ACL, also known as anterior cruciate ligament, is a ligament found deep in the knee.

Mostly composed of collagen fibers, with a small proportion of elastic fibers, the ACL possesses high tensile strength which enables it to provide passive rotational stability for the knee and keep the shin from sliding out forward.


What happens when the ACL is injured?

ACL injuries are commonly caused when one does a rapid turn or “cut” but the foot remains planted on the surface.

ACL injuries may also be caused by improper landing position after a jump, with or without contact in mid-air.

Based on accounts by physiotherapy patients, they felt their knee give way followed by abrupt pain. Some physio patients also shared that their knee got swollen within the first two hours after they heard a click.


How common are ACL injuries?

In Australia alone, there had been 200,000 ACL reconstructions in just five years, from 2000 to 2015. Australia is considered to have the highest number of ACL reconstructions in the world and the number of incidents increases year after year.

In Mascot, Excel Physiotherapy and Wellness provides treatment to more and more patients every year, who come to the center with ACL tears.

Majority of these physio patients are recreational sport players, also called ‘weekend warriors’.



What are the treatment options for ACL injuries?

In Australia, the most common treatment for patients who have ACL tears is surgical reconstruction. However, based on recent studies, it is better to perform non-operative interventions on physio patients before suggesting that they undergo surgical reconstruction.

A randomized controlled trial concluded that individuals who have undergone rehabilitation and were given the option to have ACL reconstruction later on led to better results at a five-year follow up compared to those who underwent rehabilitation after an ACL reconstruction.


The important role of physiotherapy in the treatment of ACL injuries

Whether a person who has an ACL injury opts for surgery before rehabilitation or not, physiotherapy is crucial for recovery.

Physiotherapists will provide treatment and rehabilitation that are specifically designed for each person’s unique condition, focusing on sport-specific exercise rehabilitation, deficits on range of motion, ways to strengthen the lower limb and improve neuromuscular agility, patient education, goal setting, and a progressive return to pain-free function and sport.

As each patient’s injury is unique, physiotherapists provide customized treatments and recovery periods will vary from one person to another.

Typically, it takes about 9 to 12 months of rehabilitation for patients who have undergone an ACL reconstruction to be able to go back to sports.

For those who have not undergone surgery, however, recovery is said to be a lot sooner. This is because, as mentioned previously, ACL reconstruction is not a pre-requisite for one to return to sports.

In fact, studies confirm that physio patients who did not undergo surgery are able to go back to high levels of sports activities without symptom complaints or episodes of instability.

This is said to be true for athletes at the elite level, such as NBA stars Dejuan Blair and Sean Elliott, NFL star player Philip Rivers, golf legend Tiger Woods, and Winter Olympics athlete Jessica Rich, who have all returned to their sports with torn ACLs.


Lawrence Lin is a physiotherapist at Excel Physiotherapy and Wellness located in Mascot, New South Wales, Australia.

He is experienced in treating work related and postural injuries, in particular, necks and backs.

Lawrence has a strong interest in strengthening the ‘core’ and gluteal muscles which is vital for people who suffer from low back pain, unstable knees, and other lower limb injuries.

He regularly attends professional development courses in the areas of Sports Injuries, Rehabilitation, and Orthopaedic Surgery.