Typical situations we help with
- Freshly reconstructed ACL (hamstring or patellar tendon graft)
- Conservative management without surgery
- Extension deficit, swelling or a "dead leg" feeling in the first weeks
- Strength side-to-side difference and fear of loading months after surgery
- Uncertainty about when running, jumping and competition are allowed again
- Rehab already finished, but no trust in the knee
Background
Why ACL rehab often ends too early
End of prescription is not end of rehab
Six or twelve prescribed sessions cover the early phase. The strength work that prevents re-rupture starts afterwards – exactly where standard care usually stops.
Strength deficits stay invisible
Without testing, a leg with 25 % less quadriceps strength feels "normal". Only measurement reveals the side-to-side difference – the key risk factor for re-injury.
Time instead of criteria
"Nine months and you are cleared" is not a criterion. Clearance needs strength values, hop symmetry, landing mechanics and psychological readiness.
Our approach
Your rehab in four phases – defined by markers, not by weeks
Every phase has entry criteria. You progress when you meet them – not when the calendar says so.
Phase 1 · Acute & mobilisation
Pain-free · full extension · pain-free gait
Swelling management, mobility, quadriceps activation (incl. EMG biofeedback), gait re-education with and without crutches. Entry: post-op or directly after diagnosis. Exit: full passive extension, pain-free 180° gait without limp.
Phase 2 · Strength & control
Symmetrical strength · stable single-leg stance · clean running mechanics
Progressive strength on medical devices, single-leg control, trunk and hip stability, closed-chain loading. Entry: full extension & pain-free gait. Exit: quadriceps side-to-side difference < 25 %, clean single-leg squat, pain-free jogging.
Phase 3 · Capacity & running
Strength symmetry < 10 % · controlled plyometrics · running load capacity
Heavy slow resistance, criteria-based running progression, plyometric progression, landing and change of direction. Exit: strength difference < 10 %, symmetrical countermovement and drop-jump landing, 30-minute run without reaction.
Phase 4 · Return-to-sport
Criteria-based clearance
Performance Lab test battery: isometric strength, hop test series (LSI > 90 %), jump symmetry, sport-specific loading, ACL-RSI questionnaire. Clearance only after all test criteria are met.
Building blocks
What we work with
Performance Lab
EMG, strength and jump diagnostics: we measure deficits instead of guessing.
Medical Equipment Training
Progressive strength work on medical devices – the lever for lasting capacity.
Manual Therapy
Joint and tissue techniques to quickly restore mobility and modulate pain.
Sports Physiotherapy
Pro-level return-to-sport – Bundesliga practice applied to your rehab.
Recovery Suite
Compression, cold and recovery support between training loads.
Training
Supervised athletic and build-up training after rehab.
What we base this on
- Criteria-based clearance clearly reduces re-rupture risk compared with time-based decisions (Grindem et al., BJSM 2016).
- A quadriceps side-to-side difference below 10 % is a core clearance criterion; every additional delay of clearance until all criteria are met further reduces risk.
- Psychological readiness (ACL-RSI) predicts return to competitive sport independently of strength.
- Hop-test symmetry > 90 % and normalised landing mechanics are internationally established return-to-sport markers (van Melick et al., BJSM 2016; Webster & Hewett, JOSPT 2019).
FAQ