In Part 1 of this series, we spoke with Dr Foo Gen Lin, Sports & Orthopaedic Surgeon at Apex Sports Clinic based at Core Clinic, who shared how he assesses patients in the post-operative stages of ACL
(anterior cruciate ligament) recovery. Drawing from his own experience as a former ACL patient, Dr Foo highlighted the importance of clinical assessments, timing, and collaboration with physiotherapists before patients are cleared to return to sports.
In Part 2, we turn to the team at AMP Lab — Physiotherapist Cherie, Exercise Physiologist Etienne, and Dr Foo himself — to understand the rehabilitation protocols and sports-specific assessments they implement to ensure patients return to play safely and confidently.
From Surgery to Sport: The Four Phases of ACL Recovery
Dr Foo shares that he typically follows a structured four-phase process to guide patients through their ACL recovery journey:
1. Protective Phase (First 2–3 weeks post-surgery)
During this initial stage, the focus is on protecting the new ACL graft from unnecessary strain. The primary goal is to avoid doing too much too soon, which could jeopardise the success of the surgery.
2. Range of Motion Phase (Weeks 4–6)
In this phase, the emphasis is on regaining full extension and flexion of the knee. The objective is to ensure the knee can fully straighten and bend to a sufficient degree before progressing to more advanced exercises.
3. Strengthening Phase
At this stage, rehabilitation shifts to rebuilding muscle strength and improving joint stability. The goal is to restore at least 70% of the strength of the non-injured leg before introducing running into the recovery program.
4. Return to Sport Phase
The final phase focuses on sport-specific movements, dynamic control, and psychological readiness. To advance safely, the patient should have regained at least 90% strength compared to the non-injured leg, successfully pass functional tests, and feel mentally prepared to resume sport.
Before Sport, Comes the Return to Running
Returning to running is a critical milestone in ACL recovery, typically reached around three to four months post-surgery. At this stage, the team adopts a gradual and progressive approach. Patients begin with brisk walks of up to 5km, slowly advancing to light jogging, and eventually transition into running.
However, the focus isn’t solely on increasing distance — ensuring proper biomechanics is just as important. Dr Foo assesses patients on a treadmill using
RunEasi, a gait analysis tool worn at the waist. This device measures key data points such as cadence, ground impact on each leg, running symmetry, and core stability. These indicators provide valuable insights into whether the patient is progressing safely and efficiently.
Strength, Movement Quality, and Functional Testing
Once patients regain about 70% strength of their non-injured leg, rehab shifts toward targeted strength-building and movement quality assessments. At this stage, Cherie and Etienne closely monitor patients’ form and function. Cherie on movement analysis: “We record the patient from multiple angles and compare pre- and post-intervention footage. You can often hear the difference — less pounding, more bounce, smoother strides. That’s when we know the changes are working.”
As strength builds to 90%, patients are put through hop tests:
Passing these tests signals readiness for reintroduction into sport-specific training.
Whole-Body Rehabilitation: Beyond the Knee
Cherie also emphasises that ACL rehabilitation must go beyond just the knee. “Many non-contact ACL injuries stem from deficits elsewhere — hips, ankles, or previous injuries. We don’t just rehab the ACL; we evaluate and treat the body as a whole.” Pain during the return-to-running phase — especially anterior knee pain — is common and can indicate other contributing factors like quad weakness or patellar tendon irritation. Customisation is critical. “There’s no hard-and-fast rule,” she says. “Some days, the body just doesn’t cooperate. We always listen to the patient and adjust accordingly.”
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Exercise physiologist Etienne conducts agility drills to ensure that the patient is ready to return to their sport.
Once cleared for sports-specific training, Exercise Physiologist Etienne steps in to bridge rehab and performance. He works not just with patients, but also with coaches and parents to:
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Understand the unique demands of the sport
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Modify drills accordingly
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Prevent re-injury through progressive return-to-play planning
Etienne evaluates patients' psychological readiness: “If a patient isn’t mentally confident, they’re not ready—even if they’re physically prepared. A lack of confidence often leads to hesitation, which increases injury risk.” His approach? Apply the same return-to-sport protocols used for elite athletes, scaled for everyday athletes, so that patients can enjoy the sport again, safely and sustainably.
Many patients wonder: Why do professional athletes return to sport so much faster after an ACL tear?
Cherie offers a grounded perspective: “Are you doing physiotherapy twice a day like they are? Do you have a whole team managing your recovery around the clock? If not, it’s not realistic or healthy to compare your timeline to theirs.”
Returning to sport after an ACL injury isn’t just about hitting a timeline — it’s about achieving strength, symmetry, movement quality, and mental readiness. Thanks to a collaborative ecosystem of surgeons, physiotherapists, and exercise physiologists at Core Collective, patients benefit from comprehensive, customised care — with access to full gym facilities, treadmill gait analysis, and expert guidance every step of the way. Want to learn more about ACL recovery options at Core Collective? Contact
Dr Foo from Apex Sports Clinic or the team at AMP Lab for a consultation.
Featured Contributor:
AMP Lab
AMP Lab specialises in three types of services, and they are physiotherapy, exercise physiology and sports science. They aim to deliver the best physiotherapy and performance coaching by helping their clients achieve their health, fitness and sporting goals with the right attitude, a steady mind and peak physique.
They are the first wellness company in Singapore to offer physiotherapy, exercise physiology and sports science services in a single entity to provide the best possible and holistic healthcare/fitness solution for you.
Connect with AMP Lab on their website, Facebook, Instagram and LinkedIn.
Core Collective is home to over 100 fitness, wellness, beauty and lifestyle and medical professionals who can help you live your best life. Book a tour to get started today!
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