Pivot

Safety: what Pivot does and does not do

Last updated: 21 October 2026

Review pending

Awaiting physiotherapy review. The symptom lists and the advice below are word for word what the app shows, so this page and the app always give the same advice. A physiotherapist is reviewing whether that advice is right, and the review is not finished.

This page sets out what Pivot can and cannot do for you. A rehabilitation app that is vague about its limits is unsafe. The page is linked from inside the app.

If something is wrong now

Do not use this page to work out what is happening. Contact someone.

Call 999 or go to A&E now. Tell them you have had recent knee surgery. Do not wait for a physiotherapy appointment, and do not do today's session.

For any of these:

Breathlessness or chest pain. Sudden shortness of breath, chest pain or coughing up blood, particularly with any calf symptoms.
A foot that is cold, pale or blue. A foot or toes that look pale or blue, or feel cold compared with the other foot.
Sudden severe pain, far worse than it should be. Pain that has come on or built up quickly and is much worse than anything so far, particularly with a tight, swollen calf or leg, or numbness or weakness in the foot.
Feeling very unwell. Confused or very drowsy, breathing very fast, skin that is mottled, blue or very pale, or not having passed urine all day.

A cold or pale foot, or pain far out of proportion, can mean a problem with the blood supply or the pressure inside the leg. Feeling very unwell after an operation can be sepsis. These conditions can become serious within hours, which is why they go straight to 999 or A&E.

Contact 111 now, or 999 if you have chest pain or breathlessness. Tell them you have had recent knee surgery. Do not wait for a physiotherapy appointment, and do not do today's session.

For:

Calf pain, or a calf that feels hot, hard or swollen. Pain, tightness or tenderness in the calf of either leg, or a calf that is warm, red or noticeably bigger than the other.

This can be a sign of a blood clot. Clots are a recognised risk after knee surgery and are treated urgently. A clot in the leg needs assessment the same day. A clot that has reached the lungs is an emergency: chest pain and breathlessness can mean this, and they are in the 999 list above.

Contact your surgical team today. The number is on your discharge letter. If you cannot reach them, call 111. Do not wait for your next physiotherapy appointment, and do not do today's session.

For any of these:

Feeling hot and shivery, or a temperature. Feeling feverish, shivery or flu-like, or a temperature of 38°C or more. You do not need a thermometer for this to count.
Fluid, pus or increasing redness from a wound. Any discharge from the incisions, redness spreading outwards from them, or a wound that has opened.
Unable to put weight on the leg after a fall or a twist. A fall, a twist or a knock, and since then you cannot take weight through the leg the way you could before.

Contact your physiotherapist or surgeon today. If you cannot reach either of them, call 111. Do not do today's session.

For any of these:

The knee locking or getting stuck. The knee catching, jamming, or refusing to straighten or bend past a point.
The knee giving way. The knee buckling or shifting under you, whether or not you fell.
Swelling that has come on suddenly. A knee that has become visibly more swollen over hours rather than gradually, or swelling after a specific incident.
Numbness, pins and needles or weakness. New loss of feeling, pins and needles, or weakness in the foot, toes or lower leg.
Sharp pain, or pain much worse than it has been. A sharp, catching or stabbing pain, or pain that is clearly worse than it has been and is not settling.

If you are having rehabilitation without surgery

The same symptoms, with three differences. There is no wound, so there is no wound sign. Fever, and not being able to take weight after a fall or a twist, go to your GP. And what to tell 999 or 111 is your knee injury, not an operation:

Call 999 or go to A&E now for the four symptoms in the first list: Call 999 or go to A&E now. Tell them about your knee injury. Do not wait for a physiotherapy appointment, and do not do today's session.
Contact 111 now for calf pain or a hot, hard or swollen calf: Contact 111 now, or 999 if you have chest pain or breathlessness. Tell them about your knee injury. Do not wait for a physiotherapy appointment, and do not do today's session.
Contact your GP or 111 today for a fever, or not being able to take weight after a fall or a twist: Contact your GP today. If you cannot get an appointment, call 111. Do not wait for your next physiotherapy appointment, and do not do today's session.
Contact your physiotherapist today for the knee locking or giving way, sudden swelling, numbness or weakness, or sharp or much worse pain: Contact your physiotherapist today. If you cannot reach them, call 111. Do not do today's session.

Without an ACL, a knee that gives way can damage the cartilage and the meniscus, so tell your physiotherapist the same day it happens.

What Pivot is, and what it does not do

Pivot is a companion to your physiotherapist. It shows the typical programme for the stage that you and your physiotherapist say you are in. It demonstrates each exercise, times your sets, sends reminders and keeps a record you can share with your physiotherapist. It is not a medical device, and not something to rely on alone.

Pivot does not:

Assess a symptom. The warning signs above are the same page for everyone. Pivot does not tell you what a symptom means, how likely it is to be serious, or whether you can wait. It does not record or follow up what you read there.
Decide when you move on. Your physiotherapist decides when you go to the next stage, and you tell Pivot when they have. Pivot shows what physiotherapists usually look for, beside your own numbers, and never moves you on by itself.
Change your programme from your medical details. Your graft, any other repair, your measurements, your check-ins and your surgeon's instructions are kept as your record, and none of them changes the exercises. Each exercise states what is usually advised after particular grafts and repairs. You and your physiotherapist decide what applies to you.
Tell anybody. No clinician, no next of kin, nobody. Pivot is not a monitoring service, and nobody at Pivot sees what you record.

Pivot cannot call an ambulance and does not know where you are.

Why it works this way

Deciding whether a symptom matters, whether a knee is ready for the next stage, or what a recovering knee should and should not do this week is clinical reasoning. An app that did this from a few taps would be guessing, at the moments that matter most. A sore calf at 11pm three weeks after surgery may be nothing, or the start of something serious. A phone cannot tell the difference.

For this reason Pivot will not reassure you. It has no way to know whether you are well, and an app that said so anyway would be worse than one that says nothing.

The programme, and its limits

The exercises, doses and timings are a conventional programme based on published consensus. It is the same for everyone at the same stage, and it is not a prescription for you.
Your physiotherapist decides when you move on. Pivot never moves you on by itself, and never because of time alone. The one exception is the day of your operation, when Pivot moves you from Pre-hab to the first stage because the operation has happened.
On a sore day, you choose. An easy day reduces the session to the core exercises. Pivot does not make that decision from your check-ins. If pain or swelling stays high, tell your physiotherapist.
If your physiotherapist or surgeon has given you something different, follow them. You can hide any exercise they have not asked for, or enter their programme yourself and Pivot will run it.
The notes on each exercise, such as “after a meniscal repair, usually not before about 18 weeks”, describe what is commonly advised. Your surgeon knows details of your operation that the app does not.

What you record, and how it can mislead you

The numbers you record are for you and your physiotherapist. Pivot shows them beside what physiotherapists usually look for, and does not judge them. A number measured wrongly can still mislead you, so every measurement screen includes instructions.

If you are unsure whether you are measuring correctly, ask your physiotherapist to watch you do it once. It takes a minute and makes every later reading more reliable.

Who this is for

People aged 16 and over recovering from ACL reconstruction, waiting for it, or managing a torn ACL with rehabilitation and without surgery. If you are under 18, use Pivot with your surgeon's or physiotherapist's agreement. If you are still growing, follow the programme they give you, because surgery and rehabilitation are different for a growing knee. Pivot is not a programme for other knee surgery, and not a general training plan.

Contact

support@broadai.co.uk, for anything about the app.

Not for anything about your knee. We are not clinicians and do not answer clinical questions. Answering them is what this page says the app does not do.