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ACL Injury and Rehab: A Physiotherapist’s Perspective

Have you or someone you know experienced an ACL injury of the knee? It can often be

detrimental to your lifestyle and habits, especially those surrounding physical activity and sport. Currently, one of our own K-TOWN physiotherapists is on his journey to recovery following an ACL reconstruction surgery.

What is the ACL?

The anterior cruciate ligament (ACL) is a structural piece of connective tissue that connects your shin bone (tibia) to your thigh bone (femur) at the knee. The ACL runs diagonally to help prevent the tibia from sliding forward on the femur, while also providing rotational stability. ACL injuries most commonly occur in sports involving a “non-contact” mechanism such as, pivoting or sudden deceleration (i.e. soccer, basketball, football).

What to do immediately after a suspected ACL injury?

ACL injuries can be accompanied by pain, swelling, and difficulty weight-bearing, as well as psychological factors such as anger, frustration, and uncertainty. Initially following the injury, you should focus on pain and swelling management, as well as seeking out advice from a trusted heath care professional such as a physician or physiotherapist. Other members of your rehab team may include: a sports doctor, surgeon, or even your family and friends. Diagnostic imaging such as an x-ray or MRI may also be utilized to aid in your rehab journey.

Do all ACL patients have to undergo surgery?

No, not every patient with an ACL tear will require surgery. There are many factors that should be discussed with your rehab team to determine whether surgery or non-operative care will be best for you. These factors may include:

  • Your age

  • Prior or concurrent knee injuries

  • Ongoing episodes of instability, pain or swelling

  • Your activity-related goals

Regardless of deciding to undergo surgery or utilize non-operative care, evidence is in favour of beginning high-quality rehabilitation immediately after an ACL injury. The goal should be to return to normal knee mobility, strength, and function prior to deciding to pursue surgery as a treatment option.

How can physiotherapy help?

Whether you decide to pursue surgery or not, having a trusted physiotherapist on your rehab team can be extremely helpful. A physiotherapist can guide you through a rehabilitation plan to restore normal knee function, prevent further injury and help get you back to your normal daily and physical activities. Your rehab program should be specific to your needs and goals, evidence-based, flexible to your schedule, as well as practical and enjoyable.

How long does ACL recovery take?

The rehab journey following an ACL injury is long and tedious. It involves hard work and patience. Post-operative recovery is dependent on numerous factors such as: age, gender, prior knee injuries, surgical graft selection, and many others. Research suggests there is a lower risk of re-injury following an ACL surgery by waiting 9 months minimum until you return to competitive sport. This is where a trusted physiotherapist can help you meet the return to sport criteria, as well as building your mobility, strength and confidence along the way.

Written by: Michael O’Meara, Registered Physiotherapist and current ACLR patient.

Follow along with Michael’s ACL journey on Instagram:



1. Beischer, S., et al. (2020). Young athletes who return to sport before 9 months after anterior cruciate ligament reconstruction have a rate of new injury 7 times that of those who delay return. Journal of Orthopaedic & Sports Physical Therapy, 50(2), 83-90.

1. Frobell, R. B., et al. (2013).Treatment for acute anterior cruciate ligament tear: five-year outcome of randomized trial. BMJ, 346.

1. Gleadhill, C. P., & Barton, C. J. (2021). Infographic. ACL injury journey: an education aid. British Journal of Sports Medicine.

1. Video/Exercises courtesy of Physiotec


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