A young woman I coached struggled with knee injuries and is currently playing college soccer without a full ACL.
It’s her last season, and after sitting out for the last two she decided to push through with a partial tear. However, this decision comes with many serious risks that she understands.
So, the answer to “can you play soccer without an ACL?” is not as simple as it may seem. Most doctors will, rightfully, tell you no. But there’s more to it.
Today, we’ll dive into answering this question by discussing:
- What the ACL is and its role in soccer
- ACL tears
- Anecdotes of athletes’ experiences
- Considerations for playing with an ACL tear
We’ll give you the insight you need to make an informed decision when it comes to playing soccer without an ACL.
What is the ACL?
ACL stands for “Anterior Cruciate Ligament.” It’s a ligament in your knee that connects the femur to the tibia. The purpose of the ACL is to stabilize the knee, especially during lateral movements (change of direction, sharp stops, pivots, etc).
So, when you push off one leg to change direction, the ACL is one of the major players keeping your knee together.
In sports (like soccer) that involve a sudden change of direction, abrupt stops, and jumping, the ACL is extremely important.
In soccer, we rely on the ACL when:
- Performing moves with the ball (cuts, stopovers, pullbacks)
- Changing direction
- Transitioning to and from defense and offense
- Jumping/landing from an aerial challenge
How Does the ACL Tear?
An ACL tear is an unfortunately common injury in soccer players. However, there are many different ways that ACL tears happen. In soccer, some of the most common causes of an ACL tear include:
- Suddenly pivoting with the foot planted
- Landing awkwardly/ off-balance from a jump
- Abrupt stopping
- Direct contact (often a kick) to the outside of the knee while the foot is planted
Essentially, any activity that applies force to the outside of the knee while twisting the knee may cause an ACL tear.
Partial vs Complete ACL Tear
When the ACL tears fully, it completely detaches from the bone. However, ACL tears may also be partial, which means the ACL is still attached. An estimated 10-27% of ACL tears are partial.
In the world of soccer, a partial ACL tear often still requires surgery.
This is because partial ACL tears will not heal. Some ligaments, like the MCL, can heal when partially torn. Unfortunately, the ACL will not heal from a partial tear.
Given that a partial tear cannot heal, most soccer players opt for surgery. Yet, some try to play with a partially (or even fully torn) ACL.
Can You Play Soccer With a Partially Torn ACL?
The vast majority of medical professionals will not advise you to play soccer with a partially torn ACL. Still, some players do so (and not always on purpose!).
Technically, you may be able to play with a partially torn ACL depending on a number of factors.
One possibility is that you injure your knee but don’t get it diagnosed as an ACL tear. If your pain is tolerable and goes away within a few days or weeks, it’s entirely possible to never go in for an MRI.
Without a diagnosis, some players may return to sport based on pain levels and thus play with a partially torn ACL.
Depending on the extent of the partial tear, you may not notice much of a difference most of the time.
If a player still feels stable and unhindered, they may try to play on a partially torn ACL.
To be clear, a partially torn ACL is still compromised. It is not as strong as an intact ACL, and it may be more likely to tear further or lead to more knee damage.
High-impact sports, like soccer, heavily rely on the ACL, which is why most doctors advise ACL reconstruction for a partially torn ACL.
Can You Play Soccer Without an ACL?
If you ask an orthopedic surgeon or doctor this question, there’s a good chance they will tell you no.
You absolutely SHOULD NOT play soccer without an ACL, but the truth is that some players definitely have.
A D1 Collegiate Goalkeeper Playing Without an ACL
I personally know a handful of players who have played on a partially or fully torn ACL. One example is a goalkeeper from my college team.
She tore her ACL early in the season, from landing weird after jumping to save a shot.
She had torn her ACL before and was nearly certain that was the issue. She quickly got an MRI and was diagnosed with a fully-torn ACL. At the time, we only had two goalkeepers.
The doctors agreed to let her play. They felt that with the right physiotherapy and a brace, she could make it through the season.
After a few weeks (once pain and swelling subsided) she worked her way back into training fully. For the rest of the season, she was in full.
She even had to play a full game when our starting goalkeeper got a concussion.
She did play soccer without an ACL, but she noted that she felt slightly unstable. After the season ended, she immediately got surgery and began rehab. She returned fully by the start of the next season.
Reasons Not to Play Soccer without an ACL
A few players have played soccer without an ACL tear (or with a partial tear). While it may be possible in some cases, it is not a good idea.
Here are the top risks of trying to play soccer without a fully intact ACL:
- The knee may give out during sharp turns or stops, thus simply not allowing the athlete to perform the necessary movements.
- Greater risk of more severe injury (tearing more ligaments in the knee, etc). Playing without an ACL puts the athlete at risk for severe long-term damage.
- May cause the athlete to second guess and play without confidence.
- Compensation from other surrounding muscles may lead to muscular issues as well.
When Might a Soccer Player Play with an ACL Tear?
The vast majority of the time, soccer players require surgery after an ACL tear. As mentioned, there are times when soccer players play without an ACL (or with a partially torn ACL). While this is not recommended, it does happen.
Here are some of the reasons a soccer player may play without an ACL that’s 100%:
- The athlete is not aware they have an ACL tear.
- There is a high risk for surgery/reason they cannot undergo surgery.
- Near the end of a season, no ability to redshirt.
- A championship or major game is approaching.
- The athlete has exceptional strength surrounding the knee.
Based on the above, it’s most common for an athlete to play with a torn ACL when they have few games remaining and the games are very important.
For this to happen, the medical staff and athlete must be comfortable with the decision. The athlete must be fully aware of the risk and choose to proceed.
An example of this is an alumnus from my college team. She tore her ACL during her senior season, with only a few big games left.
She played on the torn ACL with a brace because she had great length strength surrounding the knee and did not have the ability to redshirt if she underwent surgery at that moment.
The Bottom Line
Realistically, it’s not a good idea to play soccer without an ACL. For some athletes, it’s not possible to perform abrupt, explosive movements without an ACL.
Furthermore, attempting to do so puts you at risk for a host of serious, long-term injuries.
Even so, some soccer players have played without an ACL (or with a partially torn ACL) for a temporary period of time. Everyone who I personally know still got surgery or stopped playing soon after.
While undergoing surgery is frightening and rehab is long, it gives you a chance to return to sport in good health. Of course, some athletes opt not to get surgery and instead give up their sport.