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Anterior Cruciate Ligament (ACL)  Rehabilitation - What Are Your Options?

So you’ve completely torn your ACL. You probably know someone who has had an ACL injury and they’ve spent a long time out of sport. You may have even read about professional players who have lost their season to an ACL injury.

There’s two directions you can take from here – Surgery or Conservative management. Either way, physiotherapy is helpful for 3 options – Prehab (strengthening before your planned reconstruction), Post-op rehab (strengthening after your reconstruction), or Conservative rehab (strengthening without reconstruction). 


Pre-op Rehabilitation ("Prehab") 

There is much to be gained from an ACL Prehab period to prepare for a (hopefully) shorter and more efficient rehabilitation. There are some experts who suggest this leads to lower rates of re-ruptures. See our separate Prehab page for more information.

Why wouldn’t you just do the surgery sooner and get started on rehab ASAP?

There is actually evidence for delaying the reconstruction. Some suggest at least until the joint effusion has subsided. In my opinion, waiting until natural healing has peaked has merit too, but this isn’t feasible for everyone.

Also I find in many cases you may not have injured your ACL in isolation, in which case the other structures (medial ligament, meniscus, etc) need to heal first. And having no swelling when your surgery takes place reduces your risk of an infection. In this time, starting Prehabilitation is a great way to get ahead. Click here for more information on Pre-hab.


Post-op Rehabilitation 

After your ACL reconstruction, if your surgeon has a post-op protocol, we will use that to progress your rehabilitation. If they do not, there’s no problem, we have our own protocol which we have used with success over several years. This protocol is also updated regularly so you will benefit from the most current information available from experts.

The rehabilitation could take anywhere between 6 – 12 months, and there are may variables that need to be considered in this timeframe, which is beyond the scope of this article.


Non-op Rehabilitation (Conservative management) 

You may not want an ACL reconstruction. Surgery is not for everyone, and also comes with risks. The main reason people opt not to have surgery is that the recovery time is long. For some athletes it is long enough to significantly affect their chances of competing professionally, or end professional careers. For other everyday people the time off work may not be affordable.

For years people with ACL deficient knees have shown it is possible to live completely normal and functional lives. Recently several cases of professional athletes have emerged, where rehabilitation has been enough to restore normal function of the knee, and perform successfully at college and elite levels of competition.

But this isn’t for everyone – between 25-50% (about 1 in 4) of people who have an ACL deficient knee can return to sport. The rate is higher if your sport does not involve change of direction. To determine if this is you, there are some tests we can do in the clinic to see if you are suitable for non-operative management.

If you have an ACL deficient knee and you would prefer non-operative management, contact us for more information.


What can you expect from us at 20/20 Sports Physio?

We will provide you with options regarding how to best manage your ACL injury. If you have already had a reconstruction, we will provide information on recovery, and apply the latest protocols for rehabilitating your reconstructed knee. This is often with consultation with your surgeon’s preferences and protocols, so we can seamlessly integrate everything to optimise your rehabilitation. 

1-on-1 appointments at our clinic, and eventually in the gym, to help you with your rehabilitation from start to finish. 

We are specialists in rehabilitation, and we place importance on exercise technique, loading programs, how hard to push yourself, and when to back off. 

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