ACL Reconstruction Rehabilitation: More Than Just the Knee
Rehabilitation following ACL reconstruction is often viewed as a knee-focused process, but successful outcomes depend on the entire movement system. Strength, balance, coordination and psychological readiness all influence recovery and reinjury risk.
Early rehabilitation aims to control swelling, restore knee extension, and normalise walking. Regaining full knee extension early is particularly important, as delays can lead to long-term movement limitations. As healing progresses, strength training becomes central, especially for the quadriceps, hamstrings, and hip musculature.
Hip and trunk control play a significant role in knee loading. Poor control in these areas increases stress through the knee during cutting, landing and deceleration tasks. Addressing these deficits is essential, particularly for young athletes returning to pivoting sports.
For children and adolescents, return-to-sport decisions require additional care. Growth, fatigue and neuromuscular control influence reinjury risk, and time since surgery alone is not a reliable guide. Objective strength testing, movement assessment, and sport-specific drills are critical before clearance.
Psychological readiness is often overlooked.
Fear of re-injury can alter movement patterns and increase risk. Gradual exposure to sport-specific tasks helps rebuild confidence and trust in the knee.
Rehabilitation does not end at return to training. Ongoing strength and injury-prevention programs significantly reduce the risk of a second ACL injury and support long-term knee health.