When Can i run after acl surgery?
One of the most common questions buzzing around the minds of athletes who’ve undergone ACL (Anterior Cruciate Ligament) surgery: “When can I safely run after ACL surgery?”
Deciding when it’s safe to start running again after surgery isn’t super simple. It’s a big deal because it shows you’re getting back into your sports and activities. People often say it’s safe to start running again around 12 weeks after surgery, but really, it’s more about how well your knee is doing rather than just counting the weeks. So, we like to use performance based criteria rather than time to guide a safe return to running.
Does time heal?
Although time shouldn’t be used as a predictor for readiness to run, it should still be taken into account.
Significant healing of the ACL graft happens in the first 12 weeks. However, it is generally the weakest at this point compared to straight after surgery. This is because it starts to proliferate from about 4 weeks – meaning the graft tissue is going through a phase of healing. This phase is arguably the most important and is a time when you want to be careful about the exercises and activities you do to avoid re-injury or impair healing.
Whilst time is important, it does not take into account the physical or mental readiness to recommence running.
Criteria based approach
Every person and every knee is different. Let’s check out this example.
Person A: Is 12 weeks post-surgery, has had an ACL reconstruction using a hamstring graft, has recovered very well and has ticked off all return to running markers.
Person B: Is 12 weeks post-surgery, has had an ACL reconstruction using a quadriceps graft, has taken slightly longer to recover, and has ticked off some but not all return to running markers.
If we only use time (12 weeks) as a marker for running, Person B will be running with a much higher risk of joint swelling, graft re-injury or delayed healing.
For this reason, a criteria based decision should be made, when the person is ready. This may be at 12 weeks or up to 16 weeks (or more).
This approach takes into account the person’s individual progress as opposed to a one-size-fits-all model. It also provides your physiotherapist a clearer, evidence based and more robust roadmap for return to running. You should feel more confident that your therapist is using a framework and not “guessing” when you’ll be ready.
What milestones do i need to achieve to safely run after acl surgery?
Here are evidence based measures used to determine if you’re ready to run.
Remember, every person’s rehab journey will be different. One person may tick this checklist off in 8 weeks, and others not until 16 weeks. In saying this, you can expect to start running around the 12-16 week mark. Don’t make the mistake of comparing your rehab journey to another person’s.
Your therapist should be assessing your knee regularly throughout your physiotherapy rehabilitation to gauge strength, stability, mobility, response to exercise and readiness for progression.
Key points
- A criteria based approach should be used when deciding your readiness for running.
- The most common time to run is around 12 weeks post ACL surgery.
- Time does not take into account an individual’s needs or knee health.
- To minimise risk and ensure you’re safe to return to running, your physio should be regularly assessing your knee and making sure you meet the criteria to run.
We’ve helped hundreds of athletes recover from surgery. With the right support, guidance and expertise, you can return to running and full function with full confidence. If you want results, visit our sports physiotherapy clinic in Altona North and see one of our experienced physiotherapists who will guide you through your ACL rehabilitation.