A Guide To Navigating Your ACL Surgery Rehab Journey

A Guide To Navigating Your ACL Surgery Rehab Journey

Recovering from an Anterior Cruciate Ligament (ACL) reconstruction can be a challenging yet rewarding journey. As you embark on this road to recovery, it’s crucial to understand the essentials that will pave the way for a successful rehabilitation process. In this blog, we’ll explore key aspects of ACL surgery recovery and offer valuable insights to help you achieve optimal results.

Understanding ACL Surgery:

The ACL is a crucial ligament in the knee that helps stabilise and control movement. When it gets torn, this is usually due to sports injuries or sudden twists. While surgical management may not be for everyone, it is nonetheless a common treatment choice (Here is a previous Blog that outlines deciding between Surgical vs Non-operative Management! ACL Injuries- Surgical vs Conservative Management? | BeFit Training Physio).

ACL surgery involves replacing the damaged ligament with a graft, typically from your own body, or a donor. Two commonly used grafts from your own body to replace the torn ACL are:

  • The Hamstring Tendon Graft
  • The Patella Tendon Graft

Both options come with their advantages and challenges, and deciding on the most suitable graft will come back to personal choice after discussing with your surgeon.

Post-operative recovery time typically varies anywhere between 9-12 months, depending on the individual. However, everybody is unique and one rehab journey will often look different to another person’s. Therefore, whilst we have frameworks to guide rehabilitation, applying a tailored treatment plan according to your needs is integral.

Early Postoperative Phase:

Immediately following your operation, we can hit the ground running (not literally!). The key focus in this phase will be on:

  • Pain management
  • Swelling reduction
  • Regaining full knee range of motion
  • Gait retraining

This phase of the recovery journey can be challenging due to pain and inflammation, so it’s essential to stick to your prescribed pain medication and icing routine to manage discomfort.

Once we have minimised pain and swelling, achieved a good level of range of motion, and normalised walking mechanics, we can really start to get into the nuts and bolts of your rehab plan!

Muscle Strengthening

Building strength is a cornerstone of ACL surgery rehabilitation. It is completely normal to experience some loss of muscle size and strength post-operatively. However, a safe, and progressive strengthening program starting even from the early stages of your recovery can help to minimise muscle atrophy. Strengthening the muscles of the lower limb will also support your knee by contributing to overall stability.

Key muscle groups to target include your quadriceps and hamstrings. However, we don’t want to forget surrounding muscles such as your glutes and calf muscles, as these muscles also play a crucial role in overall leg strength and stability!

Balance and Motor Control:

Not only is strength a critical part of ACL rehab, but it’s important to note that balance and movement coordination can also be impacted after surgery. Again, this is a completely normal response as the body requires time to recover from the trauma of surgery.

Re-establishing balance and coordination through exercises such as single-leg stands, landing stability drills, as well as agility will be incorporated to improve your neuromuscular control. As your progress over the months of your rehab these exercises and drills become more complex to really challenge your ability to move safely with control. These activities play a vital role in restoring your confidence in everyday and sporting movements.

Cardiovascular Fitness:

Maintaining cardiovascular fitness during your recovery is essential. ACL rehab is a long journey, and so we want to make sure that we maintain a well-functioning cardiovascular system for health and performance reasons. While certain high-impact activities may be restricted initially, low-impact aerobic options like swimming, cycling, rowing, and walking are all potential exercise options. By including this within your rehab plan, we can ensure that the transition back into activities such as running is a smoother process.

Gradual Return to Running:

Once we have ticked off key clinical criteria such as full knee range of motion, nil swelling, and a solid foundation of strength, balance, and coordination, we can start to look at returning to running. At BeFit, we have a specific battery of tests that we like to apply to ensure we have left no stone unturned before running again. Once passed, the progression of running is a gradual process, as we like to steadily increase running distances, speed, and complexity over a period of time. This is to allow the body to adapt to your running loads without causing unnecessary niggles or injuries.

Sports-Specific Rehabilitation:

If you are an athlete, as you progress in your recovery the focus will shift towards sports-specific exercises. We will tailor your rehabilitation program to mimic the demands of your chosen sport, gradually reintroducing agility, jumping, and cutting movements. This aspect of rehabilitation is crucial for a safe return to your pre-injury level of activity. Better yet, returning you to greater levels of athleticism than pre-injury!


Recovering from an ACL reconstruction requires commitment, patience, and a well-structured rehabilitation program. Although it can be long, arduous, and challenging, it’s important to celebrate each milestone achieved during your recovery journey. By understanding and embracing the essentials of rehabilitation, you empower yourself to regain strength, stability, and confidence in your knee. As physiotherapists, we want to be your partner in this process, dedicated to helping you achieve a successful and lasting recovery.

Morrie Toum – BeFit Training Physio Coogee

Morrie Toum – BeFit Training Physio Coogee

Morrie completed a Doctor of Physiotherapy at Macquarie University after completing his undergraduate degree and Honours thesis in Sport and Exercise Science at University of Technology Sydney.

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