The patient-physiotherapist tango: a personalized approach to ACL recovery, a qualitative study

Key points

1. 01Patients described rehabilitation as a roller coaster of physical and psychological ups and downs, including setbacks where progress had to be paused for pain and then restarted.
2. 02Tailoring exercises to each person's needs, equipment, and goals (for example adapting around home setup and return to football) made rehabilitation feel personalized.
3. 03Reaching goals and regaining lost function, such as being able to jump sideways on one leg again, were major sources of satisfaction and happiness.
4. 04A friendly, trusting physiotherapist-patient alliance let patients ask any question and feel cared for, sometimes 'like I'm his only patient'.
5. 05Patients valued physiotherapists who were committed, professional, and acted as a guide who pushed them to do the right things in the right amount.

How it was conducted

Design

Qualitative interview study using semi-structured interviews and inductive content analysis

Participants

14 people who had undergone ACL reconstruction, 8 to 12 months after surgery

Grafts

Mostly hamstring autograft, with two patella (bone-patellar tendon) autografts

Analysis

Codes grouped into 8 sub-categories and 3 main categories under one overarching theme

What they found

• Analysis produced one overarching theme, three main categories, and eight sub-categories.
• Three main categories were: rehabilitation as a roller coaster of physical and psychological challenges; patient involvement; and the physiotherapist as stronger together.
• Sub-categories under patient involvement included tailored treatment, continuous dialogue with the physiotherapist, and factors giving satisfaction such as reaching goals and regaining function.
• Sub-categories about the clinician covered the physiotherapist-patient alliance (connection, friendly relationship, good cooperation) and physiotherapist qualities (committed, professional, acting as a guide).

Limitations

• Small qualitative sample of 14 patients from a single sports medicine setting, so findings describe experiences rather than measuring effects or generalizing.
• All participants were interviewed only 8 to 12 months after surgery, capturing one recovery window and relying on recall.
• Self-reported interview accounts are subjective and may be shaped by satisfaction with their own physiotherapist.
• No quantitative outcomes, control group, or measure of how these experiences relate to clinical recovery.

Why it matters

For patients

You can expect ACL recovery to have emotional highs and lows, and it is reasonable to ask your physiotherapist to tailor exercises to your goals and life and to build an open, trusting relationship.

For clinicians

Beyond prescribing the right exercises, invest in a trusting alliance, individualized tailoring, continuous dialogue, and shared goal-setting, since patients link these to feeling their care is person-centered.

For readers

This qualitative study maps what person-centered ACL rehabilitation looks like from the patient's perspective, highlighting the physiotherapist relationship as central.