How ACL tears happen in basketball and what athletes can do to recover stronger.
By: Marcus A. Rothermich, MD, MBA
Orthopaedic Sports Medicine Surgeon
Birmingham Squadron Team Physician
Introduction
Basketball athletes are explosive movers — sprinting, stopping, cutting, jumping, and landing dozens of times each game. Those high-impact motions place major stress on the knee, specifically the anterior cruciate ligament (ACL).
“In basketball, every athlete is constantly stopping, starting and changing direction,” says Dr. Marcus Rothermich. “Those forces put the ACL in a high-risk position — and the consequences of injury can be significant.”
Why ACL Tears Happen So Quickly
Up to 70% of ACL tears occur without contact — meaning no collision is needed.
“You plant one way, your body goes another, and the ligament just can’t absorb it,” explains Dr. Rothermich. “A misstep or awkward landing can change an athlete’s season — or career — in an instant.”
Risk increases during:
- Hard cuts in transition
- Sudden deceleration
- Jump-land sequences
- Twisting while the foot is planted
“Athletes often say, ‘I wasn’t hit — it just popped,’” he adds. “That’s how fast it happens.”
What ACL Tears Look & Fell Like
Common indicators include:
- A loud pop
- Immediate swelling
- Knee feels unstable or buckles
- Loss of full motion
“If the knee doesn’t feel trustworthy, that’s a red flag,” says Dr. Rothermich. “Instability is the knee telling you something isn’t right.”
The Vital Role Athletic Trainers Play - On the Court & On the Sideline
In pro, college and high school sports, athletic trainers (ATs) are often the first medical professionals to evaluate ACL injuries — especially in competitive basketball settings.
“Athletic trainers are our eyes and ears on the ground,” Dr. Rothermich emphasizes. “They know the athlete, they saw the injury happen, and they react instantly.”
ATs:
- Perform immediate stability tests
- Control swelling and provide immobilization
- Communicate crucial details to the sports medicine team
- Support athletes emotionally in that first difficult moment
“They are the bridge between the athlete and our medical team,” he says. “And they are essential to a successful recovery.”
The Andrews Sports Medicine Pathway: Proven, Efficient & Athlete-Centered
Andrews Sports Medicine is built on collaboration.
“At Andrews Sports Medicine, athletic trainers often refer directly to our non-surgical sports medicine physicians,” Dr. Rothermich explains.
“They perform the initial clinical evaluation, review X-rays, and order an MRI when appropriate.”
Treatment & Return-to-Play Timeline
Most competitive basketball athletes with a torn ACL require ACL reconstruction.
“The goal isn’t just to fix the ligament — it’s to restore confidence and control,” says Dr. Rothermich. “We don’t clear athletes until they prove they are ready.”
General guidelines:
- 9–12 months of structured rehab
- Strength and motion testing before return
- Physical therapists and athletic trainers supervising sport progression
“We rely heavily on physical therapists and athletic trainers throughout the entire post-surgical journey,” he notes. “They see every movement — every jump, every cut — and help ensure readiness, not just optimism.
“They perform the initial clinical evaluation, review X-rays, and order an MRI when appropriate.”
ACL Prevention: Where Games Are Won
The best defense is training movement quality.
Effective prevention includes:
- Glute, hamstring & core strengthening
- Neuromuscular and balance training
- Landing and cutting technique
- Avoiding fatigue-induced errors
“We can dramatically reduce ACL tears with consistent prevention programs,” he adds. “Teams that invest in health win more games — plain and simple.”
The Mental Comeback
An ACL injury challenges the athlete’s mind as much as the knee.
“You’re not fully back until your knee and your confidence are aligned,” Dr. Rothermich tells his players. “Physical therapists and athletic trainers are right beside them through that entire journey.”
Care For Every Level of Player
Whether he’s working with a G-League guard or a rising middle-school star:
“My job — alongside athletic trainers — is to help athletes return stronger than before,” Dr. Rothermich says. “Basketball is their passion. Keeping them healthy is ours.”
Schedule an Evaluation
If you’ve experienced knee instability or suspect an ACL injury, don’t wait. Dr. Rothermich is currently accepting new patients at our Birmingham, Cullman, and Trussville clinic locations.
To schedule an appointment with Marcus A. Rothermich, MD, MBA, call (205) 939-3699 or request an appointment online.
About Marcus A. Rothermich, MD, MBA
Sports Medicine • Sports Knee Specialist • ACL Reconstruction Expert
Marcus A. Rothermich, MD, MBA is a board-certified, fellowship-trained orthopaedic surgeon at Andrews Sports Medicine in Birmingham, Alabama, specializing in sports knee injuries, including ACL tears, meniscus injuries, cartilage restoration, patellar instability, and complex ligament reconstruction. He also has advanced expertise treating sports-related injuries of the shoulder and elbow, particularly in basketball and overhead athletes.
Dr. Rothermich serves as a Team Physician for the Birmingham Squadron, the NBA G League affiliate of the New Orleans Pelicans, and partners with multiple high-school athletic programs across Central Alabama. His sideline experience gives him unique insight into the demands placed on athletes — from professional basketball players to competitive student-athletes.
Dr. Rothermich is passionate about helping athletes of all ages return to play safely and confidently after a knee injury. He works closely with athletic trainers, physical therapists, and sports performance teams to ensure every patient receives comprehensive, high-performance care.
To schedule an appointment with Dr. Rothermich, call 205-939-3699 or request an appointment online.
