An anterior cruciate ligament (ACL) tear is most commonly seen in footballers, netball players and skiers, but can occur in a range of sporting environments. Most ACL tears occur when the athlete lands from a height, or from rapidly pivoting or decelerating.

The anterior cruciate ligament (ACL) is one of four strong ligaments connecting the bones of the knee. The ACL provides stability to the knee, limits rotational movements and reduces stress across the knee joint. It restricts excessive forward movement of the lower leg bone in relation to the thigh bone.


Possible mechanisms:

  • Landing from a jump into the air e.g. football
  • Pivoting or decelerating suddenly e.g. netball

Signs to watch out for:

  • An audible popping sound
  • Severe pain at knee at the time of event
  • Immediate Swelling with tenderness or restriction following
  • Instability in standing, feeling of “giving way”

What can I do?

At the time of injury:

  • Rest: Stop exercising, avoid excessive standing and walking
  • ICE (Ice, Compression and Elevation)
  • Book in for assessment by a physiotherapist within 24-48 hours


Your physiotherapist will complete an assessment of your knee and provide you with general advice and exercises to reduce your pain. Rehabilitation can involve conservative (physiotherapy) or surgical methods, depending on relevant factors to you, your goals, and your activity level. Your physiotherapist will offer all options to you, to make an informed decision for your rehab.

ACL tears are the most common cause of prolonged absence from sport. Rehabilitation is highly important for any individual and can be a significant impact to your normal routine. Conservative or surgical methods can take 9-12 months before full return to pre-injury sport or activity levels.

Surgical Rehabilitation

Pre-operative rehabilitation is recommended to maintain general range of movement of your knee, adequate quadricep and hamstring strength and avoiding any swelling. Education will be provided to you regarding use of crutches following surgery.

If surgical management has been recommended by an Orthopaedic specialist, awareness of the upcoming process is beneficial. Following surgery, rehabilitation starts on Day 1 and follows a 9–12-month protocol. With recommendation from your surgeon, it is best to book in with a physiotherapist 2-4 weeks following your operation to receive education and begin your exercise programme. 

Initial goals following surgery: Minimise pain, swelling, gain normal range of motion and establish normal walking pattern with and then without crutches.

Pain levels can vary between people, it is important to continue moving within your pain threshold and perform general exercises as prescribed.

Walking: You will be given crutches for walking, as well as a knee immobiliser brace for support. Walking can be performed as tolerated, starting with 10 minutes 2x/day, focusing on normal a walking, and loading pattern.