SPORTS
Lindsey Vonn is an American alpine ski racer who has competed in downhill, super-G, giant slalom, and combined events. She won a gold medal in the 2010 Olympics for downhill – a first for an American woman. She has won 84 World Cup races in her career - she is considered one of the greatest in the sport. After an impressive career, she announced her retirement in early 2019 following the World Championships, ending with a bronze medal in women’s downhill.
Almost 6 years later, in November 2024, she announced her return from retirement and set her sights on the Cortina Olympics in 2026. On January 30th, 2026, she suffered a devastating crash at the World Cup for downhill, her last race before Cortina. On February 3rd, Vonn announced she ruptured her left ACL but would still compete in the Olympic downhill events just over a week later. So how is she able to do this? When you tear your ACL you need surgery, right? The answer is more complicated than you think!
First let’s do a quick dive into what an ACL is and its primary functions.
The ACL (anterior cruciate ligament) is one of the four main ligaments in your knee. It connects the bottom of the femur (thigh bone) to the top of the tibia (shin bone). The ACL’s main functions are to prevent:
1) Anterior (forward) translation of the tibia on the femur
2) Rotational forces
In cases where the ACL is ruptured, patients often experience an increase in instability and dysfunction.
Following a rupture of the ACL, patients can be placed into one of three categories: Non-copers, Adapters, and Copers.
Non-copers are individuals who continue to have episodes of dynamic instability despite progressive rehabilitation.
Adapters are individuals who manage without reconstruction by adapting their overall activity level and participation.
Copers are individuals who resume prior levels of activity without dynamic instability.
Certain screening procedures can be used to attempt to predict which category an individual falls into, but it’s hard to know for sure without time. Generally, copers demonstrate better muscle activation, movement patterns, balance, and clinical presentation compared to non-copers. Presence of other damage will also play a role, as ACL injuries do not always occur in isolation. Concurrent injuries such as meniscus or cartilage damage may factor into a decision to pursue surgery.
When Vonn announced she would still be continuing in the Olympics, she also described how her knee is stable, she does not have swelling, and her muscles are firing and reacting as they should. All of which, as just described, are indicative of a good coper. In addition to this, she has been seen wearing a hinged knee brace that may help provide further external stability.
It’s important to note that though Vonn is currently coping with this ACL rupture, there’s still the possibility for surgical repair once the Olympics are over. Current recommendations indicate it’s generally better to get surgery sooner rather than later, as waiting can increase risk for damage to other structures such as the meniscus.
There are a lot of factors to consider following an ACL tear and when making the decision to get surgery or not. It’s important to discuss all options with your expert care team and choose the plan that suits your lifestyle and goals!
*Update: This past weekend, Lindsey suffered a lower leg fracture while competing in the downhill
Sources:
Eastlack ME, Axe MJ, Snyder-Mackler L. Laxity, instability, and functional outcome after ACL injury: copers versus noncopers. Med Sci Sports Exerc. 1999 Feb;31(2):210-5. doi: 10.1097/00005768-199902000-00002. PMID: 10063808.
Kocher MS, Sterett WI, Briggs KK, Zurakowski D, Steadman JR. Effect of functional bracing on subsequent knee injury in ACL-deficient professional skiers. J Knee Surg. 2003 Apr;16(2):87-92. PMID: 12741421.
Thoma LM, Grindem H, Logerstedt D, Axe M, Engebretsen L, Risberg MA, Snyder-Mackler L. Coper Classification Early After Anterior Cruciate Ligament Rupture Changes With Progressive Neuromuscular and Strength Training and Is Associated With 2-Year Success: The Delaware-Oslo ACL Cohort Study. Am J Sports Med. 2019 Mar;47(4):807-814. doi: 10.1177/0363546519825500. Epub 2019 Feb 21. PMID: 30790527; PMCID: PMC6546284.
