Anterior Cruciate Ligament Tear

What is an ACL Tear?

The anterior cruciate ligament (ACL) is one of the four main ligaments that ensure the stability of the knee joint, and specifically prevents the tibia from sliding forward. ACL tears occur as a result of sudden changes in direction, incorrect landing after a jump, or a direct blow to the knee. They are common in sports requiring high speed and sudden manoeuvres such as football, basketball, skiing and volleyball. A "pop" sound at the moment of injury, rapid swelling and knee instability are typical signs.

Conservative or Surgical Treatment?

The choice of treatment for an ACL tear is determined by the person's age, activity level, the presence of other ligament and meniscal injuries, and functional goals. Arthroscopic ACL reconstruction is often preferred in competitive athletes and those performing pivoting activities, while comprehensive conservative rehabilitation may be sufficient for low-activity individuals.

ACL Rehabilitation at ROMMER

At ROMMER, ACL rehabilitation is conducted with evidence-based, specific phase protocols for both conservative and post-surgical cases:

• Acute Phase (Weeks 0–2): Control of swelling and pain, quadriceps activation, achieving full knee extension and initiating weight-bearing.
• Subacute Phase (Weeks 2–6): Completing range of motion, proprioception and neuromuscular control exercises, progressive increase in muscle strengthening.
• Strengthening Phase (Weeks 6–16): Quadriceps and hamstring strengthening, single-leg balance work, foundation for sport-specific movements.
• Return-to-Sport Phase (Months 4–9): Retraining of running, cutting and jump-landing mechanics; return-to-sport criteria are evaluated with biomechanical testing.
• Neuromuscular Training: Risk of re-injury is reduced through proprioception, balance and coordination work for knee stability.

When is Return to Sport Possible?

For safe return to sport after ACL reconstruction, functional tests must be passed (quadriceps strength symmetry index ≥90%, single-leg hop tests). At ROMMER, the return-to-sport decision is made according to these objective criteria — functional-based progression is the principle, not calendar-based.