ACL injuries

The anterior cruciate ligament (ACL) is a ligament in the knee, which joins the femur (upper leg bone) with the tibia (lower leg bone) and its function is to keep the knee stable. ACL tears are common amongst sportspeople, both professional and amateur.

ACL injuries generally occur when the knee is bent backward, or twisted. This can happen when you change direction quickly, land from a jump or slow down from running, all of which are common in pivoting activities like football, rugby or skiing.

There are of course other, non-sports-related ways to injure your ACL. Other common causes are falling off a ladder or missing a step on the stairs.

Mr Shah Punwar is highly experienced in treating ACL tears and has an excellent track record, but what can you do to increase the chance of your surgery’s success?

Recuperation from ACL injuries

The journey to recovery from an ACL tear can be a long one and there is a serious risk of re-injury if a structured rehabilitation programme is not followed closely, particularly among athletes.

Surgery to repair an ACL tear can help you to return to your previous athletic form. However for contact sports, a delay in returning to the playing field of at least nine months can prevent re-injury.

One particular study showed that for every month that a return to full play was delayed, post surgery, the risk of reinjury was reduced by 51%.


Physiotherapy forms a crucial part of the recovery process after surgery on an ACL tear. Any athlete will know that it is important to warm up your muscles prior to commencing a sporting activity.

Physiotherapy performs this same function, but on a more gradual, long-term basis. This allows an injured body part to fully recover and regain strength before it is called back into action again.

The idea of fitting regular physiotherapy sessions into your schedule might seem too much to contemplate. But a recent study published in the British Medical Journal (BMJ) showed that even minimal physiotherapy can be effective in aiding recovery from ACL surgery.

We would always recommend however that a full physiotherapy programme is adhered to for optimal results.

Pre-operative physiotherapy

A growing body of evidence suggests that having physiotherapy before your surgery leads to a beneficial outcome. Indeed some patients may be able to avoid surgery altogether by following a good physiotherapy programme.

One study, published in the American Journal of Sports Medicine, found that patients who received pre-operative physiotherapy had better functional outcomes for the knee, with the benefits lasting for over two years after surgery.

Some components of a physiotherapy programme before ACL surgery might be:

  • Exercises to improve strength in the hamstring and quadriceps
  • Treatment to control swelling in the knee joint
  • Balance exercises
  • Neuromuscular training – this involves learning how best to jump and land in order to protect your knee

Pre-op physiotherapy is known as ‘prehabilitation’ and, combined with good post-operative physiotherapy and a delayed return to sport, is the best way of achieving a full recovery with reduced risk of re-injury.

For more information on ACL surgery or to book an appointment, please contact us by calling 0808 273 6283.

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