Written by Zita Sham, Fairuuz Saleh and Shiv Mohan Banka, Principal Physiotherapists at Phoenix Rehab.Clinically reviewed by Louise Yow, Principal Physiotherapist & Director, AHPC A1300363H.Last reviewed 16 October 2026.
How long is ACL rehab?
Most people need 9 to 12 months after ACL reconstruction before going back to pivoting sport such as football, basketball, badminton or netball. Walking without crutches usually comes in the first few weeks and jogging around three to four months. Going back to sport is decided by strength and hop tests against the other leg, not by the date.
The nine-month mark is not arbitrary. In the Delaware-Oslo ACL cohort, the rate of knee reinjury fell by roughly half for each month that return to pivoting sport was delayed, up to nine months after surgery, and patients who passed return-to-sport criteria before going back reinjured less (Grindem and colleagues, British Journal of Sports Medicine, 2016).
| Stage | Typical time after surgery | What it works on |
|---|---|---|
| 1. Calm & Protect | Weeks 0 to 2 | Swelling down, the knee fully straight, the quadriceps switched back on. |
| 2. Move & Mobilize | Weeks 2 to 6 | Full bend, walking without a limp, off crutches. |
| 3. Rebuild & Strengthen | Months 2 to 6 | Quadriceps and hamstring strength against the other leg, single leg control, jogging once criteria are met. |
| 4. Return & Perform | Months 6 to 12 | Hopping, cutting and landing, sport-specific work, and return-to-sport testing before clearance. |
Your surgeon’s protocol takes precedence, and meniscus repairs done at the same operation slow the early stages. If you are past six months and still cannot hop on the operated leg, the Stalled Recovery Review measures where it stopped. Every first visit is one 45-minute Assessment & Treatment, $230, nett, no GST.
Physiotherapy after surgery
ACL Reconstruction Recovery Program
The graft is fixed on day one. The knee you can trust on a side-step takes most of a year.
For ACL reconstruction with a hamstring, patellar tendon or quadriceps graft, with or without a meniscus repair at the same time. A staged physiotherapy program run to your surgeon’s plan, at five Singapore clinics.
No referral needed to start. Bring your operation note, discharge summary or scan report.
Start here
Where are you right now?
An ACL knee is a different problem depending on the week you are reading this. Pick the one that matches.
How the program runs
4-Stage Structured Recovery
You move up a stage when you meet the criteria for it, not when a number of weeks has passed. That is Criteria Before Clearance, and it is why the last appointment is a graduation rather than a discharge.
The shape of it
What happens, week by week
The weeks below are the usual shape after a reconstruction. A meniscus repair at the same time slows the early weeks, and graft type changes some of the detail. Your surgeon’s protocol takes precedence over anything on this page, every time.
- Weeks 0 to 2Stage 1 · Calm & ProtectCrutches as your surgeon directs. Swelling down, the knee fully straight, and a straight-leg raise without the knee sagging. A knee that does not straighten in the first weeks is the one that is hardest to fix later, so this is the first job.
- Weeks 2 to 6Stage 2 · Move & MobilizeOff crutches once you walk without a limp. Bend past 90 degrees and on toward the other side. Static bike, step-ups, and early strength work.
- Months 2 to 6Stage 3 · Rebuild & StrengthenStrength, single-leg control and balance. Quadriceps and hamstring strength tested against the other leg. Straight-line jogging usually starts here, once the criteria are met.
- Month 6 onwardStage 4 · Return & PerformHopping, landing, change of direction, and the drills your sport needs. You go back to pivoting sport when the hop and strength tests say so, and not before nine months.
After the operation
Is this normal?
Usually expected
- Swelling that comes and goes with activity for months.
- A thigh that looks visibly smaller than the other side.
- Numbness on the outer side of the scar, especially after a patellar tendon graft.
- Kneeling that stays uncomfortable for a long time.
- An ache after a long day on your feet, settling overnight.
- Clicking without pain or swelling.
Contact your doctor
- Call 995 or go to the emergency department now: sudden shortness of breath, chest pain, or coughing up blood. After leg surgery these can mean a clot that has traveled to the lungs.
- Doctor the same day: a calf that becomes painful, swollen, warm or tender, which can mean a clot in the leg.
- Doctor the same day: fever, or a wound that is red, hot, opening or leaking.
