How long does ACL rehab take?

Longer than most people expect. OrthoInfo notes that most patients are allowed to return to full sports participation within 6 to 12 months after reconstruction, and ChoosePT notes it may take an athlete over a year to regain the strength, stability and power to return safely. Your timeline depends on your surgery, your progress and your sport.

Can an ACL tear heal without surgery?

OrthoInfo says nonoperative management, including physical therapy to rebuild quadriceps strength and confidence in the knee, is always an option. It also notes that complete tears typically have a less favorable outcome without surgery and that instability can lead to injuries elsewhere in the knee. That decision belongs to you and your orthopedic surgeon.

Do I need an ACL doctor or a physical therapist?

Usually both. An orthopedic surgeon diagnoses the tear, sometimes with an MRI, and decides with you whether surgery makes sense, while a physical therapist guides rehab before and after. With most plans, you can start physical therapy in New York without a referral, but a suspected ACL tear should be evaluated by a physician.

ACL Rehab and Physical Therapy in Buffalo | Lake Erie Physical Therapy

Q: Should I do physical therapy before ACL surgery?

If your surgeon recommends it, yes. ChoosePT notes that some surgeons refer patients for a short course of physical therapy before surgery to decrease swelling and improve knee motion. Ask your surgeon whether prehab fits your situation.

ACL rehab starts before surgery. The swelling, motion and quadriceps strength your knee has going into the operating room shape where rehab begins afterward. If you’ve been searching for an ACL doctor near me, you’ll likely work with two professionals: an orthopedic surgeon who diagnoses the injury and decides on surgery, and a physical therapist who guides recovery before and after. Lake Erie Physical Therapy in Buffalo handles the rehab side.

Searching for an ACL doctor near me? Start with a diagnosis

OrthoInfo describes the classic signs of an ACL injury: a popping noise, a knee that gives out, and swelling within 24 hours. A physician should confirm the diagnosis, sometimes with an MRI, and check for other damage in the knee. OrthoInfo notes that nonoperative management with physical therapy is always an option, though complete tears typically do less well without surgery. That choice belongs to you and your surgeon.

ACL rehab, phase by phase

Your surgeon’s protocol sets the timing. These phases describe the general flow.

Before surgery (prehab)

ChoosePT notes that some surgeons refer patients for a short course of physical therapy before surgery to decrease swelling and improve knee motion. We also work on getting the quadriceps firing, walking without a limp, and learning the exercises you’ll do in the first days after surgery.

Early after surgery

OrthoInfo calls physical therapy a crucial part of successful ACL surgery, with exercises beginning immediately after the operation. Early goals are reducing swelling, regaining full range of motion, and strengthening the quadriceps and hamstrings, all while protecting the graft as your surgeon directs.

Strength and control

Progressive strengthening, balance and single-leg control come next. When heavy loading isn’t appropriate yet, blood flow restriction training may be an option, with your surgeon’s approval and after screening. Dr. Will Tso, PT, DPT, Cert. MDT, co-owner, is Level 1 certified in BFR.

Running, jumping and sport skills

When strength, motion and control allow, we add a running progression, then jumping and landing, then cutting and sport-specific drills. Our sports physical therapy page covers return to play more broadly.

Return-to-sport criteria

OrthoInfo says most patients are allowed to return to full sports within 6 to 12 months, once there is no pain or swelling, full range of motion, fully restored strength, endurance and functional use of the leg, and restored balance and control. ChoosePT adds that it may take an athlete over a year to regain the strength, stability and power to return safely. In practice, that means testing rather than counting weeks:

Strength of the surgical leg compared with the other leg
Hopping and landing tests, judged on both distance and quality of movement
Change-of-direction drills at increasing speed
A gradual return to practice before full competition

Your surgeon makes the final clearance decision. Our testing gives them, and you, objective information.

When to call a physician instead

Physical therapy does not replace a medical diagnosis or your surgeon’s care.

Before surgery: a knee injury where you can’t put weight on the leg, or a knee that locks and won’t straighten, needs a physician’s evaluation.
After surgery: call your surgeon for calf pain or swelling, fever, or increasing redness or drainage at an incision. OrthoInfo also advises telling your doctor if your pain has not begun to improve within a few days after surgery.
Anytime: sudden shortness of breath or chest pain needs emergency care, since a blood clot can travel to the lungs.

Getting started

Bring your surgeon’s protocol and operative report. With most plans, you can start physical therapy in New York without a referral, but most people coming out of ACL surgery have one, and some insurance plans require it to pay, so confirm your coverage with us. For other procedures, see post-surgical rehab.

Torn ACL, surgery scheduled, or just cleared to start? Call (716) 332-4838 or request an appointment.

Sources

Written by the Lake Erie Physical Therapy clinical team. This page is general information, not a diagnosis; your physical therapist will assess your situation in person.

ACL Rehabilitation