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Returning to Play After an ACL Injury or Tear

Recovering from an Anterior Cruciate Ligament (ACL) tear cannot be rushed, especially when athletes are eager to return to their sport. While you may feel better in a few short months after surgery, the new ACL still needs time to heal. Before you get back in the game, your surgeon and physical therapist want to make sure that you have gone through proper training. Your doctor will have you accomplish specific return to play criteria, including a series of physical examinations and tests that determine if muscle strength has been restored in the leg and that the ACL surgery has fully healed.

After you have passed all five phases of ACL surgery rehabilitation, your physical therapist will notify your doctor that you are ready to test for return to play. To be cleared to return to play, your physical therapist will compare your operated leg to your non-operated leg to determine:

  • Restored mobility
  • Flexibility
  • Strength
  • Function

Your physical therapist will communicate the results of your physical testing to your surgeon. Your surgeon will consider the results of your physical testing, the stability of your knee, and possibly imaging.

If your doctor does not clear you to return to play, he or she may recommend the physical therapist work on specific areas to strengthen the leg or to continue practicing agility drills.

After an ACL injury, it’s crucial to focus on:

  • Proper technique with changing directions and landing from jumps
  • Muscle balance of the quadriceps, hamstrings, and hip muscles
  • Core strength

Our ACL sports medicine experts use science-based return-to-play criteria to help provide personalized, sport-specific training so athletes can safely return to sport.

When your surgeon clears you to return to play, you must gradually return to full and normal practice. This phase of recovery helps to improve overall confidence in your knee and your ability to play sports.

Studies show that within one year of ACL reconstruction surgery:

  • Only one-third of athletes return to their previous level of competition
  • Less than 50 percent return to the same level of play within two to seven years
  • Only 81 percent will return to any level of athletic participation

When cleared to return to play, your doctor may recommend wearing a brace while participating in high-risk activities. The brace can help protect the injured leg from contact while also restoring confidence when returning to the playing field.