The Truth About ACL Tears: Recovery, Rehab, and Getting Back in the Game
Introduction:
An ACL tear is one of the most common knee injuries I see as a physiotherapist. It can feel overwhelming—especially if you’re active in sports or fitness—but with the right care, recovery is very possible. This blog will walk you through what the ACL is, how injuries happen, what symptoms to watch for, treatment options, and how physiotherapy supports healing.
What Is the ACL?
The anterior cruciate ligament (ACL) is one of the main ligaments in your knee. Its job is to keep your shin bone (tibia) stable and stop it from sliding too far forward. It also helps control twisting and turning movements—things we do a lot in sports like soccer, basketball, or skiing.
How Do ACL Tears Happen?
Most ACL tears happen without contact—not from getting hit, but from how the knee moves. Common causes include:
Suddenly changing direction (pivoting or cutting)
Landing awkwardly from a jump
Stopping suddenly while running
Overstretching the knee (hyperextension)
Athletes, especially young women, are at higher risk because of movement patterns, strength imbalances, and sometimes anatomy.
Signs and Symptoms:
If you’ve torn your ACL, you may notice:
A “pop” sound or feeling when the injury happens
Swelling within the first few hours
A sense of the knee “giving way” or feeling unstable
Pain with movement or weight-bearing
Trouble bending or fully straightening the knee
Diagnosis:
A doctor or physiotherapist can test your knee using specific movements. Often, an MRI scan is used to confirm the injury and check for other damage, such as to the meniscus or cartilage.
Treatment Options:
Treatment depends on your activity level, goals, and how unstable your knee feels.
Physiotherapy only (non-surgical): Some people—especially those not playing pivoting sports—can do very well with rehab alone. Strengthening and balance training can help the knee feel stable and functional.
Surgery plus physiotherapy: Active individuals who want to return to sports with cutting, pivoting, or jumping movements may need ACL reconstruction. The surgery rebuilds the ligament, but rehab is just as important as the surgery itself.
How Physiotherapy Helps:
Physiotherapy is central to both surgical and non-surgical recovery. A good rehab plan will include:
Early phase: Reduce swelling, restore knee motion, and get your quadriceps muscles working again.
Strength training: Build up quads, hamstrings, hips, and core muscles for stability.
Balance and control: Improve your body’s ability to react to movement and keep the knee steady.
Sport-specific training: Gradually add drills like cutting, pivoting, and jumping before returning to full play.
Recovery takes time. For athletes after surgery, return to sport is often 9–12 months, depending on progress. The goal isn’t just healing, but making sure the knee is strong, stable, and ready to handle the demands of your activity.
Can ACL Tears Be Prevented?
Yes—prevention programs work! Research shows that doing structured warm-ups with strength, balance, and jump-training exercises can reduce ACL injury risk. Coaches, trainers, and athletes can use these as part of regular training.
Final Thoughts
An ACL tear is a big injury, but it doesn’t mean the end of sports or activity. With the right plan—whether that includes surgery or not—plus dedicated physiotherapy, you can get back to doing the things you love.
If you’ve injured your knee and suspect an ACL tear, book an assessment with a physiotherapist. The earlier you start, the better your recovery can be.
Written By: Stacey Stys
References:
Massachusetts General Hospital. (n.d.). Rehabilitation protocol for anterior cruciate ligament (ACL) reconstruction. Retrieved from https://www.massgeneral.org
Physiopedia. (n.d.). Anterior cruciate ligament (ACL) rehabilitation. Retrieved from https://www.physio-pedia.com
Grindem, H., et al. (2019). Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction. British Journal of Sports Medicine, 53(15), 963–969.
Filbay, S. R., & Grindem, H. (2019). Evidence-based recommendations for ACL rehabilitation: How should clinicians manage patients? British Journal of Sports Medicine, 53(5), 260–268.
Arundale, A. J., et al. (2018). Clinical recommendations for ACL injury prevention programs: A systematic review and meta-analysis. British Journal of Sports Medicine, 52(23), 1507–1517.
