How Sports Massage can help with ACL Rehab

Oct 19, 2021

One of the most common sports injuries is an anterior cruciate ligament sprain or tear. It’s the one you often see impact top level (or wannabe top level!) footballers or basketballers. And it’s one that can be difficult to recover from, often requiring surgery and subsequent physiotherapy to ensure it heals correctly.

If you are suffering with an anterior cruciate ligament (ACL) injury, sports massage should definitely be on your list of options to consider. Whether you’ve had a reconstruction but not received the subsequent rehabilitation post-surgery, or you’ve been cleared by your surgeon and physio but your ACL is giving you issues again after a period of time, sports massage is the perfect way to work on the affected area and improve your quality of life and ability to exercise.

In this tutorial, I’m talking about the anatomy of the knee and how sports massage can work to improve ACL outcomes.

The anatomy of the knee

While you might think the knee is relatively straightforward joint as it mainly bends forwards and backwards, you couldn’t be further from the truth. The knee and surrounding area actually houses a huge amount of ligaments, tendons, muscles that wrap around it and many, if not all of them, will be impacted if there is a degree of injury, or has been corrective surgery, in the area.

The importance of the cruciate ligaments

In short, there are three bones that meet to form your knee joint. The thighbone, or femur, coming down from your hip, the shinbone, or tibia, coming up from your ankle and then the patella, or kneecap, that sits in front of the joint, offering some protection to the knee.

These bones, as with all joints are connected by ligaments, some of which travel alongside your joint, supporting the knee and controlling sideways motion, while others, the cruciate ligaments, are found inside the knee joint. The anterior cruciate actually sits in front of the posterior cruciate, forming an “X” shape right inside the middle of the knee, behind the patella.

The anterior cruciate ligament is vital to stop the tibia from sliding in front of the femur and it also provides rotational stability to the knee. Cartilage and tendons play their part as well.

Because of this complex make-up of the knee, if you injure these deep-set ligaments it’s very likely you’ll find there are more issues than just the cruciate, which means any treatment will need to focus not only on that individual ligament, but all of the interconnecting parts and the way they work together.

You can see more of the anatomy of the knee in the video above.

What are we looking for during assessment?

When we look at assessing for cruciate damage, we need to consider that when these ligaments are compromised, they will compromise the basic stability of the knee. It will be normal to find a degree of tension and tightness in the area as other muscles and tendons move to pick up the slack. We need to take into account the long tendons that reach from the hamstring down to the shin bone and the gracilis and sartorius muscles that wrap around the quadriceps and onto the outside of the pelvis. Grastrocnemius, the muscle of the lower leg, will also likely need some degree of therapy. We may find, too, that you have developed scar tissue where surgery took place – this will also need some work.

As part of the assessment process, we’ll be looking at a range of motion, both flexion and extension, but not necessarily rotation of the knee. During the session I’ll be palpating, or prodding, feeling the tension of the various areas and looking for scar tissue which may or may not be directly underneath your surgery scars.

Setting goals for sports massage treatment

In the vast majority of cases, the goal of treatment will be to improve the range of movement. We’ll also look at reducing pain levels and improving any issues with stability. As the ligaments, tendons, fascia and muscles all work together to keep everything working as it should, even just one of those tissues being compromised can offset the whole system. This means we need to work on a complete rebalancing or restabilisation from the knee itself and up into the quadriceps and hips if necessary.

How does sports massage for ACL work?

When you come in for a sports massage we will likely be focusing on:

  • Quads
  • Hamstrings
  • Gastrocnemius
  • Adductors
  • Gracilis insertion
  • Sartorius
  • Scar tissue
  • Glute medius & minimus

Again, you can find out more about these in the video. But in summary, over a number of sessions we’ll be working to ease tension and tightness in these tissues as well as working through any scar tissue that might be causing problems, breaking it down so the muscles and tendons can rebuild themselves properly.

This usually involves focusing on quads and hamstrings to start with, focusing on the inside of the knee to work on the flexion and extension and looking at any medial knee pain. And as the sessions progress, we’ll introduce the gastrocnemius and the glute minimus as we move further away from the knee.


Unfortunately, ACL rehab is not magic, there will be a period of time over which improvement and rehabilitation of the tissues happens. But if you’ve had an ACL reconstruction and you’re in those initial phases, or you’ve had surgery a couple of years ago and you’re experiencing pain around the knee, sports massage therapy really could be the solution you’re looking for.

To book a Sports Massage in Bristol click here

Stay connected with news and updates!

Join our free monthly newsletter to receive the latest news and updates from our team.
Don't worry, your information will not be shared.


50% Complete

Two Step

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.