What to expect during acl recovery
Recovery from ACL rupture is no small feat. The ACL recovery timeline for most athletes sits around 9–12 months, and the process can feel overwhelming without the right plan and guidance.
With the right support, though, ACL recovery can be structured, intentional, and even empowering.
If you’re starting ACL Recovery with us at Souva PT & Performance, here’s exactly what you can expect throughout the process. Our goal is simple: help you return to sport stronger, more confident, and better prepared than before your injury.
ACL recovery phase 1: before and after acl surgery
Your ACL recovery journey should start before surgery — and this phase is non-negotiable.
1. Controlling Swelling
After an ACL surgery, swelling is unavoidable. But how quickly we reduce it matters.
We use the RICE principle (Rest, Ice, Compression, Elevation) for a reason. One important note: when elevating your leg, I want it as high as possible, not just a few inches above your heart. Proper elevation helps calm the knee faster and sets the stage for better recovery.
2. Restoring Full Knee Range of Motion
Regaining full knee extension is one of the most critical goals before and after ACL surgery.
Restoring full extension early reduces stiffness, improves walking mechanics, makes post-op rehab smoother and lowers the risk of long-term complications
We also work toward restoring knee flexion so your movement feels natural again.
3. Rebuilding Quad & Hamstring Function
ACL injuries can absolutely wreck quadriceps strength due to a process called arthrogenic inhibition. Simply put, your knee “shuts down” the muscles around it.
By calming swelling and restoring motion, we begin bringing life back into your quads and hamstrings. Strength work in this phase is essential and sets the foundation for everything that comes next.
This phase is also where education happens. I make sure you understand what’s coming after surgery, so there are no surprises. The work we do here can truly make or break the later stages of ACL rehab — and we don’t take it lightly.
ACL recovery Phase 2: rebuilding phase
This is the longest phase of ACL rehab, for good reason.
The rebuilding phase typically runs from about 6 weeks post-op through month 6 (or longer).
By this point, we aim to have full knee extension and flexion, minimal to no swelling and noticeable strength gains in the quadriceps and hamstrings.
During this phase, you’ll eventually return to running, low-level plyometrics, and progressive strength training
But here’s the key:
We don’t use time-based milestones.
You don’t start running just because “it’s been 12 weeks.”
You earn progression by passing comprehensive ACL testing at each stage.
Starting high-level activity too early does you a disservice even if the calendar says you’re ready. My job is to protect your long-term success, not rush the process.
I’ll be honest with you throughout this phase: I’ll tell you when you’re crushing it and when adjustments are needed
This phase is often the most rewarding. You’ll see physical changes, confidence growth, and the emergence of a stronger version of yourself , both mentally and physically.
acl recovery Phase 3: Return to sport training
The return-to-sport phase typically begins after the 6-month mark, depending on your progress and confidence from Phase 2.
This phase focuses on:
Sport-specific movements
Cutting, landing, and change-of-direction drills
Preparing you mentally and physically for competition
To enter this phase, you should have:
At least 80% strength symmetry
Full knee range of motion
No swelling
Improved confidence with jumping and cutting
By the end of this phase, our goal is 90% or greater strength symmetry compared to your uninjured side.
I use an extensive return-to-sport testing battery to: Measure progress objectively, Identify remaining weaknesses and most importantly finalize your return-to-play plan
The best part? The end result of this stage is when you step back onto the field and return to game action. By this point I expect you to feel stronger, more prepared, and more resilient than before. You can learn more about our return to sport training HERE.
Wrapping up your acl Recovery
ACL recovery isn’t just about getting your knee “good enough” to play again. It’s about rebuilding trust in your body, restoring confidence in your movement, and making sure you don’t have to go through this process a second time.
From pre-surgical preparation to rebuilding strength, and finally returning to full game speed, every phase of ACL recovery serves a purpose. When each stage is done with intention and not rushed, you give yourself the best chance at a long, healthy athletic career.
You need to ask yourself: “Is my current ACL treatment plan meeting these goals? Does my physical therapist take the time to work with me individually or am I battling for their attention? Are they progressing me to the next stages without any testing?” If the answer is no, we would love to work with you at Souva PT and Performance.
I’m Jake Souva, and I’d love to help you write your rehab success story.
My experience as both a patient and a physical therapist shaped the business I wanted to create: an environment where you feel heard and are pushed to achieve greatness.
The best part of what I do is helping people like you see what’s truly possible through a personalized plan and relentless teamwork to get you back to your strongest self. I would love to help you become the next great ACL success story at Souva PT and Performance, my Sports Physical Therapy Clinic in Shelby Township, Michigan. Click the link below to discuss your injury with me.
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ACL Physical therapy Built Different
We have access to 11,000 square feet of world class sports rehab and performance equipment to help deliver a pro level experience to athletes of all levels. Located inside Umbra Strength in Shelby Township, MI
