ACL Injury Recovery: Your Week-by-Week Return to Sport Guide

An anterior cruciate ligament (ACL) rupture is one of the most common — and feared — sports injuries in the UK. Whether you're a professional footballer or a recreational runner, understanding the rehabilitation process is crucial to achieving a safe and successful return to sport.

Phase 1 (Weeks 1–2): Acute Management

Immediately following an ACL injury or surgery, the priority is controlling swelling, restoring full knee extension, and achieving a good quadriceps contraction. Ice, elevation, and gentle range-of-movement exercises form the core of this phase.

Phase 2 (Weeks 3–6): Regaining Range of Movement and Muscle Activation

By week three, you should be working towards full knee flexion and beginning to build quadriceps and hamstring strength. Walking without crutches typically occurs in this phase following surgical reconstruction.

Phase 3 (Weeks 7–12): Strength and Proprioception

Closed-chain exercises (leg press, step-ups, cycling) are introduced. Balance and proprioception training become central, as ACL injury affects the knee's position sense.

Phase 4 (Months 4–6): Functional Strength and Movement Patterns

Running begins, initially in straight lines. Strength testing against the uninjured leg is used to guide progression. The goal is to achieve at least 80% limb symmetry before advancing.

Phase 5 (Months 6–9): Return to Sport

Sport-specific training, agility work, and cutting movements are reintroduced under physiotherapy supervision. Clearance for full contact sport is based on objective strength and functional testing, not time alone.

Our sports physiotherapy team at PhysioRevive has guided hundreds of athletes through ACL rehabilitation. Book a specialist assessment today.