To operate or not to operate…that is the question, literally. While not quite a line out of Shakespeare it's certainly a line out of the life of a true ACL injury sufferer. ACL knee injuries are serious and usually accompanied by considerable pain. ACL injuries can happen during sports, motor vehicle accidents, at even home or work. The ACL (Anterior Cruciate Ligament) is a small ligament that sits deep within the joint located behind the knee cap. While very small, when torn it can cause significant pain and loss of mobility.

ACL knee injuries may require any one of a variety of surgical procedures. There are also several non-surgical treatment options. The plan that ends up being best for you depends on the nature and severity of the tear. Age and lifestyle will also affect your ultimate choice of treatment method. This important decision should be made by you in consultation with your sports medicine physician.

Whether you opt for or against ACL knee surgery, an experienced sports therapy clinic will be essential to your full recovery. Progressive physiotherapy and rehabilitation can restore the knee to a state close to where it was before the torn ACL. A custom knee brace is also imperative when treating a torn ACL - with or without surgery - to help stabilize it during recovery.

A good sports therapy clinic will offer education and a treatment plan that will reduce the likelihood of recurring injury. But since non-surgical treatment options come with no guarantees after time spent trying to nurse an injury back, many people go for surgery to avoid possible relapses of instability of the knee. Your team of sports therapy clinic professionals will have valuable input to guide you in knowing which decision is right for you.

Generally speaking, people may choose a non-surgical solution for repairing a torn ACL for circumstances when:

• It is exclusively the ACL that is injured (that is, that the ACL injury is not combined with other injuries in the knee);

• The tear is partial and no instability symptoms are present;

• The individual does not live a physically demanding lifestyle or have a physically demanding job.

The main motivation for having ACL knee surgery is that the procedure prevents future instability. By restoring the knee's stability, athletes can resume their participation in their sports, and often, much sooner.

ACL knee surgery often involves replacing the ACL with a substitute graft made of tendon taken from somewhere in the patient's body. This process is called autograft so you could be looking at patellar tendon autograft, or hamstring tendon autograft.

Active, athletic adults or those with a physically demanding job are generally the best candidates for ACL knee surgery. The elderly generally are better to avoid it. For those having surgery, rehabilitative therapy should begin before surgery, to make the postoperative recovery easier, and also about 10 days after surgery.

Working with an experienced physiotherapy clinic will ensure reduction of swelling in the knee, as well as improve mobility, prevent anterior knee problems and eventually restore the joint's full range of motion.