ACL Surgery – Getting Back To Your Sport

With Advanced Exercise Videos

ACL injury

Two-hundred-fifty-thousand – that’s the number of ACL injuries that occur every year in the United States. Most of these injuries happen in young athletes in sports that involve jumping, pivoting, or hard cutting. One-hundred-thousand is the number of ACL reconstruction surgeries in the US each year1. Just about every athlete wants to know one thing after their ACL surgery…

“When can I get back to my sport?”

To answer this, we’ll look at:
– How much time you should spend in Physical Therapy rehabilitating
– How many months after surgery are proven to give the best outcomes
– Physical requirements for returning to sports

Trust the Process and Give It All You’ve Got

Getting back to your sport is your main focus – I know. I also know that you want to get back as quickly as possible. To get you there successfully, there are 2 questions you should be asking yourself during your rehabilitation process:

1. How can I maximize my recovery to perform at the level I was at before injury?

– Why? Because only 65% of athletes get to this level2

2. How can I prevent getting re-injured?

– Why? Because 23% of athletes younger than 25 returning to sports are re-injured3

These statistics should give you a sense of reality that rehabilitating your knee is important. I can’t tell you how common it is for an athlete to just go through the motions of ACL rehab. They’ll stick around for a couple months and then stop showing up, thinking they’ll be fine once they reach “x” amount of months.

Only 55% of patients participate in regular supervised rehab for at least 6 months after ACL surgery. And only 30% perform jumping, landing, and agility during rehab – this is a shame. But you don’t have to become another statistic – you can become a success story if you follow the proven path…

If you stay motivated for at least 6 months, and give ACL rehab everything you’ve got, the strength and function you gain will give you a high likelihood of safely returning to your sport at 12 months4 .”

How Long Should You Wait to Play Sports After ACL Surgery?

We’ve all heard the success stories – pro athletes defying the odds, coming back from ACL injuries in 6–9 months and performing better than ever. These stories are inspiring, but let’s not overlook the facts – re-injuries can happen. To give you the best chance of avoiding re-injury, it’s best you wait.

Every month after ACL surgery you wait to return to sport, your risk of re-injury goes down by 51% (until 9 months)5.

That’s right, the longer you wait after the operation, the greater your chance of success.

But it’s not just time that matters…

Physical Requirements You Must Meet For Sports

Simply put: your leg needs to be strong. How strong?

The research says you need to be able to perform at least 90% as well as your non-injured leg on hop tests6 , which typically look at the distance and quality of your jumping and landing.

Another determining factor is your Quadriceps strength – they need to be at least 90% as strong as your non-injured leg7.

A great way to test the strength of one leg versus the other is by performing single leg rises from a 90-degree bend.
– Sit on a bench
– Stick your Right leg out in front of you and rise up to a standing position using only your left leg
– Repeat as many times as you can without any rest between repetitions
– Then compare that number to your other leg

A recent study looked at the number of repetitions you should be able to perform to have a good long-term outcome after ACL reconstruction. Less than 22 repetitions of single leg rises is associated with decreased knee quality-of-life 3 years after surgery 8. 22 reps isn’t easy – so get to work!

Bottom line: strength matters!

ACL Rehab Advanced Exercises

Here’s some ways you can work on strengthening your leg and, as it gets stronger and as your therapist advises, to start incorporating more explosive plyometric and lateral exercises – all to get you primed and ready to get back to what you love.

1. Single leg squats


2. Plyometric Depth Jumps


3. Ice Skaters


Question: What exercises have you found to help maximize strength after ACL surgery? You can leave a comment by clicking here.

  1. Logerstedt DS, et al. Knee stability and movement coordination impairments: knee ligament sprain revision 2017. Clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2017;47(11):A1-A47.doi:10.2519/jospt.2017.0303.  ↩
  2. Ardern CL, Taylor NF, Feller JA, Webster KE. Fifty-five per cent return to competitive sport following anterior cruciate ligament reconstruction surgery: an updated systematic review and meta-analysis including aspects of physical functioning and contextual factors. Br J Sports Med. 2014;48:1543–1552.–2013–093398  ↩
  3. Wiggins AJ, Grandhi RK, Schneider DK, Stanfield D, Webster KE, Myer GD. Risk of secondary injury in younger athletes after anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Am J Sports Med. 2016;44:1861–1876.  ↩
  4. Ebert JR, et al. Strength and functional symmetry is associated with post-operative rehabilitation in patients following anterior cruciated ligament reconstruction. Knee Surg Sports Traumatol Arhroscop. 2017. Sep 15. Doi:10.1007/s00167–017–4712–6.  ↩
  5. Grindem H , et al. Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Osio ACL cohort study. Br J Sports Med. 2016;50(13):804–8.  ↩
  6. Grindem H , et al. Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Osio ACL cohort study. Br J Sports Med. 2016;50(13):804–8.  ↩
  7. Grindem H , et al. Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Osio ACL cohort study. Br J Sports Med. 2016;50(13):804–8.  ↩
  8. Culvenor AG, et al. Dynamic single-leg postural control is impaired bilaterally following anterior cruciate ligament reconstruction: implications for reinjury risk. J Orthop Sports Phys Ther. 2016;46(5):357–64.  ↩
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