1). Clinical Assessment

When you present with an ACL injury, our first priority is establishing a clear working diagnosis through a thorough clinical and data-backed evaluation. During your assessment, your physiotherapist will perform:

• Subjective Assessment: Reviewing the mechanism of injury (i.e. how you actually got injured in the first place), and assessing immediate swelling and instability. This helps give our team a picture of how the injury ocurred.
• Objective Assessment: Using specific ACL and knee stability tests alongside range of motion and movement evaluations. Based on if you’ve just injured your ACL (acute), or if it’s been a little white afterwards, our team can get objective measures using VALD testing, allowing for precision measurements on not only the strength of the knee, but the surrounding muscles, such as quads and hamstring.

Establishing a diagnosis of a suspected ACL tear early on allows the team to implement protective and proactive measures immediately.

2. Protection & Stabilisation

Protecting the ACL and the knee during the initial stages is critical to prevent secondary knee or cartilage damage. This allows us to better preserve all future treatment options, such as surgery or non-surgery outcomes.

We’ll typically fit you with a hinged knee brace using specific clinical parameters.

• Free Flexion: Allowing comfortable, unforced knee bending as tolerated by your pain & movement
• Controlled Extension: Avoiding end-range extension to reduce strain on the healing environment
• Extension Locking: Commonly locking extension around 30 degree, and progressively extending range as the ACL tear settles.

Bracing is vital because it stabilises the knee against secondary knee injuries and keeps non-surgical options viable.

3. Diagnostic Imaging & Specialist Referral

To confirm the extent of the injury and screen for associated joint damage (such as meniscal tears or bone bruises), formal imaging is required. We coordinate diagnostic pathways by:

• Organising an MRI Referral: Referring directly for an MRI via radiology or in collaboration with your General Practitioner (GP).

• GP Collaboration for Specialised Protocols: Involving your GP early if structured non-surgical pathways (such as the Cross Bracing Protocol) are being considered.

• Specialist Pathways: Facilitating direct referrals to trusted orthopedic surgeons or sports medicine specialists when surgical opinion or specialised medical input is indicated.

4. Proactive Early Rehab – Don’t Wait for the Scan

One of the most critical principles of our ACL rupture rehab protocols is not waiting for MRI results before beginning treatment.

During your first 10 days (sessions 1-2 onwards), our active management focuses on:

• Quietening the Knee: Implementing targeted strategies to manage swelling, reduce pain, and settle other irritations as a result of the injury.
• Early Quad Activation: Re-establishing strength, movement and connection to the quad muscles is important to prevent rapid muscle inhibition and strength loss.
• Locking in Consistent Early Care: We recommend three clinical consultations within the first 10 days to build momentum, manage pain and issues, and guide safe movement progression. This also allows us plenty of time to communicate with your GP and work together to find the right option for your next steps.

Step 5: Early Education & Shared Decision Making

ACL rupture rehab is not a “one-size-fits-all” process. Today, both surgical reconstruction and non-surgical (conservative) rehabilitation are evidence-based options depending on you as an individual.

From the initial sessions, our team introduces these pathways early:

• Explaining the pros, cons, and timelines of surgical vs. non-surgical management.

• Considering key individual factors including patient age, sport or activity goals, occupational physical demands, and joint stability.

• Planting the seeds of education early so that a fully informed, shared decision can be made alongside orthopedic specialists, GPs, and the patient over time.