ACL Tear Rehab: Duration of Recovery

Can ACL Rehab Be Accelerated for Athletes to Return to Sports?

For many athletes, an ACL tear means the end of the athletic season. An ACL injury can even interfere with being ready for their next competitive season.

As a result, ACL reconstruction is a common surgery for athletes who injure their anterior cruciate ligament (the ACL).

Can ACL tear rehab be sped up? This article describes ACL reconstruction surgery and what it takes to heal from one. It also explains how long you might expect to undergo physical therapy before you can return to sports or other strenuous physical activities.

What Is the ACL?

The ACL is one of four major knee ligaments. Each of these four ligaments is critical in contributing to the stability of the knee joint. Without a functioning ACL, the knee can be prone to the sensation of giving out. This instability can make participation in many sports difficult or impossible.

For this reason, many athletes with an ACL injury choose to undergo ACL reconstruction surgery. Following surgery, there is an intensive rehab period necessary to restore knee function, strength, and stability.

meniscus repair rehab
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How the ACL Is Repaired

When you have ACL reconstruction, a new ligament is created and held in your knee with screws or other fixation devices. The ACL then has to heal in this position in order to withstand the repetitive stress of sports.

The problem with any type of ACL graft fixation method is that, if the graft is repeatedly stressed before it has healed in position, it will eventually fail. That means the new ACL graft can become loose or re-torn.

There are other risks of returning to activity too soon. For example, former NFL wide receiver Jerry Rice famously made a comeback 3.5 months after undergoing ACL reconstruction in 1997. In his first game back, he fractured his kneecap, where the graft was taken from. The new injury ended his season.

The ACL is a crucial ligament that helps support the knee, and injuries to it are common. Surgery to repair an ACL tear requires a rehabilitation period to ensure the knee has properly healed. Appropriate rest and rehab reduce the risk of re-injuring the knee.

ACL Tear Rehab: How Long Does It Take?

The media is filled with reports of athletes who make a fast recovery and return to sports sooner than expected. Does this mean that you can have a faster recovery after surgery for an ACL tear?

Exactly how long the ACL graft takes to heal sufficiently is open to debate. Some sports and activities will place a higher demand on the ACL, meaning more healing may be necessary prior to participation. Most orthopedic physicians agree that a minimum of six months is needed before returning to competitive sports. Because of the potential risks of reinjury, however, most recommend waiting seven to nine months.

ACL rehab can vary. As a result, you should always discuss returning to sports with your surgeon. The type of graft used and surgeon preference can change your recommended healing path. Other procedures performed along with the reconstruction, such as meniscus repairs or cartilage repairs, can also affect your progress.

In addition, ACL rehab is not simply an issue of time. It involves a progression of therapeutic and sport-specific activities. In order to progress from one step of rehab to the next, you must be able to complete certain activities. If you're unable to continue this progression, the pace of your overall rehab may be delayed.

Once you return to playing sports, optimized muscle balance and coordination can actually protect your ACL by minimizing the stress placed on it. That is why working with a physical therapist is so important after ACL surgery.

Summary

Recovering from ACL reconstruction can be affected by a number of factors. The type of graft you have, the level of activity you'll be returning to, and your pace in physical therapy can all change your recovery process. Though athletes are often eager to return to their sport of choice, successful recovery shouldn't be rushed.

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  1. American Academy of Orthopaedic Surgeons. OrthoInfo. Anterior Cruciate Ligament (ACL) Injuries.

  2. Bliss JP. Anterior cruciate ligament injury, reconstruction, and the optimization of outcome. Indian J Orthop. 2017;51(5):606-613. doi:10.4103/ortho.IJOrtho_237_17

  3. Beischer S, Gustavsson L, Senorski EH, et al. Young athletes who return to sport before 9 months after anterior cruciate ligament reconstruction have a rate of new injury 7 times that of those who delay return. J Orthop Sports Phys Ther. 2020;50(2):83-90. doi:10.2519/jospt.2020.9071

  4. Ajuied A, Smith C, Wong F, Hoskinson S, Back D, Davies A. A survey of rehabilitation regimens following isolated ACL reconstruction. JMED Research. 2014;2014(118077). doi:10.5171/2014.118077 

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