9 Essential Steps for Effective Anterior Cruciate Ligament (ACL) Rehabilitation

Initial assessment and accurate diagnosis: The first step is a thorough evaluation of the injury. Your physiotherapist will perform specific tests to determine the extent of the rupture, assess knee stability and identify any associated damage.

Conservative or surgical treatment: Based on the assessment, you and your healthcare professional will make an informed decision between conservative and surgical treatment. New recommendations suggest that conservative treatment may be an effective option for some patients, particularly in cases where ligament laxity is minor.

Personalized ACL rehabilitation protocol: If conservative treatment is chosen, a personalized rehabilitation protocol will be drawn up, including bracing for the first 6 weeks. During this period, the physiotherapist will use manual therapy techniques to relieve your pain and reduce knee swelling.

Muscle-strengthening exercises: ACL rehabilitation will focus on muscle strengthening, particularly of the quadriceps and hamstring muscles. These exercises help to stabilize the knee and minimize stress on the ligament.

Mobilization and range of motion: Mobilization exercises aimed at restoring normal knee range of motion will be incorporated. This is crucial to avoid joint stiffness and allow full recovery.

Bracing and support: The temporary use of a brace may be recommended to stabilize the knee during daily activities. However, this depends on the severity of the rupture and the specific needs of each patient.

Regular follow-up and ongoing adjustments: Rehabilitation of the ACL is a dynamic process. Regular assessments with your physiotherapist will enable the program to be adjusted according to your progress, ensuring an adaptive approach throughout the healing process.

Continuing Education and Preventive Advice: Your physiotherapist will provide you with preventive advice, educating you on movements to avoid, activities to prioritize and how to prevent recurrences in the future. By carefully following these steps, you greatly increase your chances of a full recovery and a return to your favorite daily activities and sports. Remember that every case is unique, and a personalized approach with your physiotherapist is essential to optimize results.

By carefully following these steps, you’ll greatly increase your chances of a complete recovery and a return to your preferred daily activities and sports. Remember that every case is unique, and a personalized approach with your physiotherapist is essential to optimize the results of ACL rehabilitation.

Initial Recovery Phase:
After surgery, a period of relative rest may be recommended by the medical doctor. Follow your surgeon’s and physiotherapist’s instructions regarding brace use and initial precautions.

Pain and inflammation control:
Pain and inflammation management is a priority. Anti-inflammatory drugs and analgesics prescribed by your medical doctor may be recommended. In parallel, non-medicinal methods such as cryotherapy can be used to reduce inflammation. 

Early initiation of rehabilitation:
As soon as your surgeon gives the go-ahead, rehabilitation of the ACL will begin. Mobilization exercises and isometric strengthening techniques can be initiated to maintain muscle function without compromising the integrity of the surgical suture

Controlling joint range of motion:
Recovery of range of motion is a priority. Specific exercises will aim to restore full flexion and extension of the knee. This is crucial to avoid excessive scarring and ensure optimal joint function.

Gradual load resumption:
Your physiotherapist will guide you through progressive steps to reintroduce load on the operated knee. This includes progressive strengthening exercises, stationary cycling and static/dynamic balance exercises.

Regular assessment of progress:
Regular appointments with your physiotherapist and surgeon are essential to assess the progress of your ACL rehabilitation. Ongoing adjustments to the program will be made according to your individual progress.

Targeted muscle strengthening:
Surrounding muscles, particularly the quadriceps and hamstrings, will be targeted to enhance knee stability. Specific exercises tailored to your post-operative condition will ensure balanced strengthening.

Preventing complications:
Your physiotherapist will carefully monitor any indications of potential complications such as Arthrogenic Muscle Inhibition (AMI), joint stiffness or poor healing. Early intervention can prevent these problems. For AMI, for example, your physiotherapist will use pre-session cold application, electrostimulation, strengthening with Blood Flow Restriction (BFR), cross education and biofeedback training.

