In this episode of the RX Physiotherapy Podcast, Trent Cooksley dives into the biomechanics behind ACL injuries and re-injuries.

Drawing from landmark video analysis research and current return-to-sport evidence, we unpack:

• Why ACL injuries occur within 40–50 milliseconds of ground contact
• The role of knee valgus, internal rotation, and near-full extension
• Why ACL injuries are often a system failure — not just a knee problem
• The importance of quadriceps strength in reducing re-injury risk
• How fatigue alters landing mechanics late in games and seasons
• Why young athletes are up to 15x more likely to sustain a second ACL injury

ACL injuries are rarely random.
They are predictable.
And that means they are modifiable.

If you’re an athlete, coach, parent, or clinician, this episode is essential listening.

In our next episode, we’ll explore non-surgical ACL rehabilitation and what to expect from that pathway.

Disclaimer: Before making any health changes, consult with a healthcare professional.

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An ACL injury is one of the few injuries where people are asked to make a permanent decision within days — swollen knee, unclear scans, season pressure… and somehow you’re expected to already know if you want surgery.

In this episode of the RX Physiotherapy Podcast, Trent Cooksley unpack what surgery actually does, and what it doesn’t.

Because here’s the truth:
Surgery restores anatomy.
Rehab restores capacity.

We explore the research behind immediate vs delayed reconstruction, why rehab quality matters more than surgical timing, and how strength, confidence, and knee stability should guide decision-making — not fear or urgency.

This conversation isn’t about choosing sides. It’s about slowing the process down, understanding your options, and making an informed decision based on how your knee responds to structured rehab.

If you or someone you know is navigating an ACL injury, this episode offers clarity grounded in evidence — not pressure.

Disclaimer: Before making any health changes, consult with a healthcare professional.

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An ACL injury can feel overwhelming. In the first few days, opinions come fast — you’ll need surgery, your season is over, your knee will never be the same. But the evidence tells a very different story.

In this first episode of our ACL series, physiotherapist Trent Cooksley breaks down what actually happens during an ACL injury and why rushing decisions early can lead to poorer outcomes. We explore the true role of the ACL, how these injuries occur, and why the ligament alone does not determine your future function.

Drawing on landmark research and modern rehabilitation frameworks, this episode explains:

• What the ACL actually does (and doesn’t do)
• Why ACL injuries aren’t “bad luck” but influenced by movement, load, and fatigue
• What matters most in the early stages after injury
• Why rehab-first approaches are evidence-based, not “second best”
• How strength, capacity, and confidence — not timelines — guide return to sport

An ACL injury is not a career-ending diagnosis, and surgery is not always inevitable. With the right information, time, and rehabilitation, outcomes improve — with or without surgery.

This episode sets the foundation for the series. In Episode 2, we’ll explore surgical vs non-surgical management and how to decide which path is right for you.

Disclaimer: Before making any health changes, consult with a healthcare professional.

Connect with us:

• Dive deeper into health tips and stay updated by following us on Instagram.
• Explore exclusive offers and discover additional resources on our website.