The Standard for ACL Rehabilitation
Criteria-based rehabilitation guiding athletes back to sport
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A Clear, Structured Path After ACL Injury
An ACL injury brings a lot of uncertainty — for athletes and parents alike.
Questions usually come fast:
Are we doing the right things early on?
How do we know when it’s actually safe to progress?
What happens after basic rehab ends?
At Primal Recovery, our goal is to remove that uncertainty.
We guide ACL athletes through a criteria-based rehabilitation process designed to support them from the early stages of recovery through a confident return to sport. Progression is not based on timelines or visit limits, but on demonstrated readiness, supported by objective testing and consistent supervision.
This allows families to understand:
Where their athlete is in the process
What needs to improve next
Why certain progressions are (or are not) appropriate
No guessing.
No rushing.
Just a clear plan forward.
Why Criteria-Based Rehabilitation Matters
Time alone does not determine readiness after ACL injury.
Athletes return to sport safely when they demonstrate:
restored strength and symmetry
controlled movement under load
tolerance to running, cutting, and reactive demands
confidence in sport-specific environments
Our programs are built to assess and develop these qualities systematically, using monthly performance testing to guide progression and decision-making.
This approach reduces uncertainty for families and supports long-term durability for athletes.
Experience That Brings Perspective
ACL rehabilitation is a central focus of our practice.
300+ ACL athletes treated and guided back to sport
Youth, high school, collegiate, and competitive adult athletes
Experience across all major graft types and surgical approaches
Athletes from soccer, basketball, football, volleyball, hockey, and more
That experience informs how we structure care, communicate with families, and make return-to-sport decisions.
If you’d like to better understand how this process works and which option is most appropriate for your athlete, we recommend starting with a Discovery Call.
We are proud to have served and continue to serve athlete's in the following organizations:
What Athletes and Families Are Saying
Zack was the only person I met with pre surgery who gave me an outline of what my next few months would look like based on how i was performing and not just how many weeks it had been since surgery. I’m about 6 months out now. Most of my test numbers already look better than they did before injury. I would 100% recommend Primal Recovery to any athlete with going through acl rehab or any injury for that matter.
Zack is amazing! I spent several weeks with him during my offseason and he was a joy to work with. I’m feeling fit and strong and ready for the upcoming season! He’s the best!!! I would highly recommend!
Primal Recovery has absolutely changed my body. Zack & Spencer actually focus on fixing the problem rather than just putting a bandaid on it. I have been dealing with hamstring issues for over 8 years, and after working with Zack for just 2 months my hamstrings are stronger than ever and I no longer feel pain in them. He has taught me how to fire all of my muscles in the proper way. I’m going into my 5th year as a professional soccer player in the NWSL, and I have never felt more confident in my muscles and my body. Thank you will never be enough!!!
I have been working with Zach for 5 years now. He is very knowledgeable about how to keep players healthy as well as rehabbing injuries. He uses functional movement techniques specific to your sport. Zach truly listens to the athlete to create the best plan possible for them. Not only that but he works his butt off day and day out to be the best physical therapist in the country!
Dr Nolff is one of the most knowledgeable people i’ve ever interacted with. He has dedicated his valuable time to help me recover from my ACL injury.
Zack is extremely knowledgable and was so helpful in my recovery and prevention of my minor soft tissue and joint issues over the off-season. He was very flexible and understanding in my schedule and finding times to get sessions in. He consistently checked in to see how things were going. I would highly recommend Zack to anyone, especially in the soccer area, who is looking for assistance.
Zack has been awesome helping me rehab my ankle sprain! His soccer-specific techniques were truly exceptional. Tailoring the rehab process to focus on soccer-related movements made a significant difference in my recovery. The personalized approach and take home programs not only accelerated my healing but also improved my overall performance on the field. Grateful for his expertise and dedication to his clients.
Great ACL rehab, these guys are amazing
I would highly recommend Primal Recovery PT and Performance! As a professional athlete, being injured not only affects my lifestyle but more importantly my job. Recently, I had a calf injury and could not train or walk without pain. This was weeks before playing in the TST 7v7 soccer tournament in Cary, North Carolina. I sent a message to Zack and immediately got a response for an appointment. Not only did he significantly help but I saw immediate results and have not had any calf pain since. He is an extremely dedicated, professional, and personable physical therapist. I would recommend him to all ages of athletes. I will continue to see him through different injuries that will arise through my career. I can’t thank him enough!
What Makes Our ACL Program Different
ACL rehabilitation should feel organized, intentional, and steady — not confusing or reactive.
At Primal Recovery, our goal is to guide athletes and families through the entire process with clarity. We do this by combining structured progression, frequent supervision, and objective testing so that every step forward is earned and understood.
A Process You Can See and Understand
From the beginning, we outline how ACL rehabilitation works and what success actually looks like.
Families are not left guessing:
where their athlete is in the process
what the current priorities are
or what needs to happen before progressing
Instead of chasing timelines, we follow a clear progression built around readiness and performance benchmarks. This transparency helps athletes stay focused and helps parents feel confident in the decisions being made.
Priorities That Set the Tone for the Entire Recovery
Restoring motion, managing swelling, and reestablishing quadriceps control are treated as essential, not optional. These early priorities influence how quickly and how safely an athlete can tolerate loading, running, and higher-level demands later in the process. By addressing these fundamentals thoroughly, we reduce the likelihood of lingering issues that can stall progress down the road.
Consistent Supervision, Not Isolated Sessions
ACL recovery does not happen in isolation.
