Children's Hospital Colorado

ACL Rehabilitation and Recovery

An athletic trainer checks a young male athletes knee after a knee injury.

The anterior cruciate ligament (ACL) is one of the main stabilizing ligaments within the knee. It prevents the tibia (shinbone) from sliding forward on the femur (thighbone). It also helps prevent the tibia and femur from rotating out of position during various sports movements.

Research has shown that about one in every 60 young athletes will experience an ACL tear at some point during their athletic career. Unfortunately, these numbers are increasing due to the increased intensity of sports.

The importance of physical therapy after ACL surgery

ACL repair surgery will help you progress 10% of the way back to a healed ACL, but the remaining 90% of the work will be up to you through physical therapy. Each athlete's rehabilitation experience is different, and your length of recovery time will depend on your specific progress.

Our physical therapists (PTs) tailor their rehabilitation methods to your injury, progress and the demands of your sport. You must put in the work to be successful in rehabilitation so that you can safely return to your sport.

Our PTs focus on helping you regain strength, balance and range of motion after surgery. They also address faulty movement patterns that may contribute to the original injury itself. This approach helps decrease your risk of re-injury on the same side that you injured and assists with preventing additional injuries on the opposite side.

Components of ACL rehabilitation

If you break our rehabilitation approach down to a simple process, the physical components of ACL recovery and preparation for return to sport are:

  1. Get rid of the swelling in the injured knee.
  2. Get the motion back in the joint.
  3. Make the quadriceps work again.
  4. Walk normal.
  5. Recover the strength in the entire leg to be comparable with the other leg.
  6. Re-train balance, agility, symmetry of movement and the ability to move with explosive, quick patterns.
  7. Recover foot speed and every other skill your particular sport requires.

Timeline for ACL rehabilitation

To complete ACL rehabilitation thoroughly and safely, our sports medicine experts use a 9-12 month average timeframe for returning an athlete to their sport. While this process and timing will vary for each athlete, below is the typical timeline:

Getting back into the game takes patience

Prior to clearing you to return to your sport, our PTs will conduct the return-to-sports test once deemed appropriate. This test measures:

  • Endurance
  • Strength
  • Power production
  • Balance
  • Agility

In order to "pass" the return-to-sport test, the athlete must achieve more than 95% in each category when comparing the surgical side to the uninvolved side. Quality of movement and form is also assessed by the testing PT. The PT will discuss gradual progression back to sport(s) to help ensure that a safe return to the field or court is achieved.

Returning to your sport after recovering from your ACL injury will be exciting – athletes start to feel like themselves again. However, you, your coach and your team will all need to have patience and understand that getting back to playing as you did before, or even better, will take time.

Sports injuries and recovery don't just affect an athletes body, it can also take a mental toll on an athlete. Learn about the psychology of recovering from a sports injury.