- Surgeon soon: a knee that locks and will not straighten at all, or a give-way with sudden swelling.
- Surgeon soon: a knee that has not reached full straightening by about six weeks.
- Review soon: no change in range or strength over 3 to 4 weeks of therapy.
We would rather send you back to your surgeon early than be the reason you went late.
If it is not going to plan
Six months on, and it still does not feel like your knee
The surgeon is happy with the graft. You are walking, you are back at work, and you still take the stairs one at a time going down.
You avoid the jump in the futsal game. You never quite put your full weight on that leg when you stand. The thigh is still smaller, you can see it in the mirror, and nobody has measured it since week eight.
A knee that has plateaued after reconstruction is usually a strength problem that has been managed as a pain problem. The pain went. The quadriceps never came back. The fix starts with numbers: strength side to side, hop distance, and how the knee behaves when you land on it.
The Stalled Recovery Review is three appointments, one a week for three weeks, with the same physiotherapist. The first finds what is holding you back. The next two measure how it responds, because what a joint does under load cannot be read in one visit. $690, nett, no GST.
More on what the three appointments cover: the Stalled Recovery Review.
Logistics
When can I…
Your surgeon decides, based on healing and what your job demands. These are typical points, not permissions.
| Activity | Typical point | What has to be true first |
|---|---|---|
| Desk work | 1 to 2 weeks | Swelling controlled, and you can get to work safely on crutches. |
| Driving | 2 to 6 weeks | Off strong painkillers and able to do an emergency stop. Right knee takes longer than left in an automatic. Your surgeon agrees, and check your insurer. |
| Walking without crutches | 2 to 4 weeks | Full straightening and a walk without a limp. |
| Jogging in a straight line | 3 to 4 months | Stage 3 criteria met, including strength and a hop without pain. |
| Gym, legs | From week 2, progressed | Within the exercises your surgeon allows, loaded on criteria. |
| Pivoting sport: football, basketball, badminton | 9 months or later | Stage 4 criteria met, including hop and strength tests within 10 percent of the other leg, and your surgeon’s clearance. |
| IPPT (sit-ups, push-ups, 2.4 km run) | Sit-ups and push-ups often well before the run. The 2.4 km run usually 6 to 9 months or later | Hop and strength tests against the other leg, a continuous run built up to 2.4 km without swelling, and your surgeon’s go-ahead. Your unit’s medical officer decides your medical status and when you take IPPT. |
| Medical certificate | Your doctor issues it | Physiotherapists do not issue MCs. We can write a report on your functional limits for your doctor or employer. |
Questions
Questions people ask after ACL surgery
How long is recovery after ACL surgery?
Most people need 9 to 12 months after ACL reconstruction before going back to pivoting sport such as football, basketball or badminton. Walking without crutches usually comes at 2 to 4 weeks and straight-line jogging at around 3 to 4 months. Return to sport is decided by strength and hop tests against the other leg, and by your surgeon.
How long does it take to walk normally after ACL surgery?
Walking without crutches usually comes at 2 to 4 weeks. What has to be true first is a knee that straightens fully and a walk without a limp. Your surgeon’s instructions on how much weight to put through the leg come first.
When can I drive after ACL surgery?
Usually between 2 and 6 weeks. You need to be off strong painkillers and able to do an emergency stop. A right knee takes longer than a left in an automatic car. Your surgeon has to agree, and check with your insurer before you drive.
When can I go back to work after ACL surgery?
Desk work is usually possible at 1 to 2 weeks, once swelling is controlled and you can get to work safely on crutches. Physical jobs take longer and depend on what the job demands. Your doctor issues the medical certificate. Physiotherapists do not issue MCs.
When can I go back to sport after ACL surgery?
Pivoting sport such as football, basketball and badminton usually comes at 9 months or later, once hop and strength tests are within 10 percent of the other leg and your surgeon clears you. In the Delaware-Oslo ACL cohort, reinjury risk fell for each month that return was delayed, up to nine months.
The program
What it costs and what is in it
ACL Reconstruction Recovery Program, Stages 1 to 4
Per 45-minute appointment, nett, no GST. The ACL Reconstruction Recovery Program is 12 appointments, $2,760 in all. You pay for each appointment as you attend it. If you need more, your physiotherapist shows you which stage criteria are still open, and each extra appointment is $230.
