ACL Injury: Understanding the Damage
The ACL (Anterior Cruciate Ligament) is the primary restraint against anterior tibial translation and rotational instability in the knee. ACL rupture is one of the most common and career-affecting sports injuries.
Phase 1: Acute Management (Weeks 0–2)
Reduce swelling, restore full extension, normalize gait, and begin quad activation. The goal is a 'dry' knee with full extension before any surgical consultation.
Phase 2: Strength Foundation (Weeks 2–12)
Progressive quadriceps, hamstring, and hip strengthening. Single-leg squat, Bulgarian split squat, Nordic hamstring curls. Limb symmetry index must reach 70% before advancing.
Phase 3: Return to Running (Months 3–6)
Linear running, change of direction, progressive cutting drills. Strength symmetry must reach 85% before unrestricted running.
Phase 4: Return to Sport (Months 6–12)
Sport-specific training, reactive agility, psychological readiness assessment. Return to pivoting sport criteria: 90% strength symmetry, normal hop tests, psychological confidence.