actually take)
Any other advice?
Find a good orthopedic doctor. You will need one for the MRI anyways. They can help you understand if your knee laxity might be a danger to you if your ACL is torn.
Consult with them about your decisions and give them feedback as time progresses.
Leave questions below. I am happy to share more info about my exercises and stretched in the comments.
Tyler is an award-winning entrepreneur, former athlete, and founder of several successful online publications about sports, health, and well-being. Tyler has both a storied career in business and as an author/writer — contributing to publications like Forbes, The Harvard Business Review, The New York Post, and many more. A former competitive athlete, Tyler is now the founder of InjuryHealthBlog.com.