Physiotherapy After an ACL Tear: Why It’s Essential and What to Expect

An ACL tear (anterior cruciate ligament tear) is one of the most common and significant knee injuries, often affecting athletes and active individuals. Whether you choose to manage your injury conservatively (without surgery) or opt for ACL reconstruction, physiotherapy is a key part of your recovery—helping you regain strength, control, and confidence in your knee.

✅ Why is Physiotherapy Important After an ACL Tear?

Physiotherapy is essential for:

Reducing pain and swelling
Restoring knee range of motion
Rebuilding strength and stability
Re-training balance and movement control
Preparing for a safe return to sport or daily activities
Preventing re-injury or long-term complications

Rehab is not just about healing the ACL—it’s about retraining the whole body to move well again.

🛠️ What Are the Options for ACL Injury Rehab?

There are now multiple pathways for managing ACL injuries, thanks to recent research and innovations in physiotherapy and orthopaedics.

🔹 1. Conservative ACL Rehab – Including the Cross Bracing Protocol (CBP)

Recent advances have made non-surgical ACL healing a real possibility for select patients, especially those with:

Acute injuries
Good alignment of torn ligament ends
Lower physical demands (or a willingness to modify activity short-term)

✴️ The Cross Bracing Protocol (CBP)

One of the most promising developments in non-surgical ACL rehab is the Cross Bracing Protocol, designed to promote natural healing of a torn ACL by holding the knee in flexion.

The knee is braced at 90° flexion for the first 4 weeks after injury.
Range of motion is gradually restored over 12 weeks using specific brace settings.
Patients are typically non-weight-bearing for 6–8 weeks.
Evidence shows up to 90% of patients show MRI-confirmed ACL healing at 3 months, with excellent knee function and return to sport.

This method challenges traditional rehab protocols and shows great potential, particularly when started within 10 days of injury.

🏋️‍♀️ Modern Conservative Rehab Also Includes:

Blood Flow Restriction (BFR) training for strength without joint strain
Hip, core, and neuromuscular control retraining
Criteria-based progression (not just time-based)
Psychological support for return-to-play confidence

🔹 2. Post-Surgical ACL Rehabilitation

If surgery is chosen, a structured rehab program is essential for a full recovery. New surgical techniques, like quadriceps tendon grafts and internal brace augmentation, allow for stronger repairs and more dynamic rehab.

🗓️ Post-op rehab includes 5 phases:

Early recovery (Weeks 0–2): Focus on swelling, quad activation, and knee extension
Strength & movement control (Weeks 2–12): BFR, NMES, core and single-leg stability
Dynamic neuromuscular work (Weeks 12–20): Landing mechanics, balance, agility
Sport-specific drills (Months 5–9): Plyometrics, deceleration, change of direction
Return-to-sport testing (Months 9–12+): Hop tests, strength symmetry, and confidence assessment

We use tools like force plates, wearable sensors, and movement analysis to track your progress and tailor your program.

⏳ How Long Does ACL Rehab Take?

Cross Bracing Protocol rehab: Typically 3–6 months of supervised physiotherapy
Post-surgical ACL rehab: Around 9–12 months for full return to sport
Full recovery: May take up to 24 months for high-risk sports like soccer or basketball

Progress is based on function and readiness, not just time.

🧠 Why Choose After Hours Physio for ACL Rehab?

At After Hours Physio, we combine the latest science with personalised care. Whether you’re exploring non-surgical options like the Cross Bracing Protocol or recovering after ACL surgery, we offer:

One-on-one, hands-on care
Evidence-based rehab with modern tech tools
Home visits and after-hours appointments
Return-to-sport testing and long-term follow-up

📍 Supporting Patients Across Blackburn, Kew, and Nearby Areas

If you’ve suffered an ACL tear, it’s critical to start rehab as soon as possible—whether you’re aiming for natural healing or surgical recovery. Book an appointment today to explore your best options and begin your recovery journey with confidence.