Key Milestones in ACL Rehab: A Month-by-Month Breakdown

Recovering from ACL surgery is a journey. While every person heals at their own pace, knowing what to expect during each phase of rehab can ease uncertainty and help you stay motivated. This month-by-month guide outlines the typical milestones during ACL recovery. Keep in mind that everyone’s journey is different and that an ACL timeline is not set in stone – we heal and recover at different rates. This is just an example and is showing you how a structured biokinetics approach supports long-term success.

Why a Month-by-Month Breakdown Matters

ACL rehabilitation isn’t a one-size-fits-all process. Recovery involves several phases, each with distinct goals, challenges, and progress markers. A month-by-month timeline offers:

  • Clear expectations for each stage
  • Guidance on when to progress or slow down
  • A way to monitor your improvements and setbacks
  • Motivation through realistic short-term goals

Let’s walk through what a typical ACL rehab journey looks like, from the moment surgery ends through to return-to-sport milestones.

Month 1: Regain Range of Motion and Control Swelling

Goals:

  • Reduce inflammation and pain
  • Regain full knee extension
  • Begin gentle weight bearing
  • Reconnect with quad activation

What to Expect:

  • You’ll likely wear a brace and use crutches
  • Your biokineticist will help you gently move the knee and begin light isometric exercises
  • Focus on mobility: especially full extension (straightening the knee)
  • Early activation of your quadriceps is critical

Key Exercises:

  • Heel slides
  • Quad sets
  • Straight leg raises
  • Ankle pumps

Tips:

  • Ice regularly
  • Elevate your leg
  • Be consistent, not aggressive

Learn more about how biokinetics can support recovery

Month 2: Build Strength and Walking Confidence

Goals:

  • Walk without crutches
  • Improve knee flexion (bending)
  • Strengthen hips and core
  • Begin closed chain movements (feet planted)

What to Expect:

  • You’ll feel more stable walking but may still have some stiffness
  • Sessions now focus on building strength around the knee and correcting gait (walking) patterns
  • You may start using resistance bands or light gym equipment

Key Exercises:

  • Mini squats
  • Wall sits
  • Glute bridges
  • Step-ups

Tips:

  • Don’t rush walking without a crutch unless your biokineticist gives the green light
  • Be patient with stairs

Month 3: Strengthening and Balance Work

Goals:

  • Increase strength and endurance
  • Improve balance and coordination
  • Move into more functional patterns

What to Expect:

  • Your sessions will now feel more like training
  • Single-leg strength and neuromuscular control become priorities
  • You might feel strong but aren’t ready to run or jump yet

Key Exercises:

  • Lateral band walks
  • Step-downs
  • Balance drills
  • Core strengthening

Tips:

  • Focus on quality of movement, not just reps
  • Expect muscle soreness

Follow our ACL rehab timeline for detailed phase-by-phase guidance

Month 4–5: Plyometrics and Controlled Impact Work

Goals:

  • Introduce low-level jumping and landing
  • Maintain knee control under load
  • Build symmetry between legs

What to Expect:

  • Your biokineticist may assess symmetry between injured and uninjured legs
  • Controlled plyometric drills are introduced
  • You’ll learn how to land properly and safely

Key Exercises:

  • Jump and stick (land and hold)
  • Box step-offs
  • Split squats
  • Proprioception drills

Tips:

  • Focus on soft landings and knee alignment
  • Don’t compare yourself to others—your recovery is yours

Month 6–8: Return-to-Running and Agility

Goals:

  • Resume running under supervision
  • Improve agility and sport-specific patterns
  • Strengthen in all planes of motion

What to Expect:

  • Running may begin around month 6, based on strength and control benchmarks
  • Cutting, pivoting, and lateral movement are reintroduced
  • Your biokineticist will test for readiness with hop and strength assessments

Key Exercises:

  • Agility ladder drills
  • Cone drills
  • Controlled acceleration and deceleration
  • Return-to-run programs

Tips:

  • Use a graded return-to-run plan
  • Don’t rush into full-speed drills

Month 9+: Return to Sport

Goals:

  • Meet criteria for return to sport
  • Continue building sport-specific strength and endurance
  • Finalise psychological readiness

What to Expect:

  • Functional testing (e.g., single-leg hop tests, strength ratios)
  • Clearance for sport based on objective measures, not just time
  • You may continue rehab to prevent re-injury

Tips:

  • Prioritise confidence and control
  • Stay in touch with your biokineticist even after returning to play

Why Working with a Biokineticist Matters

Throughout the ACL journey, a biokineticist ensures:

  • Your rehab matches your individual needs
  • You meet milestones safely
  • Setbacks are managed early
  • Progress is tracked with objective testing

See when to consult a biokineticist for knee pain or post-surgical rehab

Ready to take control of your recovery? Book an ACL assessment today and get a personalised month-by-month rehab plan with one of our biokineticists.