ACL injuries – what is best practice when it comes to rehab or prehab


Anyone who’s torn their ACL can tell you how traumatic, painful, and life-changing the injury can be — and the recovery process certainly isn’t an easy one; Rehab post ACL reconstructive surgery takes 9-12 months.

The Anterior Cruciate Ligament (ACL) is a band of dense connective tissue which attaches from the femur (thigh bone) to the tibia (shin bone) at the knee. It’s considered a key structure in the knee joint because it prevents forward movement of the tibia and rotation of the knee.


Prevention is better than cure! 50% 0f all type of ACL injuries (contact and non-contact) can be reduced with the implementation of an injury prevention program2These programs have also been found to improve running speed, jumping height and lower the risk of other lower limb injuries such as ankle (by 40%)2

What to include in an ACL injury prevention program?

More than 30 mins per week (or more than 20 mins per session) that focuses on3:

  1. Mobility – hip, knee and ankle3
  2. Strengthening – core, hip, knee and ankle e.g. single leg squats, lunges, Nordic hamstring exercises, side planks3
  3. Plyometrics – e.g. lunge jumps, squat jumps3
  4. Balance – single leg landing (multidirectional), jump with perturbation 3
  5. Running and agility – cutting, backwards and forwards running, bounding 3


Rehab first begins with injury recovery and readiness for surgery with the main goals to eliminate swelling, regain full range of motion and regain 90% strength in the quads and hamstrings (compared to the other side)1 Post-surgery, rehab can be separated into 4 phases, all goals of each phase MUST be achieved before moving to the next:

  1. Recovery from surgery –get the knee straight, settle the swelling and get the quadriceps firing1
  2. Strength and neuromuscular control – regain most of single leg balance, muscle strength and be able to single leg squat with good alignment1
  3. Running, agility and landings – excellent hopping performance (technique, distance and endurance), agility program and modified play game, regain full strength and balance1
  4. Return to sport – successful completion of above, athlete is confident and comfortable, ACL prevention program is discussed1


  1. Hughes, M. and Cooper, R., n.d. . Melbourne ACL Rehabilitation Guide 2.0
  2. LTD, P., 2021. An Update On ACL Injury Prevention Programs – Discover – Premax. [online] An Update on ACL Injury Prevention Programs – Discover – Premax. Available at: <> [Accessed 21 January 2021].
  3. Physiopedia. 2021. ACL Rehabilitation: Re-Injury And Return To Sport Tests. [online] Available at: <> [Accessed 21 January 2021].

ONERO Exercise Classes at Sans Souci Physio! 


ONERO is an exercise program specifically tailored to improve/ maintain bone mineral density. 

Weekly Classes:

Monday 8:30-9:15am

Tuesday 8:30-9:15am

Tuesday 10:30-11:15am

Wednesday 8:30-9:15am 

Thursday 5:30-6:15pm

Please call for more information and bookings.