If you have been unlucky enough to have suffered a total Anterior Cruciate Ligament (ACL) rupture and subsequent surgical reconstruction then this information should be very relevant to you.

The following protocol has been designed using research based on accelerated ACL rehabilitation and from clinical experience. It was originally compiled by Grant when he was working at the Musculoskeletal Centre of Excellence, BUPA Wellness, Barbican, London, UK, so thank you to the staff there for their valuable input at that time. It has been updated now to apply to our Willis Street Clinic. This protocol is primarily designed to be used with patella tendon grafts, but can also be applied to hamstring graft reconstruction. However, any pure hamstring exercises need to be started very gradually and will also be delayed with tendon grafts. Although this protocol has been carefully designed it MUST be stated that these guidelines are dependent on:

• type of ACL reconstruction; patella tendon or hamstring graft 
• surgeon’s protocol 
• extent of injury (involvement of other structures).
• Bracing may be used by the surgeon to maintain joint integrity and control functional range of motion.
• Braces may be worn for 5-10 weeks (advised by surgeon)
• Patients must sleep in the brace and perform exercises with the brace on in the early stages.

A good outcome from ACL reconstructive surgery is dependent on: 

• good pre-operative management 
• surgery delayed for at least 4 weeks 
• effective ‘hands-on’ rehabilitation 
• controlled milestone rehabilitation
• the use of closed kinetic chain exercises in rehabilitation following ACL reconstruction, and using open kinetic chain exercises when the athlete is looking to do sport–specific drills at around 4-5 months and advancing prior to resuming competition around 9-12 months.