ACL Rehabilitation Guide - The True Active Physio Way

Expert ACL Rehabilitation Backed by World-Class Training

At our clinic, ACL (anterior cruciate ligament) rehabilitation is one of our core strengths. Our team brings extensive experience and advanced training to the management of ACL ruptures, working with a high volume of clients across a range of sports. Whether you're aiming to return to netball, basketball, soccer, or AFL, or simply rebuild confidence in daily movement, we design evidence-based programs tailored to your goals. Our clinicians have also worked with elite and professional athletes through roles in the AFL, AFLW and Netball Victoria, allowing us to bring high-performance insights into every stage of your recovery.

Learning From Global Leaders in ACL Management

In 2023, members of our team travelled to Aspetar Orthopaedic and Sports Medicine Hospital, one of the world’s leading centres for sports injury management, to attend the International ACL Conference. This opportunity sharpened our clinical approach and strengthened our commitment to delivering best-practice rehabilitation. During this time, our staff collaborated with experts who manage athletes from the EPL, NFL and NBA. The principles learned from these world-class practitioners are now embedded into our rehabilitation framework—ensuring every client receives the highest standard of care and the best possible chance of a successful, confident return to sport.

What is the ACL?

The ACL (anterior cruciate ligament) is one of the major ligaments inside your knee and plays a key role in knee stability. It keeps the shin bone steady under the thigh bone, especially during twisting, pivoting, jumping and landing. The ACL works together with other ligaments, cartilage and muscles to provide smooth, coordinated movement. When it is injured or torn, this stability system becomes disrupted, often causing the knee to feel loose, unstable or “unsafe” during everyday activities and sport.

Role of the ACL in Sport

In high-demand sports like AFL, netball and soccer, the ACL prevents the knee from giving way when you suddenly change direction, decelerate, or land from a jump. It controls rotation of the knee and helps absorb load so your muscles can generate power safely. Without a functioning ACL, athletes often notice hesitation, reduced speed, buckling of the knee, and difficulty trusting the leg during quick movements.

When is ACL Surgery Recommended?

Surgery may be recommended when:

• The knee repeatedly gives way

• You want to return to high-demand pivoting sports

• There are additional injuries such as meniscus or cartilage damage

• Strength and stability cannot be restored through non-surgical rehab

ACL reconstruction aims to restore mechanical stability, but rehabilitation before and after surgery is essential. Factors such as your goals, age, activity level, biomechanics and knee function all influence whether surgery is the right choice. Surgery may not be necessary if returning to pivoting sport is not part of your goals.

What Should I Do Before Surgery? (Prehab)

Preparing the knee prior to surgery leads to much smoother healing afterward. Before ACL surgery, the essential criteria are:

• Full and symmetrical knee extension

• >120° knee flexion

• Minimal swelling

• Good quadriceps activation

• Normal walking pattern

This “prehab” phase improves strength, reduces stiffness, enhances early postoperative recovery and sets you up for a stronger and faster rehabilitation.

Core Principles of ACL Rehabilitation

At True Active Physiotherapy, your ACL rehabilitation follows the latest evidence-based ACL guidelines to ensure a safe, strong and confident return to sport.

Individualised Programming

Your ACL rehab is tailored to your knee, your graft type, your sport and your goals. We monitor swelling, movement, strength and pain week-to-week so your program adapts as you recover.

High-Quality Movement Coaching

We focus on how you move — your squat form, landing technique, running mechanics and cutting control. Better movement patterns mean safer progress and reduced re-injury risk.

Criteria-Based Progression (Not Time-Based)

You progress only when your knee proves it’s ready. We use dynamometry, force plate analysis and movement testing to track strength, symmetry and technique. This objective, criteria-driven approach is proven to improve ACL recovery outcomes.

Comprehensive Physical Development

Your ACL rehab builds multiple qualities at once. This whole-athlete approach restores performance while protecting your knee. 

Key Areas of Rehabilitation:

• Clinical recovery (pain, swelling, ROM

• Motor control

• Strength

• Explosiveness

• Reactive strength (plyometrics)

• Running

• Change of direction

• Sports skills

• Conditioning

Progressive, Sport-Specific Return

Early rehab calms and protects the knee. Later phases rebuild strength, explosiveness, running mechanics and sport-specific skills, preparing you for a safe, confident return to your sport — and ideally stronger than before.

ACL Recovery Roadmap

Your rehabilitation follows a structured progression through phases of recovery—from early protection and swelling management to sport-specific strength, running, change-of-direction drills and return to play.

When Will I Be Discharged?

You’ll be discharged from formal ACL rehabilitation once you’ve reached the key strength, movement and sport-specific milestones showing your knee is functioning safely and confidently. By discharge you will have:

• Restored ≥ 90% symmetry in all strength and power testing 

• Completed a return-to-running and change-of-direction program

• Demonstrating safe, symmetrical landing & change of direction mechanics

• Returned to sport-specific skills such as:

  • AFL: kicking, contact prep, marking patterns

  • Netball: landing control, pivoting, defensive footwork

  • Soccer: ball striking, reactive change of direction, high-speed runs

• Reporting confidence in knee, and psychological readiness to return to play

• Completed several weeks of full team training without swelling or pain

Having a clear plan with outlined goals and criteria to progress in each stage is key to success in rehabilitation. True Active Physiotherapy has significant experiencing in putting together comprehensive rehabilitation and return to play programs together following ACL injury. For enquiries, give us a call at (03) 7503 7657 or you're able to make an appointment online.