ACL injury

Injury to the ACL occurs most commonly in high intensity change of directions sports like football, netball, soccer or skiing. Most injuries occur as a result of a player’s own movement, like an awkward landing or missed step. But, some injuries may involve contact from an opponent or object. People who have injured an ACL often describe a sensation of a pop, followed by pain and a sensation of instability in the knee or giving way when trying to get up or walk or run after the injury.

The Anterior Cruciate Ligament (ACL) is an internal ligament in the knee that connects the two main bones in the knee (femur and tibia). Although the ACL provides stability to the knee to help us to do many activities, there are many other structures (muscles, other ligaments) which also assist.

Our approach to ACL injuries

At Complete, we pride ourselves on being at the cutting edge of ACL injury management. Through La Trobe University, the clinic has contributed to a large volume of ACL research (e.g. here and here), including innovative rehabilitation approaches (e.g. here and here) and development of patient resources (here).

We have been one of the lead clinic sites in La Trobe University’s recent large NHMRC funded ACL rehabilitation trial.  Our experienced clinicians see a high volume of people following ACL injury, and given our expertise we are regularly consulted for second opinions in difficult and challenging cases.

We will work closely with you throughout your ACL rehab journey to support you to get back the things that are important to you. Book an appointment at our Melbourne clinic at 656 Bridge Rd, Richmond.

ACL management pathway decision making

The first step in successfully managing your ACL injury is deciding on your management pathway.  Whilst surgical reconstruction of the ACL has been considered the gold standard in the past, there have been some exciting recent developments in our understanding of ACL rehabilitation, and the ACL itself which have opened the door to other management pathways.

There are three main pathways to consider following an ACL injury:

  1. Non-surgical rehabilitation
  2. Surgical re-construction + rehabilitation
  3. ACL healing protocol + rehabilitation (including the Cross bracing protocol)

Not all pathways are suitable for everyone.  At Complete we take the time to make sure you understand these options and what’s involved to help you to make the right decision for you and your circumstances. 

For more information on these pathways and the important considerations around making decisions, see Tim Trevail’s blog here.

ACL Rehabilitation

Rehabilitation following ACL injury can be a long and involved process, but it can differ considerably based on variables such as your chosen pathway (see Management pathway decision making), surgical approach (if you choose this route) and your goals.

Rather than adhering to timeframes to progress through rehabilitation, the rehabilitation following ACL injury is broken into phases. Each phase will have milestones to achieve before moving to the next phase. Some pathways may have additional phases, and some people may spend longer on particular phases than others. But it is important to progress through the phases in turn based on your chosen pathway and goals. See the figure below for an outline of the phases of rehabilitation for each pathway.

It is important to understand that it is always possible to move to the surgical reconstruction pathway later, even if you have opted for one of the other pathways initially.  There is no reported difference in outcomes of a delayed surgical reconstruction.

Return to sport testing

The return to sport following ACL can be an exciting, but anxiety inducing step. The risk of re-injury returning to sport is real but, achieving certain functional and psychological milestones based around you and your goals can reduce the risk of re-injury.

At Complete. Physio Exercise Performance, our clinicians will design a return to sport testing battery around you and your goals. Testing may include:

All testing is compared between limbs, and also to normative values to give a picture of return to sport readiness.

Learn more about how we treat knee pain at Complete.

Do ACL injuries require surgery?


Located in Richmond

High value physiotherapy care at 656 Bridge Rd, Richmond. We’re here when you need us!