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ACL Injury Management: ACL Surgery vs ACL Injury Physiotherapy

Your anterior cruciate ligament (ACL) provides stability to your knee. Unfortunately, this ligament is vulnerable to injury, especially if you play a contact sport. 

If you’ve injured your ACL, your knee can collapse or ‘give way’ when you turn or twist on it.

There’s no quick fix for an ACL injury. 

Historically, ACL reconstruction surgery followed by a lengthy recovery period was the most common method of treating ACL injury. However, depending on your injury, ACL surgery might not be the only treatment option available to you. 

Non-surgical management of ACL injury, with your physiotherapist, is becoming increasingly popular. 

Whether to combine surgery and physiotherapy or try physiotherapy alone will depend on your individual case. Not all ACL injuries are alike, so how best to treat yours depends on several factors.

At Physionorth we’ve supported many clients through ACL injury physio. Book in to chat about whether conservative treatment might be right for you.

What is an ACL injury?

Firstly, we need to explain what an ACL injury is. 

Your anterior cruciate ligament is a strong band of tissue providing stability to your knee. It connects your femur (thigh bone) to your tibia (shin bone). 

An ACL injury is when the ligament is stretched or torn (either partially or completely), usually due to a sudden change in direction or a blow to the knee. If your ACL is injured your knee can become very unstable.

Several symptoms could indicate you’ve injured your ACL:

  • You could hear or feel a ‘pop’ in your knee.
  • Sudden and intense pain.
  • Swelling.
  • Difficulty bending or straightening your leg.
  • Pain when walking.
  • Your knee may feel unstable. It could even buckle or give way when you weight bear on it.

ACL injuries are common in high-impact sports like football, netball, and basketball.

How is an ACL injury treated?

Before deciding on an appropriate method of treatment for your injury a thorough assessment is required. This could involve a physical examination with your physiotherapist or orthopedic doctor, x-rays, and an MRI. 

Once the severity of your injury is determined you’ll weigh up the pros and cons of each treatment option with your healthcare team. This involves considering your circumstances, occupation, activity level, lifestyle, and goals.

In some cases, your team may opt for the conservative approach. This means surgery’s not required. You’ll follow a rehabilitation exercise program with your physiotherapist. 

In other cases, you may need to have your ACL surgically repaired before starting your physio rehab program.

How can ACL injury physiotherapy help?

Physiotherapy following an ACL injury focuses on helping you regain movement, stability, and function. We aim to get you back to living life without the hindrance of injury.

Even without surgery, this is no quick fix. Physio exercises for ACL injuries require your commitment long term. 

Your physiotherapist will tailor a treatment plan aiming to strengthen structures in your knee and hip to help stabilise your knee joint. 

Some of the benefits of managing your ACL injury conservatively may include:

  • Shorter rehabilitation time than ACL surgery recovery time.
  • Less expensive than ACL surgery.
  • Avoid surgical risk and trauma.
  • ACL surgery is still an option if adequate knee stability isn’t achieved.

What if I need to have surgery?

While conservative treatment is suitable for many ACL injuries, surgery may be necessary for others. 

ACL surgery might be recommended if you’re an athlete or if you need to return to activity quickly. ACL injury surgery could also be recommended if you have additional injuries, such as a meniscus tear.

If you do need surgery, your physiotherapist can work with your surgeon to develop a rehabilitation plan to support you during your recovery. This typically includes exercises to help you regain strength, range of motion, and stability in your knee.

Physionorth can help

When it comes to ACL injuries, there’s no guarantees as to which option will provide the best result for your specific injury.

This is why choosing whether or not to have surgery can be difficult. If you’re not sure what to do, trialling physio exercises for ACL injury before having surgery might be sensible.

But remember, there’s no shortcuts. 

It doesn’t matter at the end of the day if you decide on ACL surgery or ACL injury physio, in both cases, putting time and effort into rehabilitation exercises is essential.

If you’ve injured your ACL, you must treat it correctly. 

Come and see us at Physionorth to chat about conservative options and whether they might be appropriate for you, before jumping straight into surgery. 

Book an appointment with one of our team at Physionorth today to see how we can help you get back to doing what you love.


*All information is general in nature and is not intended to be a substitute for professional medical advice. Physionorth can consult with you to confirm if this advice is right for you.



Healthdirect. (2022). ACL Reconstruction.

PhysioPedia. (2023). Management of Your Anterior Cruciate Ligament Injury. 


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