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When can i play sports again after ACL Surgery?

You Cannot Prevent Injuries but we can Provide the Right Means to Prepare you for the Demands of Your Sport

Post-op timelines are variable depending on post-op precautions/restrictions put in place by your surgeon and how quickly your post-op pain and swelling resolves.  Without post-op complications, most individuals are cleared to return to running 12-16 weeks post-op.  At 6 months, most individuals are cleared to return to practice and training for their desired sport and will be fitted for a brace prior to this.  It typically takes a full 12 months to not only be cleared to play in competitive games, but to be at your full speed, strength and previous ability.  

Return to play decisions are multi-factorial and depend heavily on a variety of factors such as your ability demonstrate appropriate functional movement patterns, ability to run/jump/change direction without compensatory strategies and the sport in which you are returning too.  Greater caution may be utilized for those returning to heavier contact sports such as football, ice hockey or lacrosse.  There several return to play tests that are utilized to determine your status such as the ACL Hop and Stop Test, Y-Balance Test, Selective Functional Movement Assessment and the Drop Jump Test.

Guidelines for ACL Return to Sport

Weeks 0-4

  • Decrease pain & swelling
  • Improve range of motion
  • Normalize gait pattern
  • Initiate Blood Flow Restriction training when cleared

Weeks 5 - 12

  • Initiate global strengthening program
  • Improve multi-directional locomotive patterns
  • Begin pre-running preparatory exercises
  • Y - Balance Test practice and performance → Aiming for >95% Symmetry

Weeks 13 - 20

  • Beginning jogging program *Time frame depending on post-op protocol from surgeon
  • Progressive plyometric, hopping, jumping and landing activities
  • Implementing multi-directional and transitional movements on turf
  • Functional Hop Testing practice and performance
  • Initial Return To Sport (RTS) testing for Completion

Months 5 - 9+

  • Increasing gradual participation in sports related activity
  • Full performance of RTS testing with desired >95% symmetry
    • YBT, Hop Test, Strength, Running Tests
  • No contact drills until cleared by surgeon and successful passing of RTS testing
    • Research shows reinjury rate decreases by ~50% each month from 6-9 Months
    • After 9 months to 2 years, reinjury rate plateaus
    • 84% lower reinjury rate in patients who passed full RTS testing criteria

 

 
*Simple decision rules reduce reinjury risk after Anterior Cruciate Ligament Reconstruction: The Delaware-OSLO ACL Cohort Study Br J Sports Med. 2016 July ; 50(13): 804–808. doi:10.1136/bjsports-2016-096031.