Knee & ACL Rehabilitation

ACL injuries and ACL reconstruction rehabilitation, other ligament injuries (MCL, LCL, PCL), meniscal tears and post-meniscectomy or repair rehabilitation, patellofemoral pain, patellar tendinopathy, IT band syndrome, osteochondral (OCD) lesions and knee osteoarthritis.

For surgical cases we contact your consultant directly before your programme starts to request the operation note and any specific protocol, so your rehabilitation reflects your graft type, fixation and any meniscal repair rather than a generic timeline. Where relevant, we stay in contact with the surgical team throughout.

Early rehabilitation is about the unglamorous fundamentals: full extension, swelling control, quadriceps activation and normal gait. Quadriceps inhibition after ACL surgery is profound, and the deficit created in the first six weeks can take a year to undo if it is not addressed immediately.

The middle phase is strength. Heavy, progressive loading of the quadriceps, hamstrings, calf and hip, supplemented with blood flow restriction training and EMS where full loading is not yet appropriate. This is the phase most commonly under-dosed, and it is the phase that determines your outcome.

The final phase is plyometrics, change of direction, deceleration and sport-specific exposure, added only once strength benchmarks are met. Return to pivoting sport before nine months, or with a quadriceps deficit greater than 10%, carries a substantially higher re-injury risk, so we test rather than guess.

Handheld dynamometry measures quadriceps and hamstring strength as a limb symmetry index. We want above 90% symmetry, and ideally comparison against your own pre-injury or contralateral baseline, before high-risk activity is reintroduced.

ForceDecks force plates quantify single-leg jump height, reactive strength, landing forces and how much of the load the operated leg is genuinely accepting. Athletes routinely look symmetrical to the eye while offloading measurably on the plates.

Diagnostic ultrasound is used for the surrounding soft tissue, patellar and hamstring graft sites, effusion and tendon integrity, so we can see whether irritability is structural or simply a loading response.