Getting back to sport after ACL reconstruction is a major goal for many patients, but it needs to be done safely to protect the knee and reduce the risk of another injury. The journey involves time for the graft to mature, structured rehabilitation and assessment of both physical and psychological readiness.
Early rehab focuses on controlling swelling, restoring knee extension and gradually rebuilding quadriceps and hamstring strength. Over the following months, patients progress to bike work, gym-based strengthening and balance drills, followed by straight-line running and then change-of-direction and sport-specific drills.
Evidence suggests that returning to high-risk pivoting sports before 9 months after surgery is associated with a significantly higher rate of re-injury. For each extra month that return to sport is delayed between 6 and 9 months, the risk of another knee injury may decrease, so patience and adherence to the program are important.
Before clearance to return to sport, strength and hop tests are often used to compare the operated and non-operated leg, aiming for as close to symmetry as possible. Confidence, movement quality and the ability to perform sport-specific skills under fatigue are also considered, not just time since surgery.
Working closely with a specialist knee surgeon and sports physiotherapist throughout recovery helps ensure that any concerns are addressed early and that return-to-sport decisions are based on objective measures as well as individual goals. This team approach supports a safe, durable return to the activities patients enjoy most.