Ski Knee Injuries ACLs R Us

Its ski season again.
The blue skies, the power, the exhilaration of speed. and with all fabulous time on the slopes comes the excitement and risk. If you push yourself outside your comfort zone, as we all do at times, you may then be unlucky enough to sustain an injury.
Preparation is everything. Here at Balance Performance Physiotherapy  in Clapham we are specialist rehabilitators for knee ligament and meniscal injury, especially the Anterior Cruciate Ligament (ACL).

CALL US on 020 7627 2308 to speak to one of our expert physiotherapists and ski injury/prevention  specialists

With 25 years experience of treating knees comes the knowledge of how to prevent treating these injuries.
Obviously an unlucky wipe-out happens like any other road traffic accident, or unexpected fall etc but being more resilient to falls, slips, hits, and twists will undoubtedly give you a better experience of the slopes  and help prevent those moments when you push your body to the edge both on your skis or snow board.

Come and ask our team at Balance how we can help you with

  • biomechanical  assessment
  • strength assessments,
  • 1:1 sessions and
  • Circuit classes


You may have been unlucky enough to have recently torn an anterior cruciate ligament or ACL. Where better to learn more about the rehabilitation than from the ACL rehabilitation specialists at Balance Performance Physiotherapy. We not only have

  • many years of experience
  • developed an impressive building
  • rehabilitation specialist gym facility t,

making BALANCE PERFORMANCE the obvious choice for any ACL injury in London.


An ACL rupture is one of the most devastating injuries you can sustain. The ACL is a ligament that stabilises the knee joint and connects the thigh and shin bones. Rehabilitation exercises and continued strengthening of the leg muscles around the knee are important to prevent reinjury to repaired ACLs. Physiotherapy is an integral part of the treatment and is recommended to start as early as possible. Preoperative physiotherapy (PREHAB) is helpful to better prepare the knee for surgery. The early aim is to regain range of motion, reduce swelling and achieve full weight bearing.

The remaining rehabilitation will be supervised by one of our physiotherapists and will involve specific and specialist exercises pitched at the functional stage of recovery specific to your rehabilitative and pathological timeline. Other activities such as cycling, swimming, proprioceptive exercises and muscle strengthening will be advised.

Don’t assume that a physiotherapist with space, gym and exercise experience can do an equal job. Its not about just doing so many reps of an exercise, its about the quality of exercise needed.


There are certain hoops to jump through after an ACL reconstruction . Main ones being

  1. Non weight bearing exercises
  2. Range of movement exercises
  3. Weight bearing exercise
  4. Rotational exercise
  5. Impact exercise
  6. Rotational impact exercises
  7. Running drills
  8. Strength to Power
  9. Speed agility quickness
  10. Acceleratory decelerator torque
  11. End stage sport specific  challenging drills
  12. Sport specificity throughout


Cycling can begin at 2 months, jogging can generally begin at around 3 months. The graft is strong enough to allow sport at around 5 months and contact sport at 7-9 months (dependent on preinjury fitness levels) however other factors come into play such as confidence, motivation, fitness and adequate fitness and training.

The rehabilitation and overall success of the procedure can be affected by associated injuries to the knee such as damage to meniscus, articular cartilage or other ligaments.


The following is a 5 stage rehabilitation protocol useful for patients and other therapists. It is a guide only and must be adjusted on an individual basis (bespoke is key) taking into account pain, other pathology, work and all other factors.




  1. wound healing and mobilise patella
  2. reduce swelling with ice, compression
  3. regain full extension ( by 2 weeks) and range through exercise and stretches
  4. .full weight bearing
  5. wean off crutches
  6. promote muscle control
  7. static cycling




  1. full active range of motion
  2. normal gait
  3. minimise swelling and pain
  4. develop muscular control for controlled pain free single leg lunge
  5. avoid hamstring strain
  6. develop early proprioceptive awareness



  1. begin hamstring loading
  2. increase holistic & leg strength
  3. promote good quadriceps control in lunge and hopping activity in preparation for running




  1. continue to improve leg strength including the progression of running and loads, torques, speed and acceleration/deceleration
  2. develop running endurance speed, change of direction
  3. advanced proprioception
  4. work n endurance
  5. integrate holistic strengthening and resilience
  6. prepare for return to sport and recreational lifestyle
  7. to cope with gradually more and more chaos



  1. Safe return to sporting activities or full lifestyle
  2. Progressing return every step of the way – increasing intensity and complexity in preparation for drills that one might be expected to do at training
  3. Improve performance and fitness beyond preinjury levels
  4. Full weight bearing range, no effusion, good quadriceps control.
  5. Circumference measures of thigh and calf to be within 1 cm of other side.
  6. Return of total confidence of use.

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