ACL Rehabilitation Explained by a Physio: Timeline, Progress, and Post-Surgery Tips

ACL Rehabilitation Explained by a Physio: Timeline, Progress, and Post-Surgery Tips

Your Complete ACL Recovery Roadmap: From Surgery to Comeback

Tore your ACL? You’re not alone. Over 300,000 ACL reconstructions happen in the US every year, but here’s the sobering truth: only 65% of people return to their pre-injury sport level.

The difference between those who make a full comeback and those who don’t? Following a proven, step-by-step rehabilitation process.

Phase 1: Recovery from Surgery (Weeks 1-6)

Controlling pain and swelling with ice and compression 

Controlling pain and swelling with ice and compression[/caption]

Your first job is damage control. Focus on:

  • Controlling pain and swelling with ice and compression

  • Getting your knee completely straight (full extension) within 2-3 weeks

  • Reaching 90 degrees of knee bending

  • Basic quadriceps exercises to wake up those sleeping muscles

  • Walking normally without crutches

Phase 2: Building Your Foundation (Weeks 6-12)

Gym-based strength training (squats, lunges, step-ups)

Once pain settles, it’s time to rebuild:

  • Gym-based strength training (squats, lunges, step-ups)

  • Balance and coordination exercises

  • Basic hopping drills

  • Swimming and cycling for cardio

  • Achieving 130 degrees of knee flexion

Phase 3: Getting Dynamic (Months 3-6)

Running progression (straight-line first)

Now we add the fun stuff:

  • Running progression (straight-line first)

  • Agility drills and cutting movements

  • Advanced jumping and landing mechanics

  • Sport-specific movement patterns

Phase 4: Return to Sport Preparation (Months 6-12)

Strength Test

The final test phase requires passing strict criteria:

  • Strength Test: 90% strength compared to your good leg

  • Hop Tests: Less than 10% difference between legs on single, triple, and crossover hops

  • Movement Quality: Perfect single-leg squats with no compensation

  • Psychological Readiness: Confidence scores showing you trust that knee again

The Reality Check
Here’s what most people don’t realize: feeling better isn’t the same as being ready. Your knee might feel “fine” at 6 months, but the graft is still maturing and your brain is still learning to trust that leg again.

Timeline Expectations

  • Minimum 9 months before return to sport

  • 12+ months is ideal for most athletes

  • 18 months recommended if you’re under 20 years old

  • Many athletes take 2+ years to reach their true pre-injury level

The “Listen to Your Knee” Rule
Throughout every phase, pain and swelling are your body’s warning system. If either increases, you’re pushing too hard. This isn’t about being tough – it’s about being smart.

Why the Process Matters
Athletes who skip steps or rush back have a 30% re-injury rate. Those who follow the complete process and pass all benchmarks dramatically reduce their risk.

The Bottom Line
ACL recovery isn’t just about time – it’s about meeting specific, measurable criteria at each phase. Your comeback depends on respecting the process, not rushing it.

Ready to ensure you’re hitting all the right markers for a bulletproof comeback? Our experienced physiotherapists specialize in evidence-based ACL recovery protocols that get you back stronger than before.

Your future athletic self will thank you for doing this right.

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Dr. April Patterson

Physiotherapist

Dr. April Patterson graduated from Bond University with a Doctor of Physiotherapy degree and founded RX Physiotherapy in 2019 with a vision to provide exceptional, personalised care. As a physiotherapist living with Ehlers-Danlos Syndrome (EDS), hypermobility, and Temporomandibular Joint (TMJ) issues, April brings a rare combination of personal insight and professional expertise to her practice. Her own experiences with these conditions fuel her passion for understanding and treating them, allowing her to empathise deeply with her patients and guide them with authenticity and compassion.

April has a huge passion for in EDS, Hypermobility Spectrum Disorders (HSD), and TMJ dysfunction, while also treating all joints and musculoskeletal conditions. She personally conducts initial assessments to understand each patient’s story, goals, and challenges before referring them to her highly skilled team for ongoing care. Her holistic, evidence-based approach blends manual therapy, strength and conditioning, pain management, and education to help clients regain function, confidence, and independence.

As Managing Director, April maintains the highest standard of care through weekly team sessions to review progress, provide guidance, and support professional development. This ensures that every patient receives structured, personalised care, while allowing her to focus on leadership, strategy, and advancing the clinic’s mission.

Outside the clinic, April enjoys hitting the gym, cooking, and spending quality time with her partner, her two dachshunds and two cats.

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Ms. Laura Flemming

Physiotherapist

Laura is a senior physiotherapist with six years of experience across hospital, private practice, community, and sports settings. She began her career at Wollongong Hospital before moving to Sydney, where she expanded her skills in musculoskeletal rehab, neurological rehab, and community-based care. During this time she became a Level 1 Strength and Conditioning Coach and worked with junior representative soccer teams in the St George region. Now back in the Illawarra, she’s excited to support her local community again.

Laura’s approach is grounded in understanding the individual—what they value, what they hope to achieve, and how their condition impacts their life. She focuses on meaningful outcomes through a blend of manual therapy, strength training, pain management, patient education, and personalised rehabilitation programs. Her experience spans acute and chronic injuries, post-operative rehab, strength and endurance training, falls prevention, and neurological conditions including stroke and brain injury.

