Returning to Sport from an Anterior Cruciate Ligament (ACL) Injury

Returning to Sport after Anterior Cruciate Ligament Injury

Recently I watched a conference presentation by Dr Claire Ardern.  The presentation can be found HERE 

If you are a Physio, or work with anyone who has knee injuries, watch this presentation!

There are a lot of different view points on whether you should or should not have surgery to repair your Anterior Cruciate Ligament (ACL).

The presentation covers a lot of very technical topics in regards to return to sport after an ACL injury.

How do we return our clients to sport after an Anterior Cruciate Ligament injury?

  1. Hard work
  2. Consistency
  3. Training the mind and brain
  4. Competency based training

These would be the key factors from my experience in working with people with ACL injuries especially.

So, lets cover each off quickly:

Hard Work after Anterior Cruciate Ligament Injury

So, what I mean by this is not necessarily blood and sweat.  I mean hard work by its hard to do because sometimes its boring, or not exciting. The first 3 months post surgery or especially the first month post injury is critical.  If I say that rest is part of your recovery, then this is a literal thing.  If we say that you have to build up one side in terms of quadricep bulk, this might mean training one side more than the other, and it might mean doing a stack of repetitions of exercises that are “easy” but feel hard at the time.

And, when we get you back to moving again, its hard to get back to moving after this surgery because you are scared of doing it again. So the hard work is more mental in this frame!

The time you need to dedicate in my experience is between 30-60mins per day working specifically on your body after the initial period of immobilisation post surgery.  This can be complicated too by meniscal (cartilage) injury or other associated injuries to the knee as well as the ACL injury.


This is the biggest let down for people. Life can get in the way, other competing priorities can make spending that time on your body hard.  Especially in the first 1 month post injury and then the 3-6 months post injury to me is the most critical time to spend that 30-60mins on your recovery.

Its not a week on week off thing, you have to spend the time to progress well and move well.  Its repetition of GOOD repetitions that build the motor skill patterns to help prevent any further injuries.

Training the Mind and Brain

You can just train the body, meaning getting stronger, increasing muscle size, increasing fitness and still not have a great outcome.

Training the mind and brain means a massive focus on the quality of movement especially in return to squat patterns, jump and land patterns and running patterns.

The video here shows Malachi, one of our coaches working with Matt, one of our clients in helping him work back into stopping, and some push to lateral stepping, and then later in the video working into a contest and focusing on stepping into a contest and staying stable whilst maintaining his body position.

Competency Based Training

If you cannot do a single leg squat with good control of knee joint, then why should you jump and land?  Jumping, Landing is more complex than a single leg squat due to the dynamic nature of a plyometric action.

So, competency based training is exactly that. When you can do a task, then you can move along the timeline onto the next task.  And thats not doing it once, thats doing it for sets as part of your program and demonstrating good technique even when your coach “is not looking, but always watching!”

So, making sure you listen to the cues provided and work really hard on controlling knee joint stability, increasing core stability and progressing these factors along as the complexity of your tasks increase.

I have had an Anterior Cruciate Ligament injury and I am still not feeling “right”

So, if this is you, then please come and see us.  Myself, as head coach, I am really passionate about helping athletes stay injury free and helping you return to sport after an injury.  Our number is 4927 8190 or email

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