ACL Tears in Combat Sports: Newsletter and Podcast
If you train jiu jitsu, wrestling, MMA, or striking long enough, your knees will get tested.
Last week on the Dr. Jiu Jitsu Podcast, I recorded a solo episode breaking down ACL injuries specifically for combat athletes. Not the highlight-reel “cutting sport” version, but the reality we see on the mats: takedowns, leg entanglements, weird rotational positions, and injuries that don’t always feel dramatic in the moment.
Here are the key takeaways.
Why the ACL matters
The ACL is a major stabilizer of the knee, especially for rotation. Combat sports are full of rotational stress: pivots in wrestling, planted-leg mechanics in kicking, and torque from leg entanglements. That’s why ACL injuries show up so often in our world.
Common combat sport mechanisms
Unlike traditional field sports where ACL tears are often non-contact, combat sports frequently involve partner contact or entanglement. High-risk situations include:
Takedowns that collapse the knee inward (valgus stress), especially scissor takedown (kani basami) and tani otoshi mechanics
Leg locks and entanglements (heel hooks are a big one because pain is not a reliable warning sign)
Positions like lockdown, 50/50, De La Riva and reverse De La Riva when someone tries to “blast through” and the knee is stuck in rotation
Diagnosis: story + exam + MRI
A lot of ACL tears can be suspected from the story alone, then confirmed with exam (Lachman is the most useful) and MRI. Combat athletes do not always present with the classic “pop + huge swelling + can’t walk” story, so context matters.
Do all ACL tears need surgery?
No. This is one of the biggest myths.
Some athletes can function without an ACL (we call them “copers”), especially if they aren’t having instability events. But the main risk of skipping surgery is not pain, it’s giving-way episodes that can lead to meniscus/cartilage damage over time.
If you choose surgery, two points matter most
Don’t rush it. Ideally you go into surgery with full motion, minimal swelling, and strong quads.
Respect the timeline. Full return to sport after ACL reconstruction is typically 9–12 months. Going back earlier raises re-tear risk significantly, even if you “feel fine.”
The part most athletes underestimate: the mental game
Rehab is long. You will feel ready before your knee is ready. Staying connected to your gym community and setting weekly goals matters more than most people realize.
Listen to the full episode
If you’re dealing with a knee injury, deciding between rehab vs surgery, or trying to plan a smart return to training, the full episode is live now on the Dr. Jiu Jitsu Podcast.
If you want the next episode to be on meniscus tears (the most common knee injury in combat sports), reply and tell me what you’re struggling with: pain, swelling, locking, or return to training.
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Dr. Megan Lisset Jimenez
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