Through our membership-based model, athletes can train under professional supervision multiple days per week. This allows for:
consistent reinforcement of proper movement
real-time adjustments to loading and technique
progression based on how the athlete is responding, not just what’s written on a plan
This level of access and oversight is difficult to achieve in traditional, visit-based care.
Continuity From Rehab to Performance
Rehabilitation does not stop once pain is reduced or basic strength is restored.
As athletes progress, their programming evolves seamlessly from early rehabilitation into higher-level strength work, running progressions, and sport-specific demands — all within the same environment and under the same standards.
This continuity builds confidence and prevents gaps during the most important phases of recovery.
Continuity From Rehab to Performance
Managing fatigue, soreness, and training tolerance is a necessary part of long-term progress.
Access to recovery tools and strategies allows athletes to maintain consistent training volumes while supporting tissue health and overall readiness. Recovery is treated as part of the rehabilitation process, not something separate from it. Includes: Normatec Compresssion Therapy, Sauna, Cold Plunge, Massage Guns, Cupping, Scraping, and Dry Needling.
Return to Sport Is a Transition, Not a Moment
Returning to sport is not a single clearance decision.
We guide athletes through progressive exposure to running, cutting, and reactive demands while coordinating with coaches and sport environments as appropriate. The goal is to ensure athletes return prepared — physically and mentally — rather than simply “released.”
Decisions Guided by Objective Testing
Progression is supported by monthly performance testing that evaluates strength, symmetry, and movement capacity.
This data helps:
identify what is ready to progress
highlight what still needs attention
support return-to-sport decision-making
Testing provides clarity for athletes, parents, and clinicians alike.
The Primal ACL 5R System
A Criteria-Based Pathway From Injury to Confident Return
Every athlete progresses through the same structured framework. Progression is not based on time since surgery — it is based on meeting clear criteria that demonstrate readiness for the next stage.
This creates clarity for athletes and families, and it ensures return-to-sport decisions are earned, not rushed.
R1 — PREHAB / RE-SET
Build the foundation before surgery (or immediately after injury)
Primary goal: Prepare the athlete to enter surgery (or early rehab) with the best possible starting point.
What we focus on:
Restoring full knee extension and improving flexion
Reducing swelling and improving comfort with daily activities
Re-establishing quadriceps activation and control
Building baseline strength where appropriate
Education for the athlete and family (what matters, what to expect)
What parents should expect:
A clear plan for what needs to happen first
Guidance on what to do (and what to avoid)
Communication with the surgical team when appropriate
R2 — RESTORE
Restore motion, control swelling, and normalize movement
Primary goal: Rebuild the essentials that must be in place before higher-level loading.
What we focus on:
Full knee extension, progressing flexion as tolerated
Swelling control and tissue tolerance
Quadriceps control, gait normalization, basic mechanics
Foundational strength patterns and movement re-education
Building confidence with safe, repeatable progressions
What parents should expect:
Frequent check-ins and consistent supervision
Clear priorities (not random exercises)
A calm, organized process focused on the essentials
R3 — REBUILD
Build strength, symmetry, and the engine that supports running
Primary goal: Develop the strength and capacity needed to tolerate progressive running and higher training loads.
What we focus on:
Progressive strength development (quads, hips, hamstrings, calves)
Symmetry and movement quality under load
Introducing impact tolerance and controlled plyometric foundations
Return-to-run preparation using criteria-based checkpoints
Continued programming updates based on response and testing
What parents should expect:
Structured progression that feels like “training,” not endless rehab
Regular updates to keep progress moving
Monthly performance testing to confirm readiness
R4 — REACT
Train the unpredictable demands of sport
Primary goal: Prepare the athlete to handle cutting, deceleration, jumping, reactive movement, and sport-specific chaos — safely.
What we focus on:
Change-of-direction progressions (planned → reactive)
Deceleration and landing strategies under fatigue
Speed development and exposure to higher intensity
Plyometric progressions (unilateral emphasis)
Sport-specific movement demands and decision-making
Building confidence in the athlete’s knee and movement
What parents should expect:
Clear progressions that don’t “jump steps”
On-field or field-based progressions where appropriate
Communication with sport coaches around training integration
R5 — RETURN
Return to sport with confidence, clarity, and proof
Primary goal: Ensure return to sport is based on readiness, not hope.
What we focus on:
Monthly performance testing continues, with emphasis on RTS standards
Return-to-sport testing battery and report
Structured ramp back into practices, then competition
Coordination with surgeon, coach, and athlete around return plan
Ongoing support through the transition (return is a phase, not a moment)
What parents should expect:
Clear testing results and what they mean
A structured return plan (not “you’re cleared, good luck”)
Ongoing guidance as sport loads increase
MONTHLY PERFORMANCE TESTING - BUILT INTO MEMBERSHIPS
Your memberships include monthly return-to-performance testing to objectively track:
strength and symmetry
movement strategy and quality
power/plyometric readiness
progress toward return-to-sport criteria
This is how we reduce uncertainty and prevent rushed decisions.
How To Get Started
STEP 1
Book your discovery call below.
STEP 2
Book Your Initial 60-Minute Evaluation
STEP 3
Build Out Your ACL Program And Get Scheduled
STEP 4
Adjust Plan Monthly Based On Testing Results.
Office: 36600 Plymouth Rd, Livonia MI 48150
Office: 783 Industrial Court Bloomfield Twshp MI 48302
Call 248-814-2029
Email: info@primalrecoverypt.com
Site: www.primalrecoverypt.com
