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ACL physiotherapy London

If you’re looking for anterior cruciate ligament (ACL) physiotherapy, and need a therapist who is thorough and thinks outside the traditional physiotherapy box, then look no further!

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0207 175 0150 or use the form below and let me help you get better.

Just call my London team on 0207 175 0150 or use the form here.

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ACL tear physiotherapy treatment

The anterior cruciate ligament (ACL) is one of the key ligaments in the knee. Its main role is to provide proprioceptive feedback to the brain about the position and movement of the knee joint. This allows the brain to coordinate the surrounding muscles to stabilise and protect the knee.

I tend to think of joints as having three lines of “defence” (which possibly comes from my lacrosse days!) The first line of defence is your muscles, which need to be strong and flexible, and able to produce power and active control, and adapt to the unexpected.  The second line of defence is your ligaments and joint capsule, which support the muscles; and the third line is the shape of your bones.  If one of your defenders is compromised, then the others need to step up to compensate.

ACL tears commonly occur during sports like football, rugby and skiing due to sudden changes in direction or landing from jumps, or through tackles or accidents in which the foot is fixed and the body moves over your shin. The ACL can become damaged when the knee joint is not adequately supported by the muscles in these situations.

Not every ACL tear requires surgery, though most do.  Around a third will respond well to “conservative treatment ” (i.e. physiotherapy), a third will need surgery fairly soon after injury, and the remaining third will opt for conservative treatment at first, but ultimately end up having surgery. But unless there are exceptional circumstances, most people should look to have some physio treatment first, even if only to prepare you for surgery.  Patients who have undergone pre-operative physiotherapy tend to do much better after the surgery.

What to expect from an ACL physio assessment

The first thing to expect is that we’ll be having a long chat!  I need to understand exactly how you damaged it, and what your symptoms are – are we looking at pain, swelling, giving way etc. I also need to understand what you’re hoping to be able to do with it!  For example, are we aiming to get you back to being able to walk to the shops; or do you want to be able to play full-contact rugby or ski moguls?

Next, I’ll be carrying out a thorough assessment to understand the extent of the ACL injury and identify any weaknesses affecting knee stability.  Within the limits of your discomfort, we’ll test your leg strength, balance and flexibility, to help identify which structures need targeted treatment. For example, muscles may need strengthening or flexibility improved to better support the knee.

Working this out may involve imaging such as X-ray or MRI; and we will definitely talk to other specialists.  This will probably primarily be an orthopaedic knee surgeon, but depending on what else we find, we may include a radiologist, a neurologist, a sports doctor or a rheumatologist.  If you do not already have a trusted knee surgeon then I can make recommendations.

ACL rehabilitation London

Specifically what we do when we undergo physiotherapy treatment for an ACL tear depends on our starting point and our goals. However, in general we will initially focus on reducing pain and swelling, and restoring normal movement patterns.

As you progress, the focus will move towards improving leg strength, balance, proprioception and coordination, aiming to enhance dynamic knee stability from the surrounding muscles and tendons.

Landing, agility and technique training helps retrain normal movement patterns; and in the later stages of rehab we will look to integrate your whole body into your treatment – it’s never just about the knee!

If surgery is required, we will go through prehab which prepares the knee joint structures for the operation; and we will then continue post-op to restore function and enable return to sport. ACL surgery is serious and you should be looking at 9-12 months of post-op rehab.

Teamwork between doctors and physios is key to success in this situation if you’re to make the best possible recovery – but don’t forget that the most important member of the team is you!

ACL physio assessments are 90 minutes

Follow-up sessions if required are usually an hour – it’s important to me to be very thorough when it comes to anterior cruciate ligament (ACL), as I want to be the last knee physiotherapist you need.

Nell Mead Physiotherapy YouTube Channel

Where i share my logical and simple formula to help you improve your own body. See all my acl physiotherapy related videos.

ACL specialist physio - Client reviews

"The best physio in town! Nell has been helping with the rehabilitation of an aspiring tennis player following major knee reconstruction and cartilage graft and the results so far have been impressive. Always available for help, advice and those healing hands, Nell is hugely recommended. She has also helped two other members of the family with other issues, all with equal great success. Thanks Nell ;)"
Charlie Carrick
"Attempting to play tennis for 24 consecutive hours is no easy task. Especially with an arthritic knee and a replaced hip! But Nell and her team took care of all of my needs, and made sure that I was still walking (and functioning) at its conclusion. Great knowledge, and a real passion for their work. I would definitely recommend Nell...."
Bright Ideas for Tennis Charity
"I visited Nell recently, having met her a few weeks earlier and describing to her a long-running problem I'd had with my knee. Where others had failed to identify the cause or the cure, her Holmes-like investigative questions and observations soon isolated the cause of the problem (oddly enough a decades-old collarbone break) and she was able to treat it. Remarkable results and I couldn't recommend 'the best physio in London' highly enough. Thank you Nell "
Martin Gladdish

Anterior cruciate ligament (ACL) physio blog

As a leading ACL physiotherapist in London, I regularly write about injuries, treatment and assessment techniques.
Matthew BeckfordMatthew Beckford
10:32 19 Nov 23
I call Nell the final boss of Physios! When I first began seeing here I had a wide variety of problems and pain. She is reassuring, will try out innovative and new ways of treating you and is determined to find the underlying problems which need addressing.
Sarah PembertonSarah Pemberton
13:43 06 Nov 23
Nell is fantastic. I was referred to her by a shoulder surgeon because I'd had serious impingement for several years and other things (e.g. steroid injections) had not helped. At the first appointment I was unable to lift my left arm above chin height. Nell traced the cause to asymmetry from a broken collarbone 16 years earlier. She got the shoulder moving again and I am now rock climbing harder than I was before I got injured. Her combination of manual therapy in clinic and giving me exercises to do at home has proved very effective. Every few months I get some other injury (e.g. broken hand from a fall) and she helps me to promptly rehab it. I've seen a bunch of physios over my lifetime but Nell is without any doubt the best!
Kirsty ClarkeKirsty Clarke
11:13 26 Oct 23
Game changer. Nell seems to have fixed a 10-year problem (plantar fasciitis) in one or two sessions and now we’re seeing what else she can help me improve! As well as being exceptional at what she does, Nell is clearly very passionate about continually learning and is absolutely delightful company too. Worth every penny - best physio I’ve ever seen by some distance, and I’ve seen a lot!
Jane KellyJane Kelly
18:21 04 Aug 23
Nell has an eye for detail and is good at solving complex problems. She is extremely knowledgable, professional and very kind.
Ben TurnerBen Turner
10:54 05 Jul 23
Nell is easily the best physio I’ve ever seen. Having had many disappointing physio sessions over the years, Nell made me feel confident that we really had got to bottom of my knee issue. Not only did she examine my knee, but all of my potential problem areas with instantaneous results. She just gets it, and she’s a lovely person too.
Howard BranleyHoward Branley
17:59 04 May 23
As a medical professional with a running injury, I knew that there was only one person that I needed to see. Nell’s approach was holistic and focussed on finding the source of the issue rather than just trying to treat a symptom in isolation. Nell’s approach was calm, professional and caring. She followed up the consultation with a number of exercises to do. Her treatment plan worked like a dream and I wouldn’t hesitate in recommending her to anyone who’s struggling with an injury, pain or stiffness. First class from start to finish.
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