ACL Injuries

An ACL injury is one of the most common knee injuries and is often a result of a sudden, sharp movement that causes either a strain, tear or rupture of the ligament.

The anterior cruciate ligament (ACL) is one of the key ligaments in the knee, connecting the thigh bone and shin bone. The ligament helps prevent excessive movement between these two bones and withstand stresses and strains from different directions.

Anterior Cruciate Ligament (ACL) injuries have a big impact on your life. Management of them has improved enormously in recent years with choices of surgical or non surgical available.

But make no mistake- ACL rehab is a big deal, it is difficult and takes time and effort.

The key thing for success with an ACL injury, no matter what you choose, is dedicated and intense rehab.

Causes of an ACL Injury

ACL injuries often occur during sports that require pivoting and jumping, particularly sports like basketball, tennis, netball, or football. Young women from netball, soccer and now AWFL have a higher proportion of these injuries.

The ACL may be put under strain with common manoeuvres in these sports, causing the knee to give way.

Symptoms of an ACL Injury

At time of injury, most people describe a popping sensation or a sense of the knee giving way or feeling like it went from underneath them.

Every ACL injury is different but immediate pain and swelling is common. You may find it hard to put weight on that leg.

Treatment options for an ACL Injury

There are a number of factors that will influence your decisions including, but not limited, to:

  • Your age
  • Whether you are regularly involved in activities that involve a lot of twisting, jumping, change of direction etc
  • Your goals
  • Previous injuries
  • What other responsibilities you have (e.g., work, family etc)
  • Initial Management

The first line of treatment following injury to the ACL should be those of the RICE principle (Rest, Ice, Compression, and Elevation). Early review by a physiotherapist is important to reduce swelling, improving movement and minimise wasting of muscles around the knee joint. Crutches are generally recommended to avoid excessive weight on the injured limb primarily during the early stages until you can walk without pain.

When is an ACL Reconstruction recommended?

Most patients who want to return to pivoting sports will require a reconstruction to prevent their knee buckling during these activities. Other indications for surgery include young patients with high activity levels and people who work in an environment where knee stability is critical for safety and function. If your knee is giving way regularly and this is interfering with your quality of life, you may want to consider an operation. This instability may occur during sport or during activities of daily living.

When should the surgery occur?

An ACL reconstruction is not an urgent or emergency operation. The best outcomes from reconstructive surgery have been shown to occur in people whose knees have had some time to stabilise and recover. In the majority of cases, it is preferred to rehabilitate your knee prior to undergoing surgery.

Pre-operative Rehabilitation

ACL injury physiotherapy prior to surgery is important to reduce the swelling, regain movement and limit the loss of strength in the muscles around your knee. It also teaches you the exercises needed for rehabilitation after the surgery.

Post-operative Rehabilitation

Physiotherapy (rehabilitation) is critical to the success of the surgery. If you cannot strictly follow the necessary precautions and rehabilitation, then it is best off not having surgery as complications such as graft loosing, graft rupture, stiffness and chronic pain can result.

It is important to start physiotherapy within 2-4 days of your surgery. You will require physiotherapy twice a week for approximately 6 weeks then reducing the amount of visits after this. Rehabilitation after an ACL reconstruction takes approximately 12-18 months.

During this period you will take part in a structured rehabilitation program with your physiotherapist, and gradually return to your normal activities. This process is designed to safely improve the strength, motion and balance (proprioception) in your knee whilst the ACL graft heals.



Recent research has allowed therapists and clinicians to easily identify and target weak muscle areas (e.g., weak hips, which leads to knock-kneed landing positions) and identify ways to improve strength and thus help prevent injury. In addition, other risk factors such as reduced hamstring strength and increased joint range of motion can be further assessed by a physiotherapist to improve performance. Prevention programs such as FIFA 11+, Footy First and Netball Knee have been shown to reduce ACL injury rates.

We have physiotherapists experienced in the rehabilitation of ACL injuries- not only professionally but personally too! To make a booking to see one of our physiotherapists for treatment of your ACL tear or injury,  please call 83462000 or contact us online

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