Patient Education Guide
Your ACL Recovery — What to Expect
A guide to understanding your rehabilitation and return-to-sport timeline
What Is the ACL and Why Does It Matter?
The anterior cruciate ligament (ACL) is one of four main ligaments in your knee. It controls rotational stability — the ability of your knee to handle twisting, pivoting, and cutting movements. When it tears, the knee becomes unstable under these loads, which is why it's a significant injury for most active people.
Surgery vs Rehab-Only
Both are valid
Decision depends on your age, activity level, instability, and what other structures were involved. We'll discuss this with you.
Typical Recovery Timeline
9–12+ months
To return to full contact sport. Criteria — not the calendar — determine when you're ready.
Reinjury Risk (before 9 months)
7× higher
JOSPT 2020 systematic review. This is why we don't rush return-to-sport clearance.
Our Discharge Criteria
Data-based
Limb symmetry index, hop tests, strength ratios — measured on VALD ForceDecks.
The Four Stages of ACL Rehabilitation
Stage 1
Protection & Early Loading
Weeks 0–6
Reduce swelling. Restore full range. Begin quadriceps activation. Walk normally.
Stage 2
Strength Building
Weeks 6–16
Progressive loading. Bilateral then unilateral strength. Address muscle atrophy from surgery.
Stage 3
Power & Neuromuscular
Months 4–8
Plyometrics. Reactive training. Sport-specific movement. Running programme introduction.
Stage 4
Return to Sport
Months 9–12+
Full contact training. Sport-specific drills. Criteria-based clearance testing.
How We Decide You're Ready to Return
Time alone is not a clearance criteria. Here is what we test before we clear you to return to full sport:
Return-to-Sport Criteria (VALD ForceDecks Testing)
- Limb Symmetry Index ≥ 90% — your injured leg must produce at least 90% of the force of your uninjured leg
- Single-leg hop test — distance hopped must be ≥ 90% of the uninjured side
- Triple hop and crossover hop — power and neuromuscular control assessment
- Quad:Hamstring ratio — balanced strength ratios between muscle groups
- Psychological readiness — confidence and willingness to return to full loading
The research is clear on early return
Athletes who return to sport before 9 months post-surgery have a reinjury rate 7 times higher than those who wait until criteria are met. We will not clear you before the data supports it — even if you feel ready.
What You Can Do to Speed Up Recovery
Sleep
Growth hormone — the primary driver of tissue repair — peaks during sleep. Aim for 8+ hours consistently. Poor sleep measurably slows recovery.
Nutrition
Adequate protein (1.6–2g per kg of bodyweight daily) supports muscle repair and rebuilding. Do not undereat during rehab — your body needs fuel to rebuild.
Consistency with exercises
Your home exercise programme is as important as your clinic sessions. The adaptations happen between appointments, not during them.
Mindset
Research shows that athletes who expect to recover fully do better than those who catastrophise. Pain during rehab does not mean damage — we will explain what sensations to expect at each stage.
Questions to Ask at Every Appointment
- What stage of rehab am I in, and what are the goals for this stage?
- What does my current LSI sit at, and what is the target before we progress?
- Is there anything I should avoid between now and my next appointment?
- What does the next stage look like, and when do we expect to get there?