What to Expect After an ACL Tear

11 Mar

An ACL tear is a tough setback for any athlete or active person. It can happen suddenly, mid-sprint, on a quick pivot, or during a non-contact moment, and it’s about much more than just the physical damage. The injury often brings emotional and mental challenges as well.

But here’s something many don’t realize: being an athlete means keeping your whole body in the game, even when part of you is healing. While your knee recovers, it’s crucial to keep training the rest of your body to maintain your overall athletic ability and reduce the loss of strength, fitness, and performance.

With the right plan, mindset, and support, healing from an ACL injury is absolutely possible. This guide will walk you through common signs of an ACL tear and five foundational principles we use at Vital Movement to help clients rebuild stronger, healthier knees while staying active and prepared for a full return to sport.

What Are the Common ACL Tear Symptoms?

Before we dive into the recovery process, let’s quickly review ACL tear symptoms so you know what to look out for:

A loud pop or feeling a sudden shift in the knee
Immediate swelling and instability
Difficulty putting weight on the leg
Decreased range of motion
A feeling that the knee is “giving out” during activity

If you’re experiencing any of these symptoms, don’t wait. Get evaluated by a movement-focused professional who understands both orthopedic care and sports performance.

5 Things You Can Expect During ACL Recovery

1. 90% Strength Return is Your Minimum Standard, Not Your Goal

Don't expect to return to sport as soon as you "feel good" or just because its’s the 9-month mark after an ACL tear. Research shows you need at least 90% strength symmetry between your injured and uninjured leg before safely returning to cutting and pivoting sports. Many athletes feel ready around 4-6 months but still test significantly below this critical threshold.

Expect comprehensive testing including:

Quadriceps and hamstring strength measurements
Single-leg hop tests for distance and control
Isokinetic testing to measure power output
Movement screening for quality and symmetry

The 90% benchmark isn't arbitrary - it's based on reinjury data. Athletes who return to sport below this threshold have significantly higher rates of reinjury. Your PT should be tracking these numbers throughout recovery, not just relying on how you feel or basic movement milestones.

Remember: meeting 90% is your minimum safety standard, not your finish line. Many successful athletes aim for 100%+ symmetry before returning to high-level competition.

2. Strength Training Isn’t Optional, It’s Foundational

Strength training helps your muscles, ligaments and tendons develop capacity and better support your knee (as well as other structures). Think of it this way: the more stress your tissues can tolerate, the further you stay from your injury threshold during high-intensity activity.

You don’t need to train like a bodybuilder, but 2 well-structured sessions per week can:

Improve joint stability
Reduce reinjury risk
Support total-body performance

Our team at Vital Movement includes PT’s certified in strength and conditioning, so you get guidance built specifically for athletes.

3. Recovery Basics Will Make or Break Your Progress

It’s tempting to skip the basics in favor of trendy recovery fixes, but for successful healing after an ACL tear, the fundamentals matter most:

Sleep: 7-9 hours per night
Nutrition: Prioritize whole foods and protein intake
Hydration: Consistent water consumption throughout the day
Stress management: Both physical and mental stress affect healing

Want to optimize your progress? Nail these first then you can add in ice baths and compression boots.

4. Volume Spikes Are the Enemy of Your Knee

One of the most common causes of re-injury after an ACL tear is doing too much, too soon.

If you're getting back to sport or training after time off, give your body at least 1-2 weeks to ramp up intensity. Sudden jumps in speed, load, or frequency can overload healing tissue and increase risk of setbacks.

In addition to gradual progression, incorporating planned deload weeks (periods of reduced training volume and intensity) allows your knee to recover and adapt. Deloading helps prevent overtraining, reduces inflammation, and keeps your progress sustainable over the long term.

Slow, steady progressive loading combined with strategic deloading is key to lasting results.

5. The Mental Hurdle Is Just as Important as the Physical

Expect to deal with some fear, hesitation, and confidence issues as you return to sport. It's completely normal to feel anxious about cutting, pivoting, or landing after an ACL tear - even when you're physically cleared for activity.

This psychological component isn't always weakness - it's your brain trying to protect you from reinjury. Force plate testing often aids in revealing these mental barriers objectively, showing differences in power output and braking forces between legs even when athletes feel like and look like they're moving normally.

Working through these mental barriers with gradual exposure and building confidence through successful movement experiences is crucial for full recovery.

An ACL tear can feel like a major setback, but with the right support, it can also be a powerful comeback.

At Vital Movement, we specialize in helping athletes and active adults heal after this injury. From post-op rehab to performance re-training, we help you move better, build resilience, and return to the field stronger than before.

Ready to write the comeback story from your ACL tear? Schedule a free intro call with us now.

Dan Manas