ACL Tears: Expert Support for your Recovery Journey
That sudden pop. The immediate pain. The swelling that appears within hours. The unsettling feeling that your knee just isn’t stable anymore. If you’ve experienced an anterior cruciate ligament (ACL) tear, you know how confronting and overwhelming it can be, from the initial injury through diagnosis, treatment decisions, and the road to recovery.
At Aret Chiropractic, we understand the physical and emotional impact of an ACL injury. Whether you’re preparing for surgery, in the midst of post-operative rehabilitation, or managing the ongoing challenges of recovery, we’re here to provide expert, evidence-based care that supports your healing and helps you return to the activities you love.
Understanding ACL Tear Grades
Grade 1: Mild Sprain
The ligament has been stretched and mildly damaged, but the fibres remain intact and can still stabilise the knee joint. People with Grade 1 tears typically experience pain, swelling, and some tenderness, but the knee remains relatively stable. These injuries often respond well to conservative treatment including rest, rehabilitation exercises, and supportive care.
Grade 2: Partial Tear
The ligament has been stretched to the point where it becomes loose, with 20-80% of the fibres torn. This is often called a partial tear. Grade 2 tears cause more significant pain, swelling, bruising, and joint instability. Walking and bearing weight on the leg may be difficult due to pain and the feeling that the knee might buckle. Treatment decisions for Grade 2 tears depend on factors like age, activity level, and the degree of instability experienced.
Grade 3: High Grade Tear
The ligament has been completely torn, either split in two or pulled directly off the bone. Grade 3 tears are accompanied by severe pain (though some people experience surprisingly little pain), obvious swelling and bruising, and significant knee instability. The knee feels completely unstable and may buckle or give way during activity.
The Road to Surgery: What to Expect
For Grade 3 ACL tears, surgical reconstruction is typically recommended to restore knee stability and allow you to return to your desired activity level, particularly if you’re active, play pivoting sports, or have experienced persistent instability.
ACL reconstruction surgery is an arthroscopic procedure where the torn ligament is replaced with a graft, either using tissue from elsewhere in your body (autograft) or donor tissue (allograft). The surgery itself has evolved significantly over the years, with modern techniques offering excellent outcomes for most patients.
However, it’s important to understand that the surgery is just one part of your recovery journey. What happens before and after surgery is equally critical to achieving the best possible outcome.
How We Can Help
Our Approach to Your Care
We specialise in post-operative ACL rehabilitation
The majority of our ACL patients come to us after surgery, and we have extensive experience guiding people through recovery, from the immediate post-operative period through return to sport or other activities.
We believe in evidence-based, individualised care
Your rehabilitation programme is tailored to your specific surgery, your healing progress, your activity goals, and your individual response to treatment.
We work collaboratively
We maintain communication with your orthopaedic surgeon and other healthcare providers to ensure everyone is working together toward your recovery. We respect your surgeon's protocols and guidelines whilst providing the hands-on rehabilitation support you need.
We monitor progress objectively
Throughout your recovery, we track measurable improvements in strength, range of motion, balance, and functional capacity. This helps us make informed decisions about when to progress your programme and when you're ready to return to activity.
You Ask, We Answer
What is an ACL Tear?
The anterior cruciate ligament is one of four major ligaments in your knee. It connects your thighbone (femur) to your shinbone (tibia) and plays a crucial role in knee stability, particularly during movements that involve pivoting, sudden stops, or changes in direction.
When the ACL tears, your knee loses a significant source of stability. The tibia can shift too far forward relative to the femur, creating that characteristic feeling of instability or “giving way” that many people with ACL injuries describe.
When should I start my rehab journey after ACL surgery?
This depends on your surgeon’s specific protocols and your individual healing. Some patients benefit from starting within the first week or two post-surgery for gentle range of motion work and swelling management. Others may wait until after their first post-operative surgeon visit (typically 1-2 weeks). If you’re having surgery soon, starting pre-operative care can also be highly beneficial.
My knee still feels unstable months after surgery. Is this normal?
Some feeling of difference or apprehension in your surgical knee is normal during recovery, especially in the first 3-6 months. However, true instability, where your knee actually gives way or buckles, is not normal and should be evaluated. This could indicate issues with graft healing, inadequate rehabilitation, weakness in supporting muscles, or problems with proprioception. We can assess your knee stability, strength, and movement patterns to determine if your instability is related to muscle weakness and poor neuromuscular control (which we can address) or if you need to return to your surgeon for evaluation.
Can you help with pain and swelling that won't go away?
Persistent pain and swelling beyond the early post-operative period can have several causes, scar tissue formation, compensatory issues, inadequate muscle activation, inflammatory responses, or occasionally complications that require surgical evaluation. We can assess the source of your symptoms and provide treatment including manual therapy, exercises, advice on activity modification, and swelling management techniques. If we suspect a complication that requires medical attention, we’ll advise you to return to your surgeon promptly.
When can I return to sport after ACL reconstruction?
The general guideline is 9-12 months post-surgery for return to pivoting sports, though this varies based on individual healing and rehabilitation progress. However, time alone isn’t the only factor, you should also meet specific functional criteria including near-symmetrical strength between legs (typically 90% or better), good balance and proprioception, ability to perform sport-specific movements with proper form, psychological readiness and confidence, and clearance from your surgeon. We’ll work with you to assess your readiness using objective testing and help you return to sport safely and confidently.
What if I'm not progressing as quickly as I expected?
Recovery timelines vary significantly between individuals, and slower progress doesn’t necessarily mean something is wrong. However, if you’re significantly behind expected milestones, we’ll assess potential factors including inadequate exercise intensity or frequency, compensatory movement patterns limiting progress, persistent swelling or pain interfering with rehabilitation. We’ll help to identify any obstacles to your progress and adjust your treatment plan accordingly. Sometimes, slower initial progress doesn’t affect the final outcome.
Can you help prevent injuries in my other knee?
Absolutely, and this is an important consideration. Research shows that the risk of ACL injury in the opposite knee is elevated after you’ve torn one ACL. We incorporate bilateral (both legs) strengthening, work on movement patterns that reduce injury risk in both legs, and identify and address any asymmetries or weaknesses that might predispose your other knee to injury. The same neuromuscular training and proper movement techniques that help you recover from one ACL tear also protect your other knee.
Is it too late to start my recovery with Aret Chiropractic, if I'm already months into recovery?
It’s never too late to optimise your recovery. Even if you’re 6, 9, or 12 months post-surgery, we can assess your current function, identify any remaining deficits or compensatory patterns, and design a programme to help you reach your goals. Quite often, patients seek our care later in recovery because they’ve plateaued, aren’t progressing as they’d hoped, or are preparing for return to sport and want additional support. We’ll meet you where you are in your recovery and work from there.
Ready to Start Your Recovery Journey?
Whether you’re dealing with a recent ACL tear, considering your treatment options, or recovering from surgery, we’re here to provide expert, evidence-based care tailored to your needs. Our North Ryde team has extensive experience supporting people through ACL injuries and can help you navigate this challenging time with clarity and confidence.
Book your consultation today to discuss your ACL injury and explore your recovery options.