Why Physiotherapy & ACL Injury Recovery: What Athletes and Everyday People Need to Know

An anterior cruciate ligament (ACL) injury is one of the most challenging knee injuries—whether you’re a competitive athlete, a recreational runner, a hockey player, or someone who simply enjoys staying active. ACL tears can affect stability, mobility, strength, confidence, and your ability to participate in the activities you love.

At Physical Edge Physiotherapy in Oakville Ontario, we treat ACL injuries every week, and we follow the latest research to provide the best possible recovery outcomes. Three important studies help explain why physiotherapy is crucial before and after surgery, and why proper rehab can make the difference between long-term success and repeated injury.

This guide breaks down the science in a way that helps athletes, weekend warriors, and active adults understand their path to a strong recovery.

1. Physiotherapy Before ACL Surgery Leads to Better Recovery

A major review (Alshewaier et al.,2017) looked at the benefits of pre-operative physiotherapy (“prehab”) and found that people who completed structured physio before surgery had:

• Faster return of knee range of motion

• Better early strength, especially in the quadriceps

• Improved walking and functional movement

• Lower risk of stiffness after surgery

• Better overall confidence going into rehab

  
  

Why This Matters for Everyone

Whether you're preparing for a competitive season or simply want to return to pain-free daily movement, strong muscles and good mobility before surgery make a major difference. Prehab reduces pain and swelling, protects strength, improves movement quality, and sets the foundation for a smoother recovery

For athletes, this means faster return-to-sport and less performance loss. For everyday active people, it means fewer setbacks and a quicker return to walking, stairs, work, and daily confidence. At Physical Edge Physiotherapy, we tailor prehab to your goals, helping every patient start recovery from the strongest, safest place possible.

2. ACL Injuries Affect Proprioception, Physio Helps Restore It

Another key study (Relph et al., 2013) found that after an ACL injury, the knee loses its ability to sense position and movement (also known as proprioception).

This affects:

• Stability when walking, running, or turning

• Balance and coordination

• Ability to trust your knee under load

• Risk of re-injury

These deficits affect everyone, not just high-performance athletes.

How physiotherapy restores proprioception:

Physio treatment includes:

• Balance and stability exercises

• Neuromuscular training

• Controlled single-leg loading

• Closed-chain strength training

• Perturbation training (controlled “unexpected” movements)

  
  

These techniques help rebuild the brain–body connection needed to move safely and confidently.

3. Advanced Rehab Techniques Improve Long-Term Function and Reduce Re-Injury

The third article (Risberg et al., 2004) focuses on rehabilitation outcomes in athletes following ACL reconstruction. Research in this area consistently supports:

Progressive loading

Strength training must be carefully progressed to rebuild the quadriceps, hamstrings, and glutes.

Eccentric strengthening

Helps improve tendon health and builds deceleration strength—crucial for both sport and daily life activities like stairs or carrying loads.

Movement pattern retraining

Guided practice to correct compensations that can develop after injury (e.g., hip shift, knee collapse).

Plyometrics and agility training

Essentials for athletes and helpful for everyday movers who need confidence in dynamic tasks.

Return-to-sport testing

Ensures strength, stability, and movement quality are balanced before you resume higher-level activities. Even non-athletes benefit from these progressions because they rebuild safe mechanics for walking, hiking, lifting, and daily function.

4. What You Can Expect During Your Physiotherapy Program

Whether you’re an athlete returning to sport or an active adult returning to daily life, a complete ACL rehab plan should include:

1. Early Recovery

• Reducing swelling

• Restoring full knee extension

• Activating quadriceps

• Gait retraining

  
  

2. Strength and Control Phase

• Lower-body strengthening (hips, knees, ankles)

• Balance and neuromuscular training

• Gradual increase in single-leg work

  
  

3. Advanced Functional Training

• Running mechanics

• Jumping and landing control

• Change-of-direction drills

• Core integration

  
  

4. Sport-Specific or Lifestyle-Specific Training

For athletes:

• Plyometrics

• Agility

• Acceleration/deceleration

• Contact or unpredictable movement training

  
  

For everyday active people:

• Stair tolerance

• Hiking readiness

• Lifting mechanics

• Long-walk endurance

• Return to workplace or childcare activities

  
  

5. Final Testing

Objective testing ensures your knee is ready for higher-level activity—reducing the risk of re-injury.

The Bottom Line

Research is clear: physiotherapy is essential at every stage of ACL injury recovery, whether or not surgery is involved. It improves strength, mobility, proprioception, confidence, and long-term knee health.

At Physical Edge Physiotherapy in Oakville Ontario, we combine evidence-based techniques with personalized care to support patients of all activity levels—from competitive athletes to active adults who simply want to keep moving comfortably.

If you’ve experienced an ACL injury or you’re noticing knee instability, we’re here to help guide your recovery and get you back to doing what you love.