ACL Injury: Symptoms, Treatment and Rehabilitation

What is an ACL injury?

The ACL, or anterior cruciate ligament, is one of the main stabilising ligaments in the knee. It helps control twisting, pivoting and forward movement of the shin bone.

An ACL injury usually occurs when the knee is placed under sudden load, especially during sport or physical activity. This may happen with a sudden change of direction, awkward landing, pivoting movement, deceleration, or contact injury.

Common symptoms

An ACL injury may cause:

• A popping sensation at the time of injury

• Sudden knee pain

• Rapid swelling

• Difficulty walking

• Reduced knee movement

• A feeling that the knee may “give way”

• Difficulty twisting, pivoting or changing direction

• Loss of confidence when returning to sport or exercise

  
  

ACL injuries can also occur alongside other knee injuries, including meniscus, cartilage or other ligament injuries.

How is an ACL injury diagnosed?

A physiotherapist will assess your knee movement, swelling, strength, stability, walking pattern and functional control.

In some cases, you may also require medical imaging, such as an MRI, or referral to a GP, sports physician or orthopaedic specialist.

Treatment options

ACL injuries may be managed with or without surgery. The best option depends on the severity of the injury, knee stability, associated injuries, activity level, sport, work demands and personal goals.

Some people recover well with structured rehabilitation, while others may require ACL reconstruction followed by a detailed rehabilitation program. Physiotherapy is important in both surgical and non-surgical pathways.

How physiotherapy can help

Physiotherapy helps guide each stage of ACL recovery. Treatment may include:

• Pain and swelling management

• Restoring knee movement

• Improving walking and daily function

• Strengthening the quadriceps, hamstrings, glutes and calf muscles

• Balance and stability training

• Running preparation

• Jumping and landing retraining

• Agility and change-of-direction drills

• Return-to-sport testing

• Education and exercise programming

The aim is to restore strength, control, stability and confidence in the knee.

Return to sport

Returning to sport after an ACL injury should not be based on time alone. Before returning, your physiotherapist may assess:

• Knee range of motion

• Strength

• Balance

• Single-leg control

• Running tolerance

• Jumping and landing mechanics

• Change-of-direction ability

• Confidence in the knee

  
  

A structured return-to-sport plan can help reduce the risk of re-injury and support a safer return to activity.

When to see a physiotherapist

You should consider seeing a physiotherapist if you have:

• Injured your knee during sport or exercise

• Felt or heard a pop in the knee

• Developed swelling after a twisting injury

• Ongoing knee instability

• Difficulty walking or using stairs

• Trouble returning to running, gym or sport

• Recently had ACL surgery

  
  

Guided ACL rehabilitation

Recovering from an ACL injury can feel overwhelming, especially when you are unsure what you should be doing, when to progress, or how to know if your knee is ready for more demanding activity.

At Urban Physiotherapy, we provide structured ACL rehabilitation to help guide this process. Your rehabilitation plan may include early injury management, pre-surgery preparation, post-operative rehabilitation, strength training, running progressions and return-to-sport testing, depending on your stage of recovery.

The goal is to give you a clear pathway forward, with each stage guided by your symptoms, strength, movement quality, knee control and individual goals.

Book an appointment

If you have injured your ACL, are preparing for surgery, or are recovering from ACL reconstruction, our physiotherapists can help guide your rehabilitation and return to activity.

Book an appointment with Urban Physiotherapy today!