Progressive return to normal activities:
Resumption of normal activities and sports will be gradual. Your physiotherapist will determine the ideal time, depending on your muscle strength, stability and ability to perform specific movements (jumps, agility courses, etc.).

Post-operative ACL rehabilitation is a well-orchestrated process that requires patience, commitment and close collaboration with your physiotherapist. Carefully following these steps offers you the best chance of a full recovery, enabling you to return to your daily activities and sports with confidence and security. Don’t forget to consult your physiotherapist regularly to adjust your ACL rehabilitation program according to your individual progress.

Immediate post-operative brace:
Following ACL surgery, your surgeon may recommend the use of an immediate post-operative brace. The aim of this splint is to limit knee mobility, reduce the risk of unwanted rotation and promote appropriate tissue healing. Follow your surgeon’s specific recommendations regarding duration of use and necessary adjustments.

Support brace During rehabilitation in the case of conservative treatment:
During the first 12 weeks of conservative treatment, a support brace will be recommended by your physiotherapist. This splint provides additional support while allowing a certain amount of freedom of movement. It can be adjusted to meet the specific needs of your progress, providing the balance of stability and mobility required for ACL rehabilitation exercises.

Customization to individual anatomy:
It’s essential that the brace is correctly adjusted to your individual anatomy. A custom-made brace may be recommended to ensure optimum support while avoiding discomfort. Modern splints are often lightweight, adjustable and designed to fit comfortably under clothing.

Regular consultation with the physiotherapist:
Your physiotherapist plays a key role in recommending and fitting the brace. Regular consultations will assess your progress, determine if modifications are necessary and ensure that the brace meets the specific requirements of your ACL rehabilitation.

The choice of brace after an ACL rupture is an individualized decision that depends on a variety of factors, including the extent of the injury, the choice of conservative treatment and your rehabilitation goals. In collaboration with your medical team, including your physiotherapist, you can choose the brace that will optimize your comfort while promoting a successful recovery. Remember to follow your healthcare professional’s specific recommendations to maximize the benefits of bracing in your ACL rehabilitation journey.

Medical consultation and individual assessment:
Before considering resuming any sporting activity, it is imperative to consult your orthopaedic surgeon and physiotherapist. A thorough assessment of knee stability, muscle strength and post-operative recovery is crucial in determining your fitness to resume sport.

Low-impact activities:
Certain low-impact activities can be considered during the ACL rehabilitation phase and even afterwards. Walking, swimming and moderate cycling are often well tolerated and can contribute to rehabilitation without placing undue stress on the knee.

Muscle strengthening exercises:
Targeted muscle-strengthening exercises, supervised by a physiotherapist, are essential before resuming more intensive activities. Strengthening the quadriceps, hamstrings and knee stabilizer muscles is essential for joint stability.

Moderate-impact sports:
Certain moderate-impact sports, such as running, can be considered after adequate recovery and several months of ACL rehabilitation. An examination of fitness to resume running should include a battery of specific tests, such as horizontal jumps and dynamic balance.

High-risk activities:
Resumption of sports involving rapid changes of direction and physical contact will require strict compliance with criteria validating return to sport, including maximum strength tests and speed/agility tests in particular.

Returning to sport after an ACL rupture is highly dependent on the nature of the injury, the surgery undertaken and the individual progress of ACL rehabilitation. Regular consultation with your medical team, open communication about your goals and adapting your activities to your physical condition are essential for a safe and successful return. Remember that every case is unique, and a personalized approach with your physiotherapist is essential to making informed decisions about resuming your favourite sporting activities.

Rehabilitation of the anterior cruciate ligament is a crucial step. By following the best international recommendations, you maximize your chances of a complete recovery and a safe return to your favorite activities. Don’t hesitate to consult your physiotherapist for a personalized approach tailored to your situation.

Continue your journey to recovery with confidence with Hugo Bogaerts, your sports physiotherapy expert with BFSP recognition at GOLD STATUS.