ACL Injury
An ACL injury raises big questions fast: surgery or not, how long, and will the knee hold up. We help you answer them with evidence and objective testing, then guide your rehab every step from there.
Your care, at a glance
The questions worth asking any clinic — answered up front.
Who you'll see
Long ACL rehabs suit physios who love strength work: Jonty pairs KangaTech with ForceDecks force-plate testing, Oliver builds programs on a strength-and-conditioning background, and Henry works with AFL and NPL soccer players. Dr Steve Saunders consults on complex knees and second injuries.
How we assess it
Full knee examination and triage of the surgical/non-surgical decision with your surgeon and GP, then baseline testing: quadriceps and hamstring strength, hop performance and movement quality — repeated at every stage.
How we treat it
Staged rehabilitation over 9–12+ months: settle the knee, rebuild quadriceps and hamstring strength, restore running, then progressively reintroduce cutting, landing and sport-specific load — each stage gated by test results.
When you progress
- Quadriceps strength approaching symmetry with the other leg (≥90%)
- Hop test battery passed at sport-specific thresholds
- Adequate time: research supports at least 9 months before return
- Completion of sport-specific training at full intensity
The evidence behind this approach
In the Delaware–Oslo cohort, athletes who delayed return and passed objective criteria had an 84% lower reinjury rate (Grindem et al., BJSM 2016); professional athletes returning without meeting six discharge criteria had four times the graft-rupture risk (Kyritsis et al., BJSM 2016). That's why our return-to-sport decisions are test results, not dates.
Surgery is not the only path
Australia has one of the highest rates of ACL reconstruction in the world, yet research increasingly supports another option for many people: structured non-surgical rehabilitation. Some studies of bracing-based management have reported ACL healing in 80-100% of cases, and many patients return to sport without surgery. The evidence also suggests non-surgical management does not carry a higher risk of osteoarthritis or later meniscus injury than reconstruction.
Current guidance supports an initial period of quality rehabilitation before deciding on your management pathway. Whichever direction you take - including the cross bracing protocol for suitable recent injuries - we can guide it.
How we assess it
We assess your knee thoroughly - ligament testing, swelling, range of movement and how the injury happened - and arrange imaging and specialist input where needed. Just as importantly, we establish your baseline: objective strength of your quadriceps, hamstrings and hip muscles using KangaTech, the measurement system our founder Steve Saunders pioneered in elite football.
Then we talk honestly through your options - reconstruction, non-surgical rehab, or a trial period before deciding - in the context of your sport, age, goals and knee. If you have just hurt your knee, early assessment matters: some options, like the cross bracing protocol, are time-sensitive.
How we rebuild your knee
Quadriceps strength is the make-or-break of ACL rehab, and it is commonly underdone: one study found only 29% of athletes had adequately restored quadriceps strength six months after reconstruction (Wellsandt et al., 2017). Our programs are built to beat that pattern, combining open-chain and closed-chain resistance exercises within protective ranges early on, progressing to heavy strength work, then hopping, landing and change of direction.
Where pain or post-operative restrictions limit heavy loading, we use blood flow restriction (BFR) training - light-load work that can produce strength and muscle gains well beyond what the same light loads achieve on their own, so you can build muscle while protecting the healing knee.
Testing before you return
Returning to sport is a criteria-based decision, not a calendar-based one. Before you go back to cutting, jumping and contact, we re-test: isolated strength and left-to-right symmetry on KangaTech, hop testing and movement quality. You will see your own numbers and know exactly where you stand - the same standard applied in elite sport, whether you play state league or Saturday social netball.
Getting back to what you love
A well-structured rehab gives you a clear path back to the activities you care about, for weekend netballers and footballers as much as elite athletes - and for people whose main goal is simply trusting their knee on uneven ground again.
Both our Adelaide CBD and Edwardstown clinics offer HotDoc online booking and HICAPS on-the-spot claims, and no referral is needed.
Frequently asked questions
Can an ACL tear heal without surgery?
In some cases, yes. Studies of bracing-based management have reported healing in a high proportion of suitable patients, and many people return to sport without reconstruction. Whether it suits you depends on your knee, your sport and your goals, which is what our assessment helps you decide.
How long does ACL rehab take?
Whether surgical or non-surgical, ACL rehab is usually measured in months, and return to sport should be based on meeting strength and movement criteria rather than a fixed date. We re-test throughout so you always know where you stand.
What is the cross bracing protocol?
A non-surgical approach where the knee is held in a brace at a set angle in the early weeks after injury to give the ACL a chance to heal, followed by structured rehabilitation. It is time-sensitive and only suits certain injuries, so early assessment is important.
Do you only work with athletes?
No. We apply the same testing and rehab standards to everyone with an ACL injury, whether you are aiming for finals or simply want to trust your knee in everyday life.