She has a strong interest in working with people with Ehlers-Danlos Syndrome (EDS) and Hypermobility Spectrum Disorder (HSD), and she brings extensive experience supporting participants within the NDIS. She also specialises in treating TMJ/jaw dysfunction, helping clients reduce pain, improve mobility, and address the muscular and biomechanical factors contributing to their symptoms. Her calm, collaborative style helps clients feel understood, supported, and confident navigating long-term conditions.

Outside the clinic, you’ll find Laura hiking up mountains, writing music, playing soccer, or training for the occasional triathlon or running event.

Whether you’re managing pain, recovering from an injury, or navigating a complex condition like EDS, HSD, or TMJ dysfunction, Laura can help with all joints and musculoskeletal concerns, guiding you with structure, clarity, and genuine care.

Mr. Trent Cooksley

Physiotherapist

Trent is a physiotherapist who genuinely cares about people — the kind who listens properly, meets you where you’re at, and helps you feel comfortable from the moment you walk in. He has that big brother energy; calm, thoughtful, easy to talk to, and always looking out for you. His focus is simple — helping you move better, feel stronger, and get back to the things that matter to you, whether that’s training, sport, work, or living life without pain.

He treats a wide range of musculoskeletal conditions, including shoulder, knee, lower back, neck, and ankle injuries, and works with people of all ages and activity levels. Trent’s approach is hands-on, structured, and tailored to the individual. He’s not about quick fixes or generic programs — he takes the time to understand your body, your goals, and what’s been holding you back, then builds a clear plan to help you move forward with confidence.

Born and raised in Wollongong, Trent grew up immersed in sport. He played soccer with the Woonona Sharks and was involved in everything from tennis and golf to swimming, footy, cricket, and AFL. As a teenager, golf became his focus, earning him a place in the IAS Golf Program and later a college golf scholarship in Abilene, Texas. Experiencing injuries firsthand — and seeing how physiotherapy restored his performance — shaped the way he now supports others through injury, rehab, and long-term recovery.

Outside the clinic, Trent is easygoing, down-to-earth, and approachable. You’ll find him on the golf course, in the surf, or catching up with friends. That same calm, supportive energy carries into his sessions, helping clients feel at ease, understood, and supported every step of the way.

If you’re dealing with pain, injury, or ongoing frustration with your body, Trent is someone you can trust to have your back — and help you move with clarity, confidence, and strength again.

Ms. Emily Yorkston

Physiotherapist

Emily is a senior physiotherapist with extensive experience across musculoskeletal, neurological, orthopaedic, women’s health, and paediatric physiotherapy. She has worked in a wide range of clinical settings, including rural outreach programs and allied health leadership roles, which have shaped her holistic, collaborative, and genuinely client-centred approach to care.

Emily is a highly empathetic physiotherapist with lived experience of Ehlers-Danlos Syndrome (EDS), giving her a rare and deeply personal understanding of the physical, emotional, and day-to-day challenges faced by people living with complex and chronic conditions. She has a strong clinical interest in hypermobility (HSD, EDS), TMJ and jaw dysfunction and women’s health, and has completed APA Women’s Health Level 1 training. Emily is skilled in assessing and treating all joints and a broad range of musculoskeletal presentations, from everyday pain to complex, multi-system conditions.

She is passionate about helping clients achieve meaningful, sustainable, long-term outcomes. Emily combines personalised rehab programs, hands-on manual therapy, and targeted rehabilitation strategies to improve function, build confidence, and restore independence. Her care is structured, evidence-based, and highly individualised, ensuring every client feels informed, supported, and actively involved in their recovery.

Outside the clinic, Emily enjoys travelling and exploring new experiences, bringing fresh perspective and energy back into her work. She is known for her warm, calm, and motivating style, helping clients feel safe, understood, and empowered throughout their rehabilitation journey.

If you’re living with pain, recovering from injury, or navigating a complex condition such as EDS, HSD, TMJ dysfunction, women’s health concerns, or any musculoskeletal issue, you don’t have to do it alone. Book an appointment with Emily today to receive thoughtful, personalised care and take the next step toward moving with greater comfort, confidence, and trust in your body again.

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Mr Reece Nikitaras

Physiotherapist

Reece Nikitaras is deeply passionate about optimising human movement and enhancing quality of life through targeted rehabilitation and evidence-based therapeutic techniques. His journey into physiotherapy was driven by a genuine desire to help individuals overcome physical barriers and reach their full potential.

As an avid runner, Reece brings both personal insight and clinical expertise to the treatment of running-related injuries. He is particularly dedicated to helping runners recover from injury, prevent future setbacks, and elevate their performance. Reece has developed a comprehensive running assessment protocol designed to identify biomechanical inefficiencies and areas of weakness, allowing for tailored interventions that support long-term improvement and injury prevention.

Reece also holds a strong clinical interest in knee rehabilitation, with an in-depth understanding of knee biomechanics and the complex nature of knee injuries. He implements highly specialised, results-driven treatment plans to restore function and accelerate recovery in clients dealing with knee concerns.

Always eager to stay at the forefront of his field, Reece consistently seeks out new knowledge and incorporates the latest advancements in physiotherapy research into his practice. His commitment to continuous learning ensures he delivers the highest standard of care to every patient.

Outside of the clinic, Reece enjoys travelling, spending time at the beach, and playing a round of golf.