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ACL Tear? What About It?

You have probably heard of the anterior cruciate ligament (ACL) tear or even one of your friends had this injury before. However, how much do you know about this injury? The ACL is actually a ligament in our knee. It functions to resist excessive anterior movement of our lower leg with respect to our thigh, as well as to resist excessive twisting movement of our knee. Injuries to the ACL is quite common among athletes. Various sports such as football, basketball, and soccer which involve a lot of cutting and decelerating movements are at higher risk of ACL injuries.

A common mechanism of ACL injuries is sudden deceleration with or without a rapid change of direction (i.e. cutting motion) when running. Your doctor might recommend the Anterior Cruciate Ligament Reconstruction (ACLR) surgery if the ACL is completely torn, as the ligament cannot reattach itself. Oftentimes, a portion of the patella tendon or the hamstring tendon is used for the autograft.

Pre-surgery and post-surgery physiotherapy are both critical processes for future knee performance. The following section is a simple guide to show you what you will expect in an ACL rehabilitation program.

Before going into the surgery, your physiotherapist will make sure that there is good knee range of motion, no swelling of the knee, and relatively strong quadriceps and hamstring strength. All of these factors encourage a good recovery after the surgery.

The initial goals after ACLR (0-2 weeks) are to decrease pain and swelling of the incision site, and at the same time increase range of motion, particularly full extension of the knee. Strengthening exercises for the quadriceps and hamstrings are also included.

In the next stage of the recovery (3-6 weeks), the goals are to achieve full knee range of motion, retrain balance, and gradually weaning off crutches. And also continue strengthening exercises.

During the 6-12 weeks post-surgery, the focus will be on advance balance training and lower limb strengthening with increased resistance. After the 12 weeks mark, your physiotherapist will start some sport-specific training with you, mainly focus on the agility and cardiovascular fitness. Ladder drills, box jumping, and biking are great exercises during this stage. The last stage of the recovery process is from 4 months to 6 months post-surgery with an end goal of returning to your own sport practice. Please note that our therapists might adjust the program based on each individual’s progression.


The post is not supposed to replace any medical advice. If you are experiencing any pain, please consult a therapist as soon as possible. You may contact us or make an appointment at 905-771-8882 or, we are more than happy to help!


Kennedy, F. (2015). Physiotherapy Following ACL Reconstruction Protocol. Fowler Kennedy Sport Medicine Clinic. London, CAN.

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