Physical Therapy Rehabilitation in ACL injury.

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Reviewed by Dr. Karan Raj Jaggi

Dr. Karan Raj Jaggi is a triple board-certified, internationally trained orthopaedic surgeon super-specialising in regenerative orthopaedics, sports injuries and fast-track joint replacements.He currently serves as the Chief Medical Officer and Head, Regenerative Orthopaedics at Osso Orthopaedic Centres, where he leads cutting-edge orthopaedic care with a focus on holistic, patient-centric treatments.

December 8, 2025

Physical Therapy Rehabilitation in ACL injury

What is the ACL injury?
Anterior cruciate ligament (ACL) injuries are common, especially among athletes and active individuals. These injuries can lead to significant pain, instability, and a loss of function in the knee. Rehabilitation after an ACL injury is crucial for restoring strength, range of motion, and stability, enabling individuals to return to normal activities and sports. Physical therapy plays a vital role in this recovery process, whether the treatment is surgical or conservative.

How can it happen?
The ACL is a key ligament in the knee that helps stabilize the joint during movement. It connects the femur (thigh bone) to the tibia (shin bone) and prevents excessive forward movement of the tibia relative to the femur. ACL injuries often occur during activities that involve sudden stops, jumps, or changes in direction. When the ACL is torn, it can lead to swelling, pain, and instability in the knee. The injury can also result in muscle weakness around the knee due to disuse during recovery, which is why rehabilitation is essential for regaining function.

What can be done?
The rehabilitation process for an ACL injury typically includes several phases with specific exercises and treatment options:

Initial Recovery Phase: Focus on reducing pain and swelling.

– Rest, Ice, Compression, Elevation (RICE): Essential for managing inflammation post-injury or surgery.
– Gentle Range of Motion Exercises: Such as heel slides and ankle pumps to maintain mobility.Strengthening Phase: Building strength in the muscles surrounding the knee.
– Quadriceps Strengthening: Exercises like straight-leg raises and quad sets help restore muscle function.
– Hamstring Strengthening: Incorporating exercises like bridges or hamstring curls.Balance and Proprioception Training: Enhancing stability.
– Balance Exercises: Standing on one leg or using balance boards to improve coordination.
Functional Training Phase: Preparing for return to activity.
– Agility Drills: Ladder drills and cone drills to improve speed and agility.
– Sport-Specific Exercises: Mimicking movements specific to the athlete sport. Return-to-Sport Phase: Gradually reintroducing sports activities.
– Cutting and Jumping Drills: Practicing movements that involve quick changes in direction.
– Plyometric Exercises: Box jumps and hopping drills to build explosive strength.

How does it work?

-Rest, Ice, Compression, Elevation (RICE): This method helps control swelling and pain immediately after an injury or surgery, promoting a better healing environment for the knee.
-Gentle Range of Motion Exercises: Maintaining flexibility is crucial for preventing stiffness in the joint; these exercises help restore normal movement patterns.
-Quadriceps Strengthening: Strengthening the quadriceps is vital because these muscles support knee stability; weak quads can lead to further instability.
-Hamstring Strengthening: Strong hamstrings help balance out the forces acting on the knee joint, reducing strain on the ACL.
-Balance Exercises: These exercises enhance proprioceptionβ€”awareness of body positionβ€”which is essential for preventing re-injury during physical activities.
-Agility Drills: Improving agility prepares athletes for the demands of their sport while reinforcing proper movement patterns that protect the knee.
-Cutting and Jumping Drills: These drills simulate real-life sports movements, ensuring that athletes can safely return to their activities without risking further injury.
-Plyometric Exercises: Building explosive strength through plyometrics enhances performance while promoting muscle coordination necessary for dynamic movements.

Wish to know more?
For further reading on ACL injury rehabilitation and recovery strategies, consider exploring these articles:

Engaging in a structured physical therapy program after an ACL injury is essential for optimal recovery. Following a well-designed rehabilitation plan tailored to individual needs, patients can regain strength, stability, and confidence in their knee function. Always consult a healthcare provider before starting any new rehabilitation program to ensure it aligns with your specific condition and goals.

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