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 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 gated by objective criteria, not the calendar. We use VALD Force Decks to test limb symmetry in strength and explosive power, targeting LSI above 90% before full return. This reduces re-injury risk significantly compared to time-based clearance.