ACL Rehab Milestones – What Your Physio Actually Measures

An ACL injury is one of the most talked-about setbacks in sport. Whether you’ve had surgery or are managing non-operatively, the road back to running, training, and playing isn’t about a calendar date — it’s about hitting the right milestones. Katie, one of our incredible physios, knows first hand what this journey entails.

At Up N Adam Performance Training & Physiotherapy in Hamilton North, we focus on objective measures to track your progress. Because safe return to sport depends on what your knee can do, not just how long it’s been since injury.

Why Timelines Alone Don’t Work

It’s common to hear “back in 9 months” after ACL surgery. But studies show athletes who return before meeting strength and control criteria are at higher risk of re-injury. That’s why we use testing, not just time, to guide each stage of your recovery.

Key Milestones in ACL Rehab

Here are some general checkpoints we use with our Newcastle athletes:

1. Early Phase (0–12 weeks)

• Swelling and pain under control

• Full extension and near-full flexion restored

• Walking without a limp

• Early quad activation measured on dynamometer

2. Strength Phase (from around 2–9 months)

• Quadriceps and hamstring strength building to at least 100% of the other side

• Balance and control in single-leg stance

• Force plate measures showing even weight distribution

3. Running Phase (from around 3–6 months)

• No pain or swelling with hopping drills

• Hamstring/quadriceps ratio within safe range

• Passing a running readiness test (hop tests, strength benchmarks)

4. Agility & Change of Direction (from around 6–9 months)

• Cutting, pivoting, and landing control assessed

• Hop distance and time symmetry >90%

• VALD force plate data confirming safe ground reaction force control

  
  

5. Return to Sport (usually around 12 months)

• Quadriceps strength at least 100% of the other leg

• Hop and jump symmetry 100%

• Completion of sport-specific training drills without issues

• Psychological readiness (confidence in knee function)

  
  

How We Test at Up N Adam Physio

We use objective tools so you know exactly where you stand:

• VALD Force Plates – measure jump/landing mechanics

• NordBord – isometric & eccentric hamstring strength

• Dynamometer – quadriceps, hip & calf / ankle strength testing

• Hop Testing – single, triple, crossover hop comparisons

These results give you confidence — and ensure your rehab isn’t just “based on feel.”

Why Objective Testing Matters

Without testing & an individualised program, it’s easy to return to sport too early. By using measurable milestones & goal setting, we:

• Give athletes a clear understanding of their rehab pathway

• Reduce re-injury risk

• Identify lingering weaknesses

• Give athletes, parents, and coaches clear progress markers

It also helps avoid frustration — you can see improvement session by session.

FAQs

Q: Do all ACL injuries need surgery?

Not always. Some individuals can manage without surgery, depending on sport, age, and goals.

Q: When can I run after ACL surgery?

Usually around 3–6 months, but only after meeting specific strength and control milestones.

Q: Can physios decide when I return to sport?

We guide the decision with objective testing and collaborate with your surgeon, GP, and coaching team.

Call to Action

If you’re in Newcastle and working through ACL rehab, our physio team in Hamilton North can help you track your milestones with objective testing and sport-specific rehab plans

This is APA Sports Physiotherapist, Darren Glendenning, signing off for now!

You can book an appointment with Darren or Newcastle Knights Physiotherapists Katie or Hayd'n at www.upnadamptphysio.com to help guide you on your ACL rehab journey.

Bookings also available on our website for the following services at Up N Adam Performance Training & Physiotherapy:

• Dietitian - Sweat testing, weight-loss or to optimise your training nutrition / fuelling www.nutrientnation.com.au

• VO2 Max testing - to discover more effective ways to train efficiently www.flowitri.com.au

• Strength & Conditioning Programs - contact us or book via the website or email us at upnadamptphysio@gmail.com

• Remedial Massage - to relieve accumulative muscle tension & keep you training well.

• CycleFit by Physiotherapist Dean Waterman - At Up N Adam, for all your bike fitting solutions www.cyclefitphysio.com