What Hockey Players Should Know about ACL Tears

Hockey is not as brutal on the body as football, where full contact is possible on every down, but due to the high-speed collisions on a rink, a hockey player can find himself suffering from a serious knee injury like an ACL tear.

It helps that hockey players have powerful legs due to the constant skating, meaning the muscles around the knee tend to be very strong. As I’ve mentioned before, a good method to preventing ACL tears is to keep those muscles that support the ACL strong.

The anterior cruciate ligament is crucial for stability in the knee, and keeping the lower leg from sliding too far in front of the femur. Like most sports, hockey puts a lot of stress on this ligament due to all the twisting, pivoting and cutting involved. So when this pressure exceeds what the ACL can withstand, the ACL will tear, leading to swelling, pain and loss of mobility.

Causes of ACL Tears to Hockey Players

One of the main ways that hockey players can suffer from an ACL tear is through a collision with another player or when a player is checked into the boards. This action can bend or twist the knee, causing the ACL to twist and tear.

Getting a skate caught in another player’s skate or in a rut can lead to a fall or twisting of the knee. Players can also fall into other player’s knees. That blow can buckle the knee joint and tear the ACL. Goaltenders are susceptible to ACL tears, too. When they overstretch for a save or a player falls on their leg.

ACL Surgery for Hockey Players

If you suffer an ACL tear you’ll typically require surgery immediately to rebuild the ruined ligament. What actually happens during the surgery? Surgeons don’t typically sew the torn ligament back together since sutures tend to fail over time. Instead, surgeons opt to repair the torn ACL by grafting a tendon from the player’s hamstring, quadriceps or even a cadaver. This way they reconstruct an entirely new ACL.

How long will it take you to recover from ACL surgery? About seven to eight months, but it depends on how well your body responds to the graft, how well your body responds to the rehabilitation (you will unfortunately lose strength in the muscles around the knee) and your coach and trainer’s decisions. Proper healing is important to avoiding a second ACL surgery, where the percentage of success plummets.

Some athletes have been back in action in less than that time, but my recommendation is that the longer you give the injury and surgery to heal, the stronger and healthier the knee and new ACL will be.

Should Hockey Players Play Through an ACL Injury?

For some players getting off the ice is not an option (or they choose to keep playing to help their team out), so they keep playing with a torn ACL. (I spoke about the pros and cons of playing through an injury in recent article.) How do they do it? They brace the knee. The dangers of doing this should be obvious, but let me spell them out for you: playing with a torn ACL is not comfortable and can lead to additional injury.

An ACL injury is a death sentence for a hockey player, but it is a serious injury and playing with in injured will open you open to further injury that could lead to the end of your career as a hockey player. I don’t recommend playing on an injured knee at all.

In addition to ACL surgery, some players are undergoing platelet-rich plasma treatments to speed healing. It’s success in other sports like football and baseball are prompting hockey players to look consider this treatment.

Dr. Rick Lehman, MD, FACS, is a globally recognized orthopedic surgeon specializing in sports medicine, orthobiologics, cartilage restoration, and joint preservation. As the founder of Lehman Joint and Performance in California and St. Louis, he helps elite athletes, active individuals, and weekend warriors stay in motion through personalized, cutting-edge care. Learn more about Dr. Rick.