What We Treat

ACL Rehabilitation

Your Healing Continues With ACL Rehab

The VTFC ACL (Anterior Cruciate Ligament) Rehabilitation program entails a goal-based comprehensive approach.  Our program takes the ACL Rehab patient through 6 phases of recovery.  Progression to the next phase is contingent on achievements of all rehabilitation goals of the previous phase.

The 6 ACL Rehab program rehabilitation phases are:

  • Phase 1:  Pre-Operative Phase
  • Phase 2:  Recovery From Surgery
  • Phase 3:  Regain Neuromuscular Control and Strength
  • Phase 4:  Running, Agility Training, and Jumping/Landing Training
  • Phase 5:  Return to Sport Progressions
  • Phase 6:  Re-injury Prevention

ACL Surgery Rehab Program Timeline

  • 9-12 months that includes formal physical therapy in combination with high-level functional exercise to prepare the patient/athlete to return to athletics and prevent future injury.  At approximately 6 months, functional testing will take place during and at the end of Phase 4 to determine if they are ready to progress to Phase 5: Return to Sport.  
  • Many physicians are conservative and prefer a return to sport after a 9-month recovery period.  Most VTFC ACL Rehab patients are ready to return to sport between 7-9 months and work towards clearance by their surgeons.
  • It is important for patients to complete their ACL rehabilitation fully.  It is easy to think once you are back to running with no knee pain that your therapy is all done. You could easily say the last ⅓ of the ACL rehab program is the most important to reduce the risk of re-injury, increase the likelihood of returning to sport successfully, and reduce the risk of knee osteoarthritis down the road.
  •  A significant integration of core training, upper body strengthening, and lower body strengthening occurs throughout the VTFC ACL Rehab program and continues long after the formal physical therapy rehab regimen has been completed.

What is the expected progression in therapeutic interventions during the ACL Rehab Program?

  • The exercises progress over the course of the ACL rehabilitation program. 
  • Initially, the focus is on knee range of motion and quadriceps activation. 
  • As the therapy progresses, the focus changes to lower extremity strengthening to include core
    stability, hip strengthening, quad/hamstring strengthening, and lower leg strengthening.  
  • Blood Flow Restriction can be implemented to accelerate strengthening and reduce post-surgical atrophy.  
  • As strength increases, dynamic movement exercises will be initiated with a progression to running, agility, and jumping/landing mechanics.
  • Return to sport progressions will be tailored to the patient’s needs based on their sport.
  • Maintaining a post-rehabilitation program is vital to a long-term successful outcome. This may include a physical therapist, athletic trainer, or personal trainer to guide this phase of the rehabilitation. 

FAQs about VTFC's ACL Surgery Rehab Program

How often should I be in PT?

Most patients will be in PT 2 or 3 days per week.  Initially, 3x/week is helpful to manage pain and inflammation and work on range of motion early.  Once the patient has improved their pain, inflammation, and range of motion a bit they can reduce their PT visit frequency to 2x/week.  The time to reduce from 3x/week to 2x/week is unique for each patient, but usually occurs after 2-4 weeks.

Can aquatic therapy help my ACL recovery?

  • VTFC has an aquatic treadmill for our aquatic therapy. Aquatic therapy is very helpful in the recovery of ACL surgery by reducing stress on the knee and lower extremity.  The reduced load on the lower extremity helps restore normal movement patterns to the injured knee when pain and fear-avoidance behaviors are a factor.  The sooner you can restore proper movement patterns the sooner you can restore function to the injured body part. 
  • Initially, you will improve your walking patterns with the aquatic therapy and later in therapy you will be introduced to jogging and running using aquatic therapy.
  • ACL surgical patients find they can walk, jog, and run earlier using aquatic therapy than without aquatic therapy. 

How soon could I start aquatic therapy after an ACL injury or surgery?

Aquatic therapy can start as soon as the surgical incision has fully closed, and has no signs of infection, following surgery; which is usually between 3-4 weeks. 

Can I speed up my ACL recovery? If so, how?

  • A patient can speed up their ACLR by staying diligent with their exercise routine in the physical therapy clinic and at home.  
  • Blood flow restriction therapy will also accelerate ACLR by reducing muscle atrophy, improve and accelerate strength gains.  Research has shown when BFR is used on the unaffected leg early in the rehabilitation process following ACL reconstruction, it will help slow down muscle atrophy and increase strength gains earlier in the surgically involved leg. 
  • Aquatic therapy can also speed up your recovery by reducing stress on the lower extremity and promoting normal functional movement patterns earlier in the rehabilitation process than without aquatic therapy.

Will I get back to full recovery after ACL rehab?

  • The answer is a resounding YES, if you put the work in. 
  • To get back to a full recovery it does take a diligent and regimented approach to stay on track and progress through good ACL Rehabilitation Guidelines. 
  • While over 85% of patients, after ACLR, return to normal or near-normal knee function, a meta-analysis has shown that 63% return back to pre-injury levels of activity.  
  • ACLR can be complicated and have several associated issues that can make it difficult for some to fully recover.  Which is why it is important to select the best surgeon and rehabilitation center that you can.


How do I best prepare myself for a successful ACL surgery and recovery?

  • The best thing you can do to make sure you have a successful surgical outcome, and return to the activities you want to be able to do, is to make sure you achieve the following 3 pre-operative goals.
    1. Eliminate swelling
    2. Regain normal full knee range of motion
    3. Regain 90% of the strength of your quadriceps and hamstrings compared to the uninvolved leg.