Healthy Minute: Rehabilitating after ACL Reconstruction

A torn anterior cruciate ligament (ACL) is one of the most common sports injuries – especially for athletes in sports like soccer, football, and basketball that require changing direction rapidly and stopping suddenly. It’s also one of the most common knee injuries in general for non-athletes and can occur while performing activities such as doing yard work, walking downstairs, or stepping out of a vehicle.

The ACL is a ligament in the middle of the knee that prevents your lower leg bone from moving too far forward on the upper leg bone. Additionally, the ACL is crucial to your knee’s stability.

If you tear your ACL, in most instances you’ll need ACL reconstruction surgery. Wondering how long the recovery will take after your surgery? Here are guidelines from Rich Green, a physical therapist and DMOS Orthopaedic Center’s Director of Physical and Hand Therapy. These timeframes are approximate, and can vary by individual:

Month 1

You’ll wear a leg brace and immediately start physical therapy several times per week. Physical therapy will focus on range of motion, strength, balance, walking and proprioception. Proprioception is your body’s automatic awareness of itself and ability to unconsciously correct course if you lose balance. Activity will be limited.

Month 2

The leg brace comes off. Intensive physical therapy continues. If healing is progressing well after two months, you’ll work on recovery more on your own with less frequent visits to your physical therapist. Limitations on activity will still exist.

Month 3

You’ll be able to return to traditional strength training, but no pivoting or twisting.

Month 4

Begin hopping and jumping.

Months 4 – 6

Athletes begin testing with their physical therapist to determine what further therapy is needed to help return to full participation.

Months 6 – 9

Athletes can generally return to competition.

“Most protocols state that athletes are safe to return to competition after six months if certain criteria are met,” Green said. “However, research is finding that a larger percentage of people who have ACL reconstruction have a recurrence either in the same knee or the opposite knee within 1-3 years of returning to competition.

“The criteria for athletes to return to play revolves around factors such as range of motion, leg strength and jump testing,” he continued. “But we’re learning that it depends quite a bit on the individual’s confidence level. By identifying those factors throughout the rehabilitation, we are able to address them and create a safe environment for them to return to their sport.  We want to get each person truly ready so they they’re less likely to experience an injury again.”