- An Assessment & Treatment first, at $230: which stage you are in, what is limiting you, and a written plan you walk out holding
- Swelling and scar care
- Staged range and strength work, progressed on criteria
- Quadriceps and hamstring strength measured against the other leg
- Hop and landing tests before return to sport
- A home program, written down
- A one-page report to your surgeon at weeks 2, 6 and 12 if you were referred
- Your next stage review dated into the diary, with the same physiotherapist
Graduation, Not Discharge. The program ends when you meet the Stage 4 criteria for the sport or work you are going back to.
Who you will see
Managed by our physiotherapy team
ACL reconstruction sits with the physiotherapy team, with the return-to-sport testing done by the same physiotherapist who saw you in week one. You stay with the same physiotherapist through the program, and every appointment is one to one for the whole 45 minutes.
Fairuuz Saleh
Principal Physiotherapist at Tampines. Post-operative ACL reconstruction and return to sport, hip pain including labral tears, and knee rehabilitation.
This program runs Stages 1 to 4 of the Phoenix Recovery Protocol. It sits under physiotherapy after surgery, alongside the other recovery programs.
Sources
Where the numbers on this page come from
- Grindem H, Snyder-Mackler L, Moksnes H, Engebretsen L, Risberg MA. Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study. British Journal of Sports Medicine, 2016.
Timings on this page are typical ranges, not predictions for any individual recovery, and your surgeon’s protocol takes precedence. Physiotherapists assess, treat, exercise, educate and refer; doctors diagnose, inject, prescribe and order imaging. If we find something that needs medical review we refer you back to your doctor.
Physiotherapy after ACL reconstruction in Singapore
Physiotherapy after ACL reconstruction usually starts within the first week and runs for 9 to 12 months. The early weeks get the swelling down, the knee fully straight and the quadriceps working. The middle months build strength against the other leg. The last stage trains hopping, cutting and landing, and ends with a return-to-sport test, not a date.
Whoever you see for it, three questions at the first appointment tell you most of what you need to know: how your strength will be measured, which tests decide when you can run and when you can go back to sport, and whether your physiotherapist will report to your surgeon.
What has to be true before each next step
| Next step | Typical point | What has to be true first |
| Off crutches | 2 to 4 weeks | The knee straightens fully, you walk without a limp, and the quadriceps can lift the straight leg without the knee bending |
| Straight-line jogging | 3 to 4 months | Little or no swelling after exercise, near-full bend, quadriceps strength at least 70% of the other leg, and a hop without pain |
| Pivoting sport | 9 months or later | Quadriceps and hamstring strength and hop tests at least 90% of the other leg, sport-specific drills without swelling, and your surgeon’s clearance1 |
In the Delaware-Oslo cohort, the rate of reinjury fell for each month that return to pivoting sport was delayed, up to nine months, and patients who passed the return-to-sport criteria reinjured less.1 In a study of professional athletes, those who returned to sport without meeting six clinical discharge criteria had about four times the rate of graft rupture.2 Your surgeon’s protocol takes precedence.
Before surgery: physiotherapy while you wait
Many surgeons prefer to operate on a knee that is not swollen, straightens fully and has a quadriceps that switches on. Physiotherapy before ACL reconstruction works on exactly that, and on walking without a limp. If your operation is weeks away, that time can be used.
Do you always need surgery for an ACL tear?
Not always. In a Swedish trial of young active adults with a new ACL tear, structured rehabilitation with the option of a later operation did as well at two years as early reconstruction, and about six in ten people in that group had not had the operation two years later.3 Surgery is more often advised when the knee keeps giving way, for pivoting sport, or when the meniscus is also torn. If you are deciding, that trial is a fair thing to raise with your surgeon. Whether to operate is your surgeon’s decision.
ACL tear symptoms
A pop at the moment of injury, swelling that builds within a few hours, and a knee that feels unstable or gives way when you turn. The pain often settles within weeks, which is why many people think the knee has healed. The giving way is what remains.
How an ACL tear is diagnosed
A doctor or physiotherapist examines the knee with tests that move the shin forward on the thigh bone or twist the knee under load: the Lachman test, the anterior drawer test and the pivot shift test. A doctor may order an MRI, which shows the ligament and whether the meniscus or cartilage is also damaged.
When to see a doctor after a knee injury
- Go to the emergency department now if the knee looks deformed, you cannot put any weight through the leg, or the foot is pale, cold or numb.
