Check out this Q&A with world renown ACLr physio Mick Hughes talking about common ACL rehab questions. In this article, you’ll find a video with almost an hour of content answering common questions regarding ACL reconstruction rehab, reviewing the evidence surrounding ACLr, and debunking myths and misconceptions.

Common ACL Rehab Questions


Video Highlights

Below are some featured common ACL rehab questions we addressed during the Q&A with a nice summary for those looking for quick takeaways.


Is there a benefit to performing pre-op ACLr physio AKA prehab?

YES! Such a common ACL rehab question. There is a significant amount of evidence published, with more emerging, that supports ACLr prehab to IMPROVE the outcomes of ACL reconstruction rehab. ACLr prehab has been shown to improve quality of life after ACLr surgery, a better chance to return to prior level of function, and return to sport participation. ACLr prehab should be the standard of care for people getting ACLr surgery moving forward!


Whats a coper?

Not the most common ACL rehab question, however someone who can cope without an intact ACL. Mick and I chat briefly about the amount of copers out there and if they necessarily should opt for surgery. We have both seen great success with copers performing ACL reconstruction rehab without actually getting ACL reconstruction surgery, but proceed with caution.


Graft types: do they matter?

Yes, but it depends. For your first ACL reconstruction surgery – if you’re a good candidate for it – it is in your best interest to take a graft from your own body – termed autograft. Allografts, meaning synthetic or from a cadaver, tend to fail more than autografts. When comparing if you should take part of your patellar tendon vs. quad tendon vs. hamstring tendon – there are a few factors that you must consider. This includes the surgeon you’re working with and what they like to use, injury history, and your specific life/sport demands after surgery. Comparing autograft donor sites and failure rates, they tend to be the same. This is a great and common ACL rehab question to ask your surgeon.


Quad tendon donor site?!?

YES! Mick and I have both seen quad tendon ACLr and are seeing great results thus far!


What do you want to see ASAP after surgery during ACL reconstruction rehab

Full knee extension, minimal knee swelling, solid quad activation, and minimal quad lag.


US vs. Australia PT ACL reconstruction rehab frequency

Mick and I chat about the differences between physical therapy here in the US and physio in Australia for those going through ACL reconstruction rehab. It is surprising to hear the differences amongst the two of us as well as differences from one patient to the other.


Open Kinetic Chain (OKC) knee extension: when, how much, and why? Is it OK?

YES! This is one of the most common ACL rehab questions and highly debated topics! Mick is super passionate about this and breaks it down when you can start this exercise, what range, and why. Listen in starting at minute 31.


Return to running: when and how

Probably the most common ACL rehab question from patients! Mick and I touch base on all things getting back to running during ACL reconstruction rehab. We agreed we like to wait until 12 weeks due to a signifiant amount of individuals that experience an ACL tear injury also experience a bone bruise. The 12 week time frame helps to allow the bone to heal. Mick and I also talk about some of the performance requirements we like to see our ACLr patients meet prior to running that are outlined in the Melbourne ACL Rehabilitation Guide 2.0 However, not every person is going to run at 12 weeks after ACLr! It all depends, and we chat about this and some of the differences we see from patient to patient in ACL reconstruction rehab.


Return to sport: is it 9 months for everyone? Or should we move away from this number?

Another common ACL rehab question from patients and parents. This is a hot topic and there is always new evidence emerging that supports waiting at least 9 months. HOWEVER, we need to push for a criterion-based protocol vs. time-based protocol. Also anyone under the age of 20 may want to wait until AT LEAST 12 months! Mick and I talk about our experiences and what we think. Listen in at 42:45


Want more ACLr Prehab/Rehab info!?

Check out this exercise playlist I put together featuring early stage ACLr prehab/rehab. Feel free to share it! This is a playlist I created on PrehabX. Click here to sign up free for ten days to create your very own playlist and share them with anyone.


Jumping Fundamentals & Plyometrics [P]Rehab Programs

Looking for two comprehensive guides that respectively take you through a step-by-step linear progression of mastering the landing ‘base’ position and practicing jump, bound, and hop variations? Our Jump Fundamentals Program is designed for those working back towards jumping and plyometrics after an injury or surgery and for those who don’t feel comfortable with jumping and landing just yet. Whereas our Plyometrics Program is designed to expose your body to all of the various potential landing and jumping movements that sports demand. This includes double and single-leg variations as well as multi-directional and continuous movements! These programs are rooted in scientific evidence, strengthening & conditioning principles, and our clinical expertise as physical therapists!

About the author : Michael Lau PT, DPT, CSCS

One Comment

  1. Alissa Pidel December 13, 2018 at 5:20 pm

    For a runner interested in getting back into running – had her latest acl reconstruction in 2016 (hamstring graft), and had a big failure of a post rehabilitation outcome – is there hope for getting back into running still? (side note, she has full extension and not full flexion. About -10 degrees)
    This was a great blog. Thank you for what you do

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