sports
UK Evidence-Informed Protocol
Anterior Cruciate Ligament (ACL) Tear & Sprain
Partial or complete disruption of the primary stabilizing ligament inside the knee joint.
Clinical Overview:
The ACL is one of the main stabilizing ligaments of the knee, preventing excessive forward translation of the tibia relative to the femur and controlling rotational stress during pivoting movements.
Living Anatomical Rig (WebGL)
03 — What Can It Feel Like?
Common Symptoms
A distinct 'pop' sensation or sound at the moment of injury
Rapid swelling (hemarthrosis) occurring within 2–6 hours
Feeling of knee instability or 'giving way' during weight-bearing
Significant loss of full knee extension and flexion
04 — Movement Consequences
How It Affects Daily Function
Inability to pivot, cut, or change directions at speed
Difficulty descending stairs due to lack of anterior knee restraint
Quad inhibition (arthrogenic muscle inhibition) causing noticeable leg weakness
05 — Clinical Assessment
What Your Physiotherapist Evaluates
Lachman Test and Anterior Drawer Test for anterior laxity
Pivot Shift Test to evaluate rotational instability
Meniscal and collateral ligament assessment (McMurray, Valgus/Varus stress)
Quadriceps strength index and single-leg hop battery (during later rehab)
06 — Treatment Options
Evidence-Informed Rehabilitation
Early swelling management and restoration of terminal knee extension
Intensive quadriceps and hamstring neuromuscular re-education
Pre-habilitation prior to surgical reconstruction if indicated
Post-operative phased rehabilitation or non-operative conservative pathway
07 — Rehabilitation Journey
*Timelines vary based on tissue biologyPhased Recovery Pathway
STAGE 01Weeks 0–4
Phase 1: Protection & Extension
Full passive extension, reduce swelling, activate quads
Focus: Straight leg raises, patellar mobilizations, and cryotherapy.
STAGE 02Weeks 5–16
Phase 2: Strength & Neuromuscular
Restore symmetrical leg strength and single-leg balance
Focus: Closed-chain squats, Bulgarian split squats, and perturbation drills.
STAGE 03Months 5–12
Phase 3: Agility & Return-to-Sport
Pass objective hop tests, cutting drills, and psychological readiness
Focus: Deceleration training, reactive agility, and sport-specific conditioning.
08 — Home Support & Education
Daily Self-Management
Prioritize obtaining 0° extension (do not prop pillows under the knee while resting)
Perform quad sets and ankle pumps frequently throughout the day
Adhere strictly to crutch and weight-bearing guidance from your clinical team
09 — Urgent Safety Guidance
When to Seek Immediate Medical Attention
Inability to bear any weight with severe bony tenderness (rule out fracture)
Coldness, pale skin, or absent pulse in the foot (vascular compromise)
Severe calf swelling, tenderness, and warmth (Deep Vein Thrombosis warning)
10 — Clinical Questions
Frequently Asked Questions
Do all ACL tears require surgical reconstruction?
Not necessarily. Active individuals desiring a return to high-demand pivoting sports often opt for reconstruction, but many patients successfully rehab non-operatively through dedicated neuromuscular strengthening.