IMAGINE kicking a ball, lunging for a shuttlecock, or landing from a jump, then it happens. A sharp pain, a pop in the knee, and suddenly, you cannot stand. Anterior cruciate ligament (ACL) injuries are becoming increasingly common among casual athletes in Malaysia, especially those who jump into sports without building proper muscle support.
Weak glutes, hamstrings, and core muscles often overlooked, leaving the knee vulnerable during high-impact movement. While more Malaysians are taking up recreational sports, national data shows 84% of adults are still not active enoughi. This gap between enthusiasm and physical readiness is fuelling a rise in avoidable injuries.
Sunway City, Sunway Medical Centre Consultant Orthopaedic, Arthroplasty & Robotic Surgeon Dr Ahmad Hisham Bin Abdul Rashid explores impact and risk of these injuries which are not limited to professional athletes.
“We’re seeing more young adults, especially those aged 20 to 45 coming in with ACL injuries from futsal,football, badminton, volleyball or even gym workouts. Most haven’t prepared their bodies for these activities. They skip warm-ups, their muscles aren’t conditioned, and they go straight into high-impact play,” says Dr Ahmad Hisham.
How ACL injuries happen
The ACL is a major ligament in the knee that stabilises it during sudden stops, turns or jumps. A tear can happen when the foot is planted but the body twists, a common occurrence in high contact sports like football or rugby.
“When the ACL tears, patients often hear a pop. There is also immediate pain, swelling, difficulty putting weight on the leg, and limited knee movement.
He shared the case of a patient in his 20s who tore his ACL who landed awkwardly while playing football, volleyball game.
“He had instant pain, swelling, and couldn’t continue playing. His MRI confirmed a full ACL tear, and he needed surgery,” he said.
Not just a sports injury
Many people downplay the pain and keep walking. But Dr Ahmad Hisham warns this is risky.
“You can walk with a torn ACL. But without treatment, the knee becomes unstable. Over time, you risk damaging other parts of the knee, like the cartilage or meniscus. This increases your chances of developing early osteoarthritis,” he said.
ACL injuries aren’t exclusive to athletes. He noted that even daily movement like sudden twisting or stepping awkwardly can cause injury, especially if the surrounding muscles are weak.
Muscle weakness is the real culprit
Key muscle groups like the quadriceps, hamstrings, glutes, adductors and calf muscles work together to stabilise the knee. If any of these are undertrained especially in sedentary office workers or casual gym-goers, the risk of injury goes up.
“People think the injury happened during the sport. But the real cause is often long-term muscle weakness. Most people train their upper body, abs or cardio. But legs are often neglected. Your knees pay the price,” Dr Ahmad Hisham explained.
Prevention: The importance of 10 minutes
Dr Ahmad Hisham stresses that prevention starts before the game begins.
“Strengthen your legs and core. Focus on balance exercises. Always warm up before sports and cool down after. It only takes 10 minutes, but most people skip it,” he said.
Exercises like squats, lunges, leg curls and single-leg balance drills can make a huge difference.
He said there is no need for fancy equipment. Even bodyweight exercises at home can help protect your knees.
With more Malaysians embracing fitness, he urges sports enthusiasts to prepare their body properly.
“It’s the best way to enjoy your sport and avoid unnecessary injuries,” he said.
When to seek help
Many people assume the pain will go away with rest or painkillers. But that delay can worsen the injury.
“If you hear a pop or if your knee is swollen, unstable, or painful during weight-bearing movements, see a doctor. Only an MRI can confirm a torn ACL. Don’t wait,” he advised.
Even if the swelling subsides, you may still have long-term instability.
“Some patients only realise months later that their knee feels weak or gives way. By then, there could be further damage,” he added.
Surgery is just one part of the recovery
When the ACL is fully torn, surgical reconstruction is the gold standard. But surgery alone isn’t enough.
“Recovery depends on the patient. The surgery takes about one to one and a half hours, but rehab takes months. Motivation is the key. Without physiotherapy, the knee won’t regain its full function,” he said.
Patients typically start gentle movement within days, progress to light exercise after three months and return to contact sports after six months with doctor approval.
“Some people think they’re fine after surgery and skip rehab. That increases the risk of re-injury. The new ligament is still healing, it needs time and training to function well,” he said.
Don’t push through the pain
One of the most important messages Dr Ahmad Hisham shares is listen to your body.
“Some people try to push through pain and keep playing. That’s how small injuries become major ones. If your knee hurts, feels unstable, or something doesn’t feel right, STOP! Get it checked,” he said.