ECP Physio are experts in helping people return to sport and activity after ACL (Anterior Cruciate Ligament) injuries. We have successfully helped many people return to exercise or sport through either conservative management or pre- and post-surgical management. We understand the physical, mental and emotional challenges this kind of an injury can have on someone, which is why we provide ongoing and continuous support throughout the entire journey.

Rehabilitation from this injury is more than just focusing on the knee; we take a holistic approach from working closely with leading Sports Doctors and Orthopaedic Surgeons, following evidence-based protocols and testing and ensuring that the whole body is performing at it’s best to give each individual the best opportunity to have a successful return to sport.

What is the ACL and how is it injured?

The ACL is one of 4 main ligaments in the knee joint. It is responsible for maintaining stability within the knee, and preventing excessive movement of the shin (tibia) on the thigh bone (femur). ACL injuries commonly occur during sports activities that involve sudden stops, changes in direction, or less-commonly, direct contact to the knee. This can result in twisting or hyperextension in the knee (or a combination of both), which then places excessive stress on the ligament, causing it to tear.

How do I know if I have injured my ACL?

Your physiotherapist will be able to determine this from asking some questions and performing a test on the knee. If there is a suspected injury to the ligament, we will then refer you for an MRI to confirm the diagnosis. If there is an injury present, we can discuss management options (in collaboration with an Orthopaedic Surgeon).

ACL Cross Bracing Protocol

Management Options: Conservative vs Surgical

Conservative Management

Conservative management (also known as non-operative management) is becoming a more popular option in managing ACL injuries. Some studies have shown that up to 40-60% of individuals have been able to return to their pre-injury level of sport after following a conservative management plan following ACL injury (Frobell et al. 2010; Filbay et al. 2020). Conservative management consists of a comprehensive rehabilitation program very similar to that performed in later stages of a post-surgical ACL program. The Cross Bracing Protocol is another conservative management strategy that is showing 90% healing rates of the ACL without surgery. For the right candidate, this non-operative management plan can mean a faster recovery and return to sport time, avoidance of surgery associated risks, and is more financially viable.

At ECP Physiotherapy, we have helped many people return to sport or daily activities through conservative management. There are specific criteria that we follow to determine if you would be a successful candidate. If you are interested in discussing your options, and whether you would be better suited to surgical or non-surgical management after an ACL injury, please contact us to find out more.

Pre-and Post Surgical Management

Surgical management of ACL injuries has been the standardised treatment option for a long time. We work closely with many leading orthopaedic surgeons, to ensure you have the best outcome following your surgery. Rehabilitation for ACL surgery is divided into two parts: 1. Pre-habilitation and 2: Post-Operative Rehabilitation.


Speaking with a physiotherapist before having ACL surgery is an important part of ensuring a good outcome post-surgery. The ‘gold standard’ recommendation is to perform at least 3 months of pre-habilitation before surgery, however,  studies have consistently shown that even a heavy strength and neuromuscular training program that is performed at least 5 weeks prior to surgery can help with improved knee function, improved quality of life and an increased likelihood of returning to the same level of sport as pre-injury.

It is important that prior to surgery there is:

  • Minimal to no swelling or pain
  • Full range of movement in the knee (ability to bend and straighten properly)
  • A normal walking pattern
  • Good level of strength in surrounding muscles
  • A good level of balance

It is also an opportunity to discuss what the plan will look like after surgery, what to expect and answer any questions you may have.

Post-Operative Rehabilitation

Your physiotherapist will arrange your first appointment at 1 week post-surgery. From here, we will follow a protocol over the next approximate 12 months. (Returning to sport less than 9 months post-surgery carries a high risk of injury and is not advised). This will include specific exercises at each phase, with different milestones that need to be achieved and testing being performed approximately every 3 months. Following this protocol and return-to-sport testing gives individuals the best opportunity of returning to the activities that they love, and minimising the chance of ACL injury in the future.

At ECP Physiotherapy, we can help guide you through both of these phases, and provide you with specific exercise-based rehabilitation programs that are suitable for what stage of recovery you are in, the specific types of movements and capabilities are needed for a successful return to sport, and are designed to be specific to your individual goals and needs. Located in Kent Town, Adelaide.

Book Now to get started today.

Read our Blog, “How Not To Rupture Your ACL” that was written by Emily Peut in collaboration with our trusted network of Orthopaedic Surgeons at Orthopaedics 360 in Norwood.

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