ACL Rehab: What to Expect in the First 12 Weeks After Surgery

⏳ The First 12 Weeks: Why Early ACL Rehab Matters

The anterior cruciate ligament (ACL) is vital for knee stability, especially in pivoting, cutting, and jumping movements. After surgical reconstruction, the early months of recovery are crucial in laying the foundation for long-term function—and preventing reinjury (1). Best-practice rehabilitation in Melbourne is individualised, progressive, and goal-driven. This guide breaks down what to expect across three phases in the first 12 weeks post-op.

🩹 Phase 1: Weeks 1–3 – Protect & Activate

Goal: Protect the new graft, reduce inflammation, and begin gentle movement (2).

Key Goals:

• Reduce swelling with ice, compression, and elevation (2)

• Regain full knee extension (2)

• Activate the quadriceps muscles to prevent atrophy (2)

• Walk safely with crutches (usually within 1–2 weeks) (2)

Exercise Examples:

• Static quads (2)

• Heel slides (2)

• Passive range of motion exercises (2)

💪 Phase 2: Weeks 4–8 – Rebuild the Foundation

Goal: Restore full range of motion and start rebuilding strength and control (3).

Key Goals:

•  Improve quadriceps and gluteal strength (3)

• Regain full knee flexion and extension (3)

• Begin proprioceptive training (3)

Exercise Examples:

• Bodyweight squats

• Bridges and single-leg bridges

• Step-ups and step-downs

• Balance drills (e.g., single-leg stance, Bosu ball) (3)

  
  

🔁 Phase 3: Weeks 9–12 – Strengthen & Stabilise

Goal: Build endurance, correct movement patterns, and reintroduce low-impact activity (4)

Key Goals:

• Increase muscle endurance and loading capacity (4)

• Improve movement symmetry between legs (4)

• Prepare for return to jogging (4)

Exercise Examples:

• Leg press (4)

• Walking or reverse lunges (4)

• Stationary cycling or elliptical machine (4)

• Balance board drills (4)

😣 Common Setbacks & How to Overcome Them

• Swelling returns suddenly? You may have pushed too hard. Scale back for 48–72 hours and refocus on ice/elevation.

• Still limping at Week 6? Time for a gait assessment and possibly soft-tissue work. Check in with a physiotherapist!

• Quads still not activating? Your physio may use neuromuscular stimulation or targeted cues.

🙋 ACL Rehab FAQs

When can I return to sport?

Usually 12–18 months post-op, depending on progress and sport demands. You’ll need to pass a battery of tests and always consult a knee physiotherapist to guide you through rehab and your return to sport (4).

What should I avoid early on?

Running, jumping, twisting and change of direction are off-limits until cleared by your physio and surgeon (4).

Can I go to the gym?

Yes—with guidance. Focus on form, avoid heavy lifting through the knee, and monitor for pain or swelling. Always consult a knee physiotherapist before returning to the gym.

👣 Final Thoughts: Recovery is a Marathon, Not a Sprint

The first 12 weeks are foundational. Expect plateaus, progress, and the occasional frustrating day. That’s normal. As a physiotherapist experienced in ACL rehab, I guide patients through every stage with a personalised, evidence-based approach. Whether you’re an athlete or a weekend warrior, my goal is to help you recover strong and get back to what you love.

Taking the Next Steps Towards Recovery

Whether you’re managing chronic pain or bouncing back post-surgery, choosing the right physiotherapist near you is key. Don’t settle for generic care. If you’re in Melbourne or Camberwell and need expert hip and knee physio, book a consultation with APA Titled Musculoskeletal Hip and Knee Physio - Emma, today.

👉 Call now on 9978 9833 or book online to take the first step toward pain-free movement.

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Disclaimer

The content provided on this website is for general information and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.

While The Hip and Knee Physio strives to present accurate and up-to-date information, we do not guarantee results or outcomes based on the information provided. Any exercises, strategies, or recommendations featured on this site should not be considered a personalised treatment plan.

Always seek the advice of a qualified healthcare provider before starting any exercise program, particularly if you are experiencing pain, injury, or a pre-existing medical condition.

Use of this website does not create a physiotherapist–patient relationship. The Hip and Knee Physio accepts no responsibility for any injury or loss arising from reliance on or use of this information.

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References

1. Adams, D., Logerstedt, D., Hunter-Giordano, A., Axe, M. J., & Snyder-Mackler, L. (2012). Current concepts for anterior cruciate ligament reconstruction: a criterion-based rehabilitation progression. Journal of Orthopaedic & Sports Physical Therapy, 42(7), 601-614.

2. van Melick, N., et al. (2016). Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus. British Journal of Sports Medicine, 50(24), 1506-1515.

3. Gokeler, A., et al. (2022). Neuromuscular training following ACL reconstruction: a systematic review and meta-analysis. Sports Medicine, 52(3), 443-461.

4. Ardern, C. L., et al. (2011). Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. British Journal of Sports Medicine, 45(7), 596-606.