ACL Rehab after Surgery

Anterior Cruciate Ligament Reconstruction (ACLR) is one of the most commonly performed surgeries by orthopedic surgeons. Unfortunately, there is a high prevalence of re-injury after surgical reconstruction, especially in young athletes returning to pivoting sports.

In order to optimize recovery and minimize risk of re-injury, a thorough rehabilitation protocol which empowers the patient to achieve objective milestones is recommended. The rehabilitation protocol outlined below is a guide for the athlete and the rehabilitation specialist to help every individual achieve their goals in a safe and efficient manner.

Although the rehabilitation protocol is milestone driven, the timeline provided should be used as a guide. Each athlete will have a unique journey and should be treated on an individual basis; therefore, some criteria might not be fully met prior to progressing onto the next phase. The rehabilitation specialist should use their clinical reasoning skills and shared decision making with the athlete to guide the process. Ideally, ALL milestones should be met before progressing to the next rehabilitation phase.

To ensure safe progression of rehabilitation by the surgical team, we recommend that post-operative assessments are sent to the surgical team at 6 weeks and 6 months after surgery. These assessments will allow the team to monitor adequate progression of rehabilitation and guide any further necessary treatment. Optional assessments at 8 to 12 months can be completed depending on the desired level of activity after surgery.

The research literature strongly supports the importance of quadriceps strength, adequate neuromuscular control and effective biomechanical movement strategies to reduce the stress at the knee joint. The improvement of these objectives combined with the successful progression of acceleration, deceleration, jumping and agility tasks will likely reduce the potential of re-injuries and facilitate return to sports.

Return to sports is usually acceptable at 9 months post-operatively to allow for healing. However; objectives, timelines and readiness should be discussed with the surgeon and rehabilitation provider.

For higher risk* or elite athletes, a more complex biomechanical evaluation can offer further objective data to inform and guide the late stages of the rehabilitation process.

ACL Protocol - Intro.pdf

Download PDF • 843KB