When to return to sports after ACL surgery

Written by:  Paul Kochoa, PT, DPT, OCS, CKTP, CGFI

Many times I’ve been asked by a patient that’s had reconstructive surgery for their ACL: “When can I go back to playing ______?”  I tell them that returning to sports after an ACL surgery depends on many factors.  A study in the Journal of Orthopedics and Sports Physical Therapy can help though.

The ACL, anterior cruciate ligament, is an important static stability structure of the knee.  It controls rotation and forward/backward movement in the knee joint itself.  It also is a key component for balance and joint position feedback to the brain.  Without the stability of an intact ACL, sports-related movements such as running and cutting or jumping and landing can be painful or unstable.  It can rupture in contact and non-contact sports on a variety of surfaces.  Depending on the type of activity that the person wants to return to, reconstructive surgery may or may not be indicated.

In the JOSPT journal, patients who underwent reconstructive ACL surgery were compared to athletes with healthy knees in several tests similar to those used by the National Football League in their NFL Combine.  Athletes were asked to hop on their ACL-repaired leg and compared those results with their uninjured leg.  Of nine different tests, three hop tests were sensitive enough to indicate differences in non-injured and post-op legs.  The tests were:  single hop forward, three hops forward, and the cross-over hop.  For how to perform these tests, check out this picture)  In these tests, the post-op leg covered only 92%, 91%, and 92% of the distance, respectively, of the uninjured side.

Performance on these tests indicated the stability and strength of their injured versus non-injured side, and thus can represent the risk of re-injury.  The post-op leg should perform at least 90% of the uninjured side prior to returning to sports activity.  Using these tests in addition to a thorough physical examination and rehabilitation program can ensure that an athlete can return to their sport with less risk and less pain.

Sports performance is all about observations, tests, and measures.  This is objective and measurable data that can determine the difference between a win and a loss.  Physiotherapy is similar.  Objective tests and measures and evidence-based rehabilitative techniques can determine the difference between a successful outcome or less than optimal results.

So if you’re an athlete that has had reconstructive ACL surgery, try these tests and see how you do.  Remember to seek medical attention if symptoms increase or contact your local physiotherapist for further advice.  If you would like more information, please call Professional Physical Therapy and Training at 973-270-7417.  Our offices are located within the YMCA locations in Madison and Summit, NJ.  You do not need to be a member of the YMCA to visit with us.