What to expect after an ACL injury

Injuries to the anterior cruciate ligament (ACL) are common during sporting activities


Due to the vast numbers and amount of time missed from sports, over the past 20 years, the research surrounding the ACL has increased ten-fold.


If you’re reading this article because you have recently suffered from an ACL injury, then you may remember what caused it. Perhaps you remember decelerating rapidly or cutting to the side during a manoeuvre, or maybe you landed awkwardly when landing from a jump on one leg.

Whatever way you damaged your ACL, the general rehabilitation will be the same, however, depending on how you became injured, it may alter how you progress. When you progress through your rehabilitation programme, these recreations of events will provide vital feedback to yourself and your therapist on how well you are improving.


Early stages of Rehab /post-surgery

So, let’s say you’ve been fortunate to have optimal care, and you’ve managed to have surgery soon after the injury, should you have opted for this choice.

The early stages of the rehab programme are going to be focussed on: decreasing swelling around the area, increasing the range of motion at the knee joint, mainly extension of the knee joint. Your therapist may possibly use some electrotherapy to help maintain some muscle activation. Oh, and don’t forget the use of a static bike for keeping your cardiovascular fitness!

Extra notes:

• The management of swelling can generally be achieved through the application of ice and through the use of a light effleurage style massage to flush excess fluid into lymph nodes.

• When working to restore extension, your therapist will often alter stuff like sitting positions so you can achieve extension by sitting with your feet up but putting pillows under your ankles to encourage your knees into extended positions.


Mid-stages of Rehab

This stage is going to have more of a focus on improving the strength of the quadriceps, hamstrings, glutes and calf muscles.

The therapist will often work within sessions to ensure you are doing your exercises correctly with proper technique. You will be tasked of doing these exercises a couple of times per week at home and in a gym.

There will also be a focus of working on your proprioception and joint position sense, and balance work will be incorporated.

The latter stages of this stage may include some change of direction work, force acceptance and force production work.

Extra notes:

• It is essential to get the surrounding musculature as strong as possible, so compliance and steadily progressing throughout this stage are going to be very important.

Late-stages of Rehab

The late stages of the rehabilitation programme are going to consist of; continuing to progress with the strength training, working in agility training, adding in sprint training and plyometrics.

Everything added into the final stage will have to aim of testing the integrity of the reconstruction. Being able to do all of these tasks comfortably will be a great sign that you’re nearing your return to sports.


As you progress through the stages, it is essential, to be honest with yourself and your therapist and avoid over-doing it. Make sure you indeed are comfortable with an exercise during and after the session. If you have any pain or complications following your session, it is crucial to speak to your therapist. The aim of the rehabilitation programme is not to cause severe pain or discomfort.

If you are not 100% about an exercise, just ask your therapist to clarify or go over it again, they would rather you do an activity with good form. Ensure clarity rather than you avoiding doing it or doing it with poor technique.

Massage can be used throughout to ease sore muscles, help with draining of swelling or just because you want one!


Hopefully, this article has given you a quick insight on what to expect over the coming months and how you may be able to help yourself throughout. The recovery from an ACL injury can be a long windy road, however, when you get there, you should be completely comfortable going into every situation.

This is not a specific programme for yourself and is not to be used as injury advice, but a guide to refer to.


Happy Recovery!


Ethan Bell


Ultimate Recovery

Holistic Centre, 2B Mather Ave, Prestwich, Manchester M25 0LA

Ultimate Recovery

E: Contact@ultimaterecovery.co.uk

M: 07729 266 240

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