Data-Driven Recovery

ACL Rehab
Frequently Asked
Questions

Return to sport safely with clear benchmarks, expert guidance, and elite performance testing. We don't just heal your knee. We rebuild your athletic capacity.

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Pre-Op

Pre-Surgery

Post-Op

After Surgery

Phase 1

Weeks 0–4

Phase 2

Weeks 5–12+

Phase 3

Weeks 20-36

Quantitative Testing

Ongoing

FAQs

ACL Rehab FAQs

Clear Answers at Every Stage

Return to run is based on both time since surgical intervention as well as quantitative testing. These tests include: 

  • Quad LSI (Limb Symmetry Index) of 70% to the contralateral side. Return to Run is not indicated before week 12 to allow for proper healing timelines for the surgical graft.
  • Single-leg step-downs: Able to perform from an 8-inch box to failure with approximately 70% of the strength and endurance of the non surgical leg.
  • Single-leg glute bridge: Can complete from a 20-inch surface to failure with approximately 70% of the strength and endurance of the non surgical leg.
  • Single-leg calf raises: Able to perform with the front foot elevated at about 70% of the other leg.
  • Single-leg wall sit: Can hold for 30 seconds, with both sides compared for endurance.

Deceleration training: Successfully performing drills that focus on slowing down, maintaining control through the knee without compensation or pain.

Like return to run, return to sport is based both on quantitative testing, as well as time since surgery. Generally, return to sport does not occur before 6 months post-operatively. These tests include:

  • Quad LSI of 80% or greater
  • Hamstring LSI to 60%
  • Looking for a 2:3 ratio between hamstrings:quads
  • Ability to perform anterior tap down from 12” box with complete control at least 15 reps while holding ⅓ of your body weight 
  • Rear Foot Elevated Split Squat (RFESS) Test (thigh parallel to floor): 50% BW for 10 reps
  • Lateral Box squat test (thigh parallel to floor): 33% BW x 10 reps
  • Bodyweight Squat MINIMUM 60%
  • Triple Hop Test
  • Agility / Force plate testing (if you’d like more information on this, click *here*)

Crutches are generally discharged when you are able to perform terminal knee extension independently and without quad lag. This is defined as the inability to perform a “heel pop” when performing quad activation in a long-sitting position, or when you are unable to keep your knee straight as you start to lift your leg from the table.. This should also be achieved in a standing position comfortably and without evidence of inability to maintain this position.

The decision is always yours! Generally, younger, active individuals involved in a sport setting are recommended to undergo surgical intervention. There are some research articles to indicate non-surgical healing or positive non-surgical outcomes in certain populations.

We will start by unlocking the brace once you have enough quad strength and control to walk safely. Your knee should be able to support your body without giving out.

After that, you’ll still use crutches for support as your walking continues to improve. When you can walk smoothly and confidently without pain or instability, we will gradually wean you off the crutches.

Criteria:

  • Adequate quadriceps control and strength for walking 
  • Ability to walk without pain or swelling
  • No signs of the knee buckling or giving out
  • Ability to perform active terminal knee extension and a straight leg raise

Your first visit focuses on understanding your goals and creating a plan. We will:

  • Review your surgery and medical history
  • Provide a full evaluation of your knee after surgery  
  • Set clear rehab goals and expectations 
  • Go over home exercises needed to be successful in early phases of rehab 
  • You will leave with a personalized program and a clear idea of your recovery timeline.

Clicking and popping is normal following surgery especially as we start initiating movement. If you are concerned about it, ask your rehab specialist or you surgeon.

  1. Swelling is normal early post operation. As we progress it can be normal following increases in activity or when we introduce new exercises. 
  2. It can be a problem if there is sustained selling that does not improve with elevation and rest.
  • Recovery from ACL surgery is a marathon not a sprint. 
  • Rehab is a process and rushing it leads to less optimal outcomes. 
  • Typical rehab should last from 6 months to a year or more  based on your goals and how you progress

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Find Your Phase

From pre-surgery prep to full return to sport, each phase has a purpose. Our process is built around clear benchmarks, advanced testing, and a plan that adapts to you.

Pre-Surgery
Pre-Surgery

Pre-Op

What you do before surgery directly impacts how well you recover after. This phase is focused on preparing your knee and your body for the demands of surgery and rehab.

We work on restoring range of motion, improving quad strength, and reducing swelling so your knee is in the best possible position going into surgery. Patients who commit to pre-op rehab consistently see better outcomes and a smoother recovery. You’ll leave with a clear plan, exercises to follow, and a full understanding of what to expect next.
Weeks 0–4
Weeks 0–4

Phase 1

This is the most critical early phase of recovery. The focus is on reducing swelling, restoring full knee extension, and reactivating your quadriceps. We guide you through safe, progressive movement immediately after surgery, using tools like neuromuscular stimulation, blood flow restriction, and targeted strength work to accelerate recovery without compromising the graft. Our goal is simple: get your knee “quiet” and functioning again so you can walk normally and move into the next phase with confidence.
Weeks 5–12+
Weeks 5–12+

Phase 2

Now we shift from recovery to performance. This phase is about rebuilding strength, control, and stability in the surgical leg. We don’t guess when you’re ready to progress, we test it. Using objective strength metrics and movement assessments, we ensure your body is prepared before introducing higher-level activity like running. You’ll follow a structured progression that builds tolerance step by step, reducing risk and setting the stage for long-term success.
Weeks 20-36
Weeks 20-36

Phase 3

This phase bridges rehab and real performance. You’re no longer just recovering, you’re preparing to return to sport at a high level. We build a program that combines strength, conditioning, and sport-specific movement. Training is structured, progressive, and designed to match the demands of your sport. By this stage, the focus is not just being “cleared,” but being fully prepared, confident, and capable when you step back onto the field.
Ongoing
Ongoing

Quantitative Testing

At every stage, we use advanced testing to guide decisions and eliminate uncertainty. From force plates and dynamometry to functional movement testing, we measure strength, symmetry, and performance so you know exactly where you stand. Return to running and return to sport are earned through data, not timelines. This ensures safer progression, better outcomes, and a higher level of performance when you’re back.