ACL & knee ligament injuries
The anterior cruciate ligament (ACL) is one of the main stabilising ligaments of the knee, and it is commonly injured in sports that involve twisting, pivoting, landing or sudden changes of direction - football, netball, rugby, skiing and running among them. Injuries range from a partial sprain to a complete tear, and can involve the MCL, meniscus or cartilage at the same time.
Not every ACL injury needs surgery. Whether you rehabilitate conservatively or after reconstruction, structured physiotherapy is what rebuilds the knee: restoring full movement and reducing swelling early on, then progressively rebuilding strength, control and confidence through to running and a criteria-based return to sport.
Melissa is passionate about ACL rehabilitation across all three pathways - prehabilitation before surgery, conservative management, and post-surgical recovery - following an evidence-based approach and monitoring progress from day one through to return to sport, with each programme individualised to the athlete and their sport.
Read more about return-to-sport & prehab at Stride.
Common questions
How long does ACL rehabilitation take?
It depends on the injury and the pathway, but recovery is measured in months, not weeks. Conservatively managed injuries and post-surgical rehab both progress through stages - settling swelling and restoring movement, then strength, then running and sport-specific work - and return to pivoting sport after reconstruction is commonly around twelve months. Progression is guided by how your knee performs against strength and control targets, not by the calendar alone.
Do I need surgery for an ACL tear?
Not always. The decision depends on the type of tear, whether other structures are involved, your knee's stability, and the sport and activities you want to return to. Many people manage well with structured rehabilitation alone, while those returning to high-level pivoting sport more often choose reconstruction. It is a decision made with your surgeon - physiotherapy plays a central role either way, including prehabilitation before an operation.
When can I return to sport after ACL reconstruction?
Return to pivoting sport is commonly around twelve months, but it should be based on meeting strength, hop and knee-control targets and feeling ready - not on time alone. Using objective return-to-sport testing to make that call means you go back when your knee can handle the demands of your sport, which reduces the risk of re-injury.