What to expect from sports physiotherapy for an ACL tear

Your physiotherapist may check swelling, pain, knee motion, walking pattern, thigh strength and how the knee responds to controlled tasks. The plan depends on whether you are preparing for ligament surgery, recovering after surgery, or managing the tear without surgery. Early work may include gentle movement, muscle activation and a home programme. Later sessions can add resistance exercises, single-leg control, balance, landing technique and sport-specific drills.

Follow the exercise dose you were given and record how the knee feels during and after activity. Increase resistance or running only when your clinician confirms that your movement and control are ready. Use the recommended support or walking aid if one has been prescribed. Do not use a sudden reduction in pain as the only sign that the knee can handle twisting, jumping or a return to competition. A gradual progression helps your team observe swelling, giving-way or loss of confidence.

Contact your clinician promptly if the knee repeatedly gives way, becomes increasingly swollen, locks, or loses movement. Seek urgent medical help for severe pain after a new injury, a cold or pale foot, new numbness, or marked calf swelling with breathlessness or chest pain. These symptoms need medical assessment rather than a change to exercises alone.

Ask whether your ACL tear needs an orthopaedic review, which activities to avoid now, what milestones should come before running, and how physiotherapy will fit around any planned surgery.