Knee Pain: How Soon Can Athletes Return To Sports After ACL Reconstruction?

Eager To Return To Sports?

For athletes, the pain and discomfort of an anterior cruciate ligament (ACL) injury can be unbearable. Almost all ACL injuries require reconstruction surgery to restore stability and maximum use of the joint. After ACL surgery, the athlete must undergo rehabilitation, which includes managing knee pain and resuming fitness. While many athletes are eager to return to sports, the total recovery timeline depends on several factors.

ACL injuries in athletes

The anterior cruciate ligament is a critical ligament that helps with the stability of the knee joint. This ligament is at the center of the joint, connected to the tibia and fibula. Along with other vital ligaments, the ACL allows athletes in contact sports to perform at a high level. A blow to the knee or an unnatural twist can cause a ruptured ACL. The injury leads to severe knee pain, swelling, instability, and reduced mobility. Athletes in contact sports like football, lacrosse, soccer, and basketball are at higher risk of this type of knee injury. Studies show female athletes are also more likely to experience ACL tears than men.

The power of reconstruction

When an ACL injury occurs, the doctors will classify the injuries as grade 1, 2, or 3, depending on the damage. ACL reconstruction surgery is typically the best treatment for athletes with a grade 2 or 3 tear. The ACL reconstruction starts with an incision along the knee to access the joint. The damaged ligament is then removed, along with any damaged cartilage. The orthopedic surgeon will then install a new ligament constructed from a graft. The graft is either a tendon obtained from the athlete’s quadriceps or a donor. The new ACL is attached to the tibia and fibula with pins, surgical wire, and screws.

Regaining strength after surgery

Anterior cruciate ligament surgery starts a long journey to being pain-free and resuming sports. The general timeline varies, but in most cases, recovery begins almost immediately after surgery. In the first 2 weeks post-op, the goal is to manage knee pain and wound healing. There will be simple exercises to encourage mobility at this time. The next 4 weeks focus on early rehabilitation. A physical therapist guides the athlete through mobility and range of motion (ROM) exercises. Months 2-4 ramp up the intensity of physical therapy (PT) exercises, incorporating more movement. Proprioception exercises are also crucial here so the joint can relearn to move naturally. Months 4-6 increase the intensity even more while incorporating training in the athlete’s discipline. At the 6-month mark, the athlete should feel recovered. However, a complete return to sports can require several more months of conditioning.

Factors affecting recovery

On average, the athlete should expect to take 6-12 months off after ACL surgery before returning to sports. The medical team will clear the athlete once certain conditions are met. However, some factors can shorten or extend the timeline. The degree of injury plays a role. If there were additional injuries to the joint, like a meniscus tear, the athlete may need extra time. Age and previous fitness levels also play a role, as younger athletes are more likely to recover faster. The type of surgery also influences the recovery timeline. Thanks to minimally invasive surgery (MIS), the surgeon only uses small incisions. For the athlete, the benefit is less post-operative pain, faster healing, and fewer complications. With MIS, the athlete can leave the hospital the same day and start recovery almost immediately

Rehab, then return to sports

The timeline for athletes to return to sports after ACL repair is generally 6-12 months. Minimally invasive ACL reconstruction shortens this timeframe. However, there are still factors such as fitness level, injury severity, and age to consider. Athletes should not rush to return to sports, regardless of the circumstances. Spend enough time improving knee strength, managing pain, and restoring fitness. In time, the athlete will return with an even stronger knee, ready to contribute to the team.


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