Building Strength and Preventing Setbacks: Physiotherapy for ACL Injuries

An ACL injury can be life-changing, affecting your mobility, confidence, and ability to stay active. Fortunately, physiotherapy is a proven solution for restoring knee function, managing pain, and supporting long-term recovery. In this blog, we’ll explore the causes of ACL injuries, how physiotherapy can help, and what you can expect on your journey to recovery.

Understanding ACL Injuries

The ACL, or anterior cruciate ligament, is a critical component of the knee that provides stability and prevents excessive forward movement of the shin bone. ACL injuries typically occur during activities that involve sudden changes in direction, such as pivoting or twisting in sports like soccer or basketball. High-impact landings, especially when the knee is overextended, can also result in damage to the ligament.

Additionally, direct blows to the knee, common in contact sports like football or hockey, are a frequent cause of ACL injuries. These injuries can range from partial tears to complete ruptures and are often accompanied by swelling, instability, and significant pain. Accurate assessment and timely treatment are essential for restoring knee function and preventing long-term complications.

The Role of Physiotherapy in ACL Injury Recovery

The frequency of physiotherapy sessions for ACL recovery depends on various factors, including the severity of the injury, progress during treatment, and specific recovery goals. During the initial phase, sessions are usually more frequent, around two to three times per week, to address pain, reduce swelling, and restore basic range of motion.

As recovery progresses to the mid-phase, the focus shifts to strength-building and functional movement, which often requires weekly visits. In the advanced phase, sessions may reduce to bi-weekly or monthly, as the focus moves to refining sports-specific skills and preventing reinjury. Throughout the process, regular at-home exercises prescribed by the physiotherapist are crucial for complementing in-clinic sessions and ensuring consistent progress.

Physiotherapy Exercises for ACL Rehabilitation

Physiotherapy for ACL injuries involves a structured progression of exercises to rebuild strength and mobility. Common exercises include:

Heel Slides: Gently extend and bend the knee while lying down to improve range of motion.
Quad Sets: Contract the quadriceps muscle while keeping the leg straight to build strength.
Straight Leg Raises: Strengthen the quadriceps and stabilize the knee.
Bridges: Engage the hamstrings and glutes to support the posterior chain and knee stability.
Balance Training: Use a wobbleboard or single-leg stance to improve proprioception.
Step-Ups: Gradual weight-bearing exercises to build strength and confidence in knee movement.

As strength and flexibility improve, clients advance to more dynamic exercises, such as squats, lunges, and sport-specific drills. These exercises are carefully supervised by a physiotherapist to ensure proper technique and progression.

How Often Should I Attend Physiotherapy for ACL Injury Recovery?

The frequency of physiotherapy sessions varies depending on the severity of the injury, individual progress, and treatment goals. General guidelines include:

Initial Phase: 2–3 sessions per week to manage pain, swelling, and restore range of motion.
Mid-Phase: Weekly sessions to focus on strength building and functional movement.
Advanced Phase: Bi-weekly or monthly sessions to refine sports-specific skills and prevent re-injury.

Regular at-home exercises prescribed by the physiotherapist complement in-clinic sessions. Consistency is key to achieving optimal results.

Avoiding Surgery for an ACL Injury: Can Physiotherapy Help?

Physiotherapy can often provide sufficient recovery for partial ACL tears or individuals with lower physical activity levels, eliminating the need for surgery. By focusing on strengthening the surrounding muscles, particularly the quadriceps, hamstrings, and glutes, physiotherapy can provide stability to the knee in the absence of a fully functional ligament.

Addressing biomechanical issues and restoring normal movement patterns further enhances knee function. Additionally, activity modifications, such as reducing high-risk movements, help manage the condition effectively without surgical intervention. For complete ACL tears, physiotherapy is frequently used as a prehabilitation approach to prepare the knee for surgery, optimizing strength and range of motion to improve post-surgical outcomes and shorten recovery times.

Physiotherapy Sessions for an ACL Injury: What to Expect

Your first physiotherapy session for an ACL injury focuses on evaluation and creating a personalized treatment plan. Here’s what typically happens:

Initial Assessment: The physiotherapist will review your medical history, the nature of your ACL injury, and your current symptoms. They may ask about pain levels, swelling, and any difficulties with movement.
Physical Examination: This includes tests to assess knee mobility, strength, balance, and stability. The physiotherapist will also evaluate surrounding muscles and joints to identify compensatory patterns.
Goal Setting: Based on the assessment, the physiotherapist will work with you to set realistic recovery goals, whether it’s walking without discomfort, returning to sports, or avoiding surgery.
Introduction to Therapy: You may begin with gentle exercises, manual therapy, or techniques to reduce swelling and pain, such as ice or compression.

The first session is also an opportunity to ask questions and understand what to expect throughout your recovery journey.

Can Physiotherapy Help Restore Full Mobility After an ACL Injury?

Physiotherapy is instrumental in restoring full mobility after an ACL injury. The process begins with regaining basic mobility through gentle stretches and assisted exercises, targeting stiff joints and tight muscles. As progress is made, strengthening the quadriceps, hamstrings, and other supporting muscles becomes the priority, ensuring dynamic movements can be performed safely.

The final stages of rehabilitation focus on achieving full extension and flexion of the knee, combined with stability training that mimics real-life or sport-specific activities. Under the guidance of a physiotherapist, regular monitoring and gradual progression ensure the recovery plan is both safe and effective, allowing individuals to return to their usual activities with confidence.

Managing ACL Injuries: Recommended Lifestyle Changes

Incorporating lifestyle changes can support recovery and protect the knee long-term. Consider the following:

Maintain a Healthy Weight: Excess weight increases stress on the knee joint, so keeping a healthy weight can reduce strain.
Prioritize Low-Impact Activities: Swimming, cycling, or yoga can keep you active without putting undue pressure on the knee.
Follow a Balanced Diet: Foods rich in protein, vitamins, and minerals support tissue repair and overall recovery.
Wear Supportive Footwear: Proper shoes can help with alignment and reduce unnecessary stress on the knee.
Stay Consistent With Exercises: Regularly perform physiotherapist-prescribed strengthening and flexibility exercises to maintain knee health.

Adopting these changes can complement physiotherapy and help you enjoy a more active, pain-free life.

Returning to Sports or Physical Activities After an ACL Injury: What to Know

The timeline for returning to sports or physical activities after an ACL injury depends on factors such as the severity of the injury, chosen treatment path, and individual recovery progress.

Athletes recovering from partial ACL tears without surgery may resume low-impact sports within three to six months, provided their strength and stability have been adequately restored. Those who undergo ACL reconstruction often require nine to twelve months before returning to high-impact activities. During this time, physiotherapy focuses on rebuilding strength, enhancing agility, and restoring confidence in the knee's functionality.

Functional tests, such as single-leg squats or assessments of jumping mechanics, are used by physiotherapists to determine whether the knee is ready for the demands of sports. Rushing back prematurely increases the risk of re-injury, making it essential to follow a structured recovery plan.

Leave Pain Behind, Embrace Health

Recovering from an ACL injury requires dedicated care, and physiotherapy offers the tools you need to regain strength, mobility, and confidence. At Maximum Potential Physiotherapy in Calgary NW, our experienced team provides personalized treatment plans to help you achieve a full recovery. Book your session today and take the next step toward a stronger, healthier future.