ACL surgery requires an extensive, specific and long recovery. The ACL recovery process is long in order to limit your risk of reinjury and to give you the best chance of returning to your chosen sport. Most athletes will require 6-8 months of hard work with a physical therapist and/or athletic trainer. Some athletes might need more than 12 months to recover from ACL surgery.
Your recovery from ACL surgery will include both physical as well as emotional or psychological components. The key to avoiding reinjury is to complete the ACL recovery. Research shows that your risk of re-injury can be over 40% if you try to return to sports too soon. Trying to come back before you are physically or emotionally ready might put you at risk for tearing your ACL again. What do we look for from a physical standpoint before allowing an athlete to return to the field following ACL surgery?
ACL tears are usually caused by a non-contact twisting injury. Most athletes recall hearing a pop, or they felt a snap and soon the knee is very swollen. Most high level athletes will chose to have ACL surgery in order to stabilize knee and return to sports.
During ACL surgery, either a repair or a formal reconstruction will be performed. The surgery should be performed by someone who performs many ACL surgeries to give you the best chance of success. Proper surgeon selection is critical. Proper ACL graft selection is critical as well. It has recently been proven that prehab or formal physical therapy before ACL surgery can improve your function and your chances of a successful return to sports.
How Long Is Recovery from ACL Surgery?
Your recovery from ACL surgery will be dependent on many things coming together. The critical components are you, your surgeon, your physical therapist as well as your athletic trainer.
- You need to be driven and willing to put in the effort
- Your surgeon needs to be good at performing ACL surgery.
- Your therapist and athletic trainer need to be well versed in proper protocols for rehab and return to sports criteria.
- You need to understand the “biology of healing”. It can take more than 12 months for some of you to return to sports.
Most athletes will require a minimum of 8 months before considering a return to sports. Returning to sports after ACL surgery prior to that is very very unusual, and very risky. Far too many who return to sports earlier than 6 months were not ready to and risk further injury. The reinjury rate following ACL surgery can be up to 40-50% if you are not properly rehabilitated. The reinjury rate falls to 12-20% if you complete a proper ACL recovery protocol.
Prehab Can Affect Recovery From ACL Surgery
Prehab or physical therapy before ACL surgery has been proven to be beneficial. This rehab should include neuromuscular training, which in the past was reserved for patients after surgery. One of the most significant benefits of meeting your therapist before surgery is that you will become comfortable with them. This will enable you to trust them after surgery when you feel timid about pushing your knee too hard.
Your physical therapist or athletic trainer will usually progress you forward depending on how well you are hitting your milestones. Contemporary rehab programs such as the MOON protocol are based on significant evidence and are milestone driven. Each of you will advance at a different pace through the rehab process. Don’t rush this.. this is a marathon and not a sprint.
Physical and Psychological Aspects of ACL Surgery Recovery
Many of you will note that you are a bit timid or apprehensive about pushing your knee and your new ACL too hard. The psychological aspects of recovery from ACL surgery can not be overlooked. Many athletes have completed their full recovery protocol and were not able to return to sports because they were fearful of reinjury or unsure of themselves. Great therapists and ATCs will help you address both the physical and the psychological aspects of recovery from ACL surgery.
I strongly suggest you read this post about the importance of your therapist in your overall ACL recovery and what to expect.
Recovery from ACL surgery requires a lot of blood, sweat and tears. You will work hard, and in time your body will respond. Having a good team by your side will help you address both the physical as well as the emotional and psychological aspects of your recovery. Do not rush your return to sports. Take the time, hit all your milestones. It will be time well spent.
Morgan says
I recently had an MRI of my knee in which the impression reads ACL tear. However it doesn’t state if it’s partial or complete. In the summary it says multiple ligament out fibers demonstrating discontinuity, while others appear intact. Does this mean it’s not a complete tear? I feel no instability in my knee, and I would like to complete my senior year of cheerleading.
Howard J. Luks, MD says
that seems to be describing a partial tear… but your examination would be able to determine that even better.
Louise Brazil says
Hello I had a full ACL reconstruction approximately one week ago I have been doing leg exercises that they showed me at the hospital I’m waiting to start physiotherapy my question is I ride horses and I also compete in dressage I am also a boxer I suppose my question is how long should recovery time be until I can ride my horse and compete her in dressage as well as writer on the daily basis? Then secondly is about the boxing when can I return two light training and full training to prepare for a boxing match? Or is this something that I am unlikely to be able to do?
The surgeons used the hand string ligament to repair that ACL and on a general basis out of 100% what will I regain of my knee?
Thank you I will look forward to your response
Howard J. Luks, MD says
Louise … your doc will need to give you the specific… but it would take many months before getting back on a horse. It will take longer (8+ months) before being able to box. Hopefully, your doc can offer you more specific guidance based on your recovery during rehab.