ACL rehabilitation is a long road — but done correctly it can make you stronger and more resilient than before.
An ACL injury is one of the most significant setbacks an athlete can face. Whether you've opted for surgical reconstruction or conservative management, the road back to sport is long, demanding, and requires expert guidance.
But here's the thing: with the right rehabilitation, many athletes return to sport performing better than before their injury — with improved strength, proprioception, and movement mechanics.
**The 5 phases of ACL rehabilitation:**
**Phase 1: Acute management (Weeks 1-2)**
Reduce swelling and pain, restore range of motion, begin quad activation exercises. Goal: straight leg raise without extension lag.
**Phase 2: Neuromuscular control (Weeks 3-8)**
Balance and proprioception training, closed-chain strengthening (squats, leg press), progressive loading. Goal: symmetrical single-leg balance.
**Phase 3: Strength building (Weeks 8-16)**
Progressive resistance training — achieving limb symmetry index >90%. Begin low-impact cardiovascular conditioning. Goal: hop test symmetry >85%.
**Phase 4: Sport-specific conditioning (Weeks 16-24+)**
Running, agility, cutting movements reintroduced progressively. Sport-specific drills at full speed. Goal: passing criteria-based return-to-training tests.
**Phase 5: Return to competition**
Based on objective testing, not time alone. Psychological readiness assessed alongside physical criteria.
**The most important principle:** Return-to-sport decisions must be based on objective test results, not time from surgery. Athletes who return based on symmetry and performance criteria have significantly lower re-injury rates.
Athletes who complete a full, criteria-based ACL rehabilitation program are up to 4x less likely to re-injure compared to those who rush their return.
