ACL Rehab: What to Expect at Every Stage of Recovery

An ACL rupture brings your training to a full stop, but it doesn't have to end your sporting life. At Stance, we've guided hundreds of athletes through reconstruction and back to competitive sport — and the single biggest factor in outcome quality is the quality of the rehabilitation protocol.

Phase 1 — Weeks 0–6: Protecting the Graft

Immediately after surgery, the priority is protecting the new graft while managing swelling and beginning to restore range of motion. You'll work on quad activation, straight-leg raises, and gentle knee flexion. Full weight-bearing in an extension brace is typically introduced within the first week.

Phase 2 — Weeks 6–12: Rebuilding Strength

Once range of motion is restored and swelling is controlled, the focus shifts to regaining quad and hamstring strength. Closed-chain exercises — squats, leg press, step-ups — form the backbone of this phase. We use VALD Force Decks to objectively measure limb symmetry, targeting a Limb Symmetry Index (LSI) above 70% before progressing.

Phase 3 — Months 3–6: Neuromuscular Control

Strength alone isn't enough to return safely to sport. This phase introduces progressive plyometrics, agility drills, and sport-specific movement patterns. Balance and proprioception training is critical — the graft is strong enough to tolerate load, but the nervous system needs retraining to protect the joint in dynamic situations.

Phase 4 — Months 6–9: Return-to-Sport Testing

Return to sport is earned through objective testing, not time alone. Our battery includes single-leg hop tests, quad and hamstring strength assessment (LSI >90%), and psychological readiness scoring. Athletes who pass all criteria demonstrate a significantly lower re-injury rate than those cleared on time alone.