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What Is the ACL?

The ACL (Anterior Cruciate Ligament) is a key stabilising ligament inside the knee.

It helps control:

• Forward movement of the tibia

• Rotational stability

• Cutting and pivoting control

ACL injuries often occur during:

• Sudden direction changes

• Deceleration

• Landing from a jump

• Non-contact pivoting movements

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Symptoms of an ACL Tear

Common symptoms include:

• Sudden “pop” sensation

• Immediate swelling

• Knee instability or giving way

• Difficulty weight-bearing

• Loss of range of motion

Diagnosis is confirmed via clinical testing and MRI.

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Do All ACL Tears Need Surgery?

Not always.

Modern research shows:

• Some individuals can successfully manage ACL tears non-operatively

• Surgery does not guarantee better long-term outcomes for everyone

• Decision-making depends on sport demands, instability episodes and goals

Surgery is often recommended for:

• High-level pivoting athletes

• Recurrent instability

• Combined ligament injuries

We work closely with Sydney-based sports physicians and orthopaedic surgeons when required.

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Evidence-Based ACL Rehabilitation

ACL rehab is structured, progressive and criteria-based.

Whether surgical or non-surgical, rehabilitation follows key phases.

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Phase 1 – Acute Management

Goals:

• Reduce swelling

• Restore knee extension

• Regain quadriceps activation

• Normalise walking

Early quadriceps strength recovery is strongly associated with better long-term outcomes.

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Phase 2 – Strength & Neuromuscular Rebuild

Focus areas include:

• Progressive quadriceps strengthening

• Hamstring strengthening

• Hip and trunk strengthening

• Single-leg control

• Balance retraining

Strength deficits are the most common cause of delayed return to sport.

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Phase 3 – Running & Plyometric Progression

Before returning to running, athletes must demonstrate:

• Minimal swelling

• Adequate quad strength

• Controlled single-leg tasks

Progression includes:

• Linear running

• Plyometrics

• Acceleration and deceleration drills

• Cutting and pivoting drills

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Return to Sport After ACL Injury

Modern guidelines strongly recommend criteria-based clearance, not time-based alone.

Return-to-sport testing may include:

• Quadriceps strength symmetry (>90%)

• Hop test symmetry

• Movement quality assessment

• Psychological readiness screening

Typical timeframes:

• Non-surgical return: variable

• Post-ACL reconstruction: 9–12+ months

Early return (<9 months) is associated with higher re-injury risk.

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Why ACL Re-Injury Happens

Re-injury risk is influenced by:

• Inadequate strength restoration

• Early return to sport

• Poor neuromuscular control

• Psychological fear or hesitation

Structured testing reduces recurrence risk.

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ACL Injury in Athletes

For athletes, rehab must integrate:

• Sport-specific demands

• Deceleration mechanics

• Cutting mechanics

• Fatigue tolerance

• Return-to-play conditioning

At Omnia Physio, ACL rehab is performance-driven, not generic.

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Frequently Asked Questions

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How long does ACL rehab take?

Typically 9–12 months after reconstruction. Some cases require longer.

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Can I return without surgery?

Some individuals can, depending on sport and stability.

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Will my knee be normal again?

With structured rehab, many athletes return to high-level sport.

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Is swelling normal after ACL surgery?

Mild swelling can persist early but should progressively reduce.

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Book ACL Physiotherapy

If you’ve recently injured your ACL or are preparing for surgery:

Omnia Physio – Potts Point, Sydney
Specialising in sports and performance rehabilitation.

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