- See a doctor the same day if the knee swells up within a few hours of a twist, or it locks and will not straighten.
- See a doctor soon if the knee gives way when you turn, weeks after the injury.
Reducing the risk of another ACL injury
Structured warm-ups that train landing, cutting and balance lower the rate of ACL injury in team sports, and they are worth keeping after you return. Strength in the quadriceps and hamstrings is the last thing to come back after surgery, so the gym work continues past clearance.
Weeks away from ACL surgery, or past six months and still not trusting the knee on a turn? WhatsApp us to Get Assessed & Treated. No referral needed.
More questions about physiotherapy after ACL surgery
Do I need a referral for physiotherapy after ACL surgery in Singapore?
No. You can see a physiotherapist at Phoenix Rehab Group without a doctor’s referral. Bring your operation note or discharge summary so the therapist works to your surgeon’s protocol. Some insurers ask for a doctor’s referral before they reimburse therapy, so check your policy first.
How often is physiotherapy after ACL reconstruction?
Appointments are usually closer together in the first months and spread out as the home and gym program takes over. Most of the work happens between appointments. Your therapist sets the plan at the first appointment and reviews it at each stage.
Can I do ACL rehab on my own?
Much of it, yes: most of the exercise is done at home and in the gym. What you cannot do on your own is measure it. The strength and hop tests that decide when you start running and when you return to sport need to be tested against your other leg.
What is the return-to-sport test after ACL surgery?
A set of measurements, not a single test: quadriceps and hamstring strength and hop tests compared with your other leg, sport-specific drills without swelling, and your surgeon’s clearance. In a large cohort study, passing return-to-sport criteria and waiting at least nine months were both linked with fewer reinjuries.
Sources: 1. Grindem H, Snyder-Mackler L, Moksnes H, Engebretsen L, Risberg MA. Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study. Br J Sports Med. 2016;50(13):804-808. 2. Kyritsis P, Bahr R, Landreau P, Miladi R, Witvrouw E. Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture. Br J Sports Med. 2016;50(15):946-951. 3. Frobell RB, Roos EM, Roos HP, Ranstam J, Lohmander LS. A randomized trial of treatment for acute anterior cruciate ligament tears. N Engl J Med. 2010;363(4):331-342.
Where are you with this right now?
1. It is settling on its own
Most knee pain that started with a specific moment settles over six to twelve weeks. Swelling that comes and goes with activity, and an ache after a long day, are usual in that window. If it is improving month on month and you can walk, take stairs and sleep, it is behaving normally. You do not need us for this, and we would rather say so.
2. It has stopped improving
You go down stairs one leg at a time. You have stopped squatting to pick things up. You test it before you trust it.
Pain settling is the first thing that happens, not the last. Quadriceps strength is the last thing to come back, and it does not come back on its own. That is the gap worth measuring, and it is not measured by how you feel on the day.
The Stalled Recovery Review is three appointments over three weeks with the same therapist, because what a joint does under load cannot be read in one visit. The first finds what is limiting it. The next two measure how it responds. $690, nett, no GST, which is three appointments at $230.
3. You have had surgery, or you have a date
Recovery after an operation has a shape, and knowing which stage you are in tells you whether you are on it. See the ACL Reconstruction Recovery Program, or knee physiotherapy if you are not sure which applies to you.
All of it runs on the same four stages. The Phoenix Recovery Protocol explains what each stage works on and what you have to meet to move up. No referral needed to start.
Next step
Find out which stage you are in
Pain is the first thing to leave. Movement and strength are the last things trained back, and most people stop before that part is done. One Assessment and Treatment is a single 45-minute appointment at $230, nett, no GST. Your therapist finds what is actually limiting you, treats it in the same appointment, and you leave with your current stage and a written plan.
Prefer to phone? Each of our five clinics has its own number on the clinics page. No referral needed to book.
Related reading
- Netball injuries
- Rugby injuries
- Football injuries
- physiotherapy after surgery
- knee physiotherapy
- Knee Pain Location Chart: Understanding Discomfort Sources
- Dealing with Knee Pain When Bending: A Comprehensive Guide
- Knee meniscal tear physiotherapy
- The Phoenix Recovery Protocol, and the four stages
- All recovery programs, hand and physio
- Dislocated kneecap
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