02/06/2026
Will Lindsey be able to COPE on the slopes?
With Lindsey Vonn in the spotlight, many athletes are searching for answers about ACL tear treatment, ACL surgery vs rehab, and whether it’s possible to return to sport without ACL reconstruction.
What most people don’t realize is that ACL treatment is individualized.
Research has identified ACL “copers” and “non-copers” — athletes who may or may not function without surgery after an anterior cruciate ligament injury.
This concept originated with Dale Daniel and was later refined by Lynn Snyder-Mackler Fitzgerald, who showed that true ACL copers are identified only after a structured ACL rehabilitation program, and typically without associated meniscus tears.
Some elite athletes may return to high-level sports without surgery.
For most patients — especially in high-risk sports like downhill skiing — ACL reconstruction remains the safest option to restore knee stability and reduce the risk of further injury.
Bottom line:
There is no single best treatment for every ACL tear. The right approach depends on the athlete, the sport, knee stability, and associated injuries — not just the MRI.
📚 Key Scientific References
1️⃣ Daniel et al. — Original “Copers” Concept
Daniel DM, Stone ML, Dobson BE, Fithian DC, Rossman DJ, Kaufman KR.
Fate of the ACL-injured patient: A prospective outcome study.
The American Journal of Sports Medicine.
1994;22(5):632–644.
doi: 10.1177/036354659402200511
🔹 This landmark prospective study followed patients after ACL rupture and identified a subset who could return to sport without reconstruction, laying the foundation for the coper vs non-coper concept.
2️⃣ Fitzgerald et al. — Identifying Copers After Rehab
Fitzgerald GK, Axe MJ, Snyder-Mackler L.
A decision-making scheme for returning patients to high-level activity with nonoperative treatment after anterior cruciate ligament rupture.
Journal of Orthopaedic & Sports Physical Therapy.
2000;30(4):194–203.
doi: 10.2519/jospt.2000.30.4.194
🔹 This study established functional screening criteria and emphasized that patients must complete a structured rehabilitation program before being classified as copers.