ACL injury recovery: why the first 4-6 weeks are crucial | Liverpool physio
Did you know that delaying ACL rehab for just a few weeks can DOUBLE your recovery time?
Meet John, a semi-professional footballer who learned this the hard way. After tearing his ACL, he assumed rest was enough. But when his knee remained stiff and weak for weeks, he realised his mistake: he had lost precious recovery time.
If you’ve suffered an ACL injury, what you do in the first 4-6 weeks could determine whether you recover in six months or struggle for over a year. At Functional Movement Physio in Liverpool City Centre, we understand the importance of this critical period.
Why early physiotherapy is essential for ACL recovery
Starting physiotherapy early is the key to a successful recovery and returning to sport. Here’s why:
Reduces swelling and inflammation: This is crucial in managing pain and ensuring proper healing in the initial stages. Techniques like ice therapy, compression, and gentle range-of-motion exercises are vital.
Prevents muscle atrophy: Without early rehab, muscles around the knee can weaken and shrink, delaying your return to full strength. Isometric quadriceps contractions and hamstring curls are introduced early.
Maintains joint mobility: The longer the knee stays stiff, the harder it is to restore its range of motion. Gentle knee extensions and heel slides are key.
Accelerates return to sport: Early intervention reduces the total time needed for recovery, helping you get back on the field faster.
Improves surgery outcomes: If surgery is required, starting physiotherapy beforehand can improve the success of the procedure and speed up post-surgery recovery.
The consequences of delaying ACL recovery
Every day you delay physiotherapy can add weeks to your recovery timeline. The best athletes know the secret: they start pre-hab before surgery. This proactive approach is why pro athletes recover faster—they don’t wait to begin their recovery process. Delaying can lead to:
Increased risk of secondary injuries.
Chronic knee instability.
Prolonged pain and stiffness.
Reduced range of motion.
Understanding ACL tears: symptoms and grades
The anterior cruciate ligament (ACL) is one of the key stabilising structures in your knee, playing a vital role in joint stability and smooth movement. It’s prone to injury, especially during sports that involve sudden stops, pivots, and twists like football, rugby, and skiing.
Symptoms of a torn ACL
A loud pop at the moment of injury.
Severe pain and swelling.
Feeling like the knee might “give way.”
Loss of range of motion and difficulty walking.
Grades of ACL tears
Grade 1: A mild sprain where the ligament is stretched but not torn.
Grade 2: A partial tear that leaves the ligament loose and unstable.
Grade 3: A complete tear, where the ligament is fully ruptured or detached.
Non-surgical vs. surgical treatment: can physiotherapy heal an acl tear?
The short answer is: yes. While surgery may be necessary for severe cases, many ACL injuries can be managed with physiotherapy, especially if you start treatment early.
Physiotherapy goals for ACL recovery
Reduce pain and swelling.
Restore full range of motion.
Strengthen muscles around the knee, thigh, and pelvis.
Improve balance and mobility.
Prevent re-injury.
At Functional Movement Physio in Liverpool City Centre, we create tailored rehabilitation plans for each patient, focusing on their personal goals and the type of physical activity they aim to return to. This could include rest, pain management, at-home exercises, and specific guidance for safely returning to sports. Sometimes, a knee brace can also provide added support during recovery.
Real stories: ACL recovery success in Liverpool
Emma, a marathon runner
Emma was devastated when she tore her ACL six months before a major event. By starting rehab within a week at our Liverpool clinic, she regained mobility quickly and returned to running within eight months. Her dedication to early physiotherapy made all the difference.
Mike, a rugby player
After suffering a grade 3 ACL tear, Mike needed surgery. Thanks to a strict pre-surgery physiotherapy plan at Functional Movement Physio, his post-op recovery was smoother. He was back to training in ten months—far quicker than expected.
Lisa, a gym enthusiast
Lisa avoided surgery entirely by sticking to a structured rehab programme at our Liverpool clinic. With consistent physiotherapy, she restored full function to her knee and is now stronger than ever.
When is ACL surgery necessary?
While physiotherapy is often enough, there are situations when surgery is the better option:
Young, active individuals who want to return to high-performance sports.
Severe tears that impair daily activities, like walking.
Injuries involving other knee structures such as the meniscus.
Even if surgery is necessary, physiotherapy still plays a crucial role—both before and after surgery. Pre- and post-surgery rehab can improve outcomes and ensure the knee regains its full function faster.
ACL injury prevention for athletes in Liverpool
Strengthening exercises that focus on hamstrings and quadriceps.
Proper warm up and cool down routines.
Plyometric training to improve landing techniques.
Agility drills to improve cutting and pivoting movements.
Proper footwear.
Pain management during ACL recovery
R.I.C.E (Rest, Ice, Compression, Elevation)
Over the counter pain medication.
Gentle range of motion exercises.
Physical therapy techniques such as ultrasound.
Frequently asked questions about ACL injuries
How long does ACL recovery take? It depends on the severity of the injury and whether you have surgery. With physiotherapy, many patients recover in 6-9 months, while post-surgery rehab can take up to 12 months.
Can you heal an ACL tear without surgery? Yes. Many ACL injuries, especially partial tears, can heal with early physiotherapy, strength training, and rehabilitation exercises. However, complete ACL ruptures may require surgery.
What are the best exercises for ACL rehab? This is dependant on what stage of healing you are at and what you want to get back to.
The road to recovery: John’s story of hope
Let’s return to John. After his ACL tear, he was determined to avoid surgery if possible. He worked with our team at Functional Movement Physio in Liverpool City Centre, focusing on strengthening his knee and improving mobility. The process wasn’t easy, and there were setbacks along the way, but after six months, John was back on the pitch, stronger than ever.
Final thoughts: start your ACL recovery today
An ACL tear can feel like the end of the road, but it doesn’t have to be. Whether you choose physiotherapy, surgery, or a combination of both, early intervention is key. Starting your recovery as soon as possible—ideally within the first 4-6 weeks—is essential for the best possible outcome.
At Functional Movement Physio in Liverpool City Centre, we’re here to guide you every step of the way, helping you regain strength, stability, and confidence.
Remember: time is tissue. The clock starts ticking the moment you're injured. Don’t wait.
Ready to start your ACL recovery journey in Liverpool?
Contact Functional Movement Physio in Liverpool City Centre today to book an appointment and take the first step toward healing.
About the author
Written by Stuart Goldfinch (Member of the Chartered Society of Physiotherapy and the Health and Care Professionals Council: Number PH112156 - Check Registration Here)
