Returning to Running After an ACL Injury
Returning to running after an ACL injury can be daunting, especially for athletes who rely on their running performance for their sport. However, with the right rehabilitation approach, it is possible to return to running safely and effectively.
The general timeframe for returning to running after an ACL injury is typically around three months post-surgery. However, this timeline can vary depending on the severity of the injury and the individual’s progress in rehabilitation. Working closely with a physiotherapist or medical professional is important to determine the appropriate timeline for returning to running.
At HKSC+, we closely follow the ‘Melbourne ACL Rehabilitation Guide 2.0’, authored by two prominent Australian sports physiotherapists Randall Cooper and Mick Hughes, for our patients.
Specific to the rehabilitation guide, for one to successfully and safely enter the running stage (known as Running, Agility, and Landings – Phase 3 in the guide), one must meet the requirements and goals at the end of the Strength and Neuromuscular Control phase (Phase 2).The following are the specific movements that are checked for the goals: 1. Passive Knee Extension
- Passive Knee Flexion
- Swelling/ Effusion
- Functional Alignment Test
- Single Leg Bridges
- Calf Raises
- Side Bridge Endurance Test
- Single Leg Squat
- Balance (when eyes open and closed)
- Single Leg Press (on a 45oincline leg press)
- Squatting (Back or Front squat, or Trap Bar squat to 90o Knee Flexion)
These goals coincide with exercises we can use in your rehabilitation program, where we work with you towards achieving the baseline to pass the requirement, and more to prepare you for the next phase. In addition to the core themes of strength, stability, and balance, it is also crucial to improve the flexibility and mobility of the knee joint. This can include stretches for the hamstrings, quadriceps, and calf muscles, as well as foam rolling and manual therapy from a physiotherapist.
When training for re-injury prevention, focusing on proprioception, balance, strength, and mobility is essential. This can include exercises such as squats, lunges, and leg presses, as
well as running and agility drills. It is important to start with low-impact exercises, however, and gradually increase the intensity and volume of the workouts as the knee strengthens. Your physiotherapist will also determine and modify exercise parameters as your performance progresses.
This leads us to the third phase – ‘Running, Agility, and Landings’. By this point, we are seeing you returning to running, agility, jumping, and hopping activities, though this is not to say you can partake in a full-fledged rugby or basketball game just yet. Here we will continue a gym-based strength and neuromuscular program, whilst incorporating change of direction training, start and stops, jumping/ hopping and landing, and perhaps even modified gameplay/ sport-specific movements training under the supervision of your physiotherapist.
It is also important to listen to your body during the rehabilitation process. You shouldn’t be experiencing swelling or obvious pain by this stage but if you do experience pain or discomfort during physical activity, it is important to notify your physiotherapist and ensure you aren’t or haven’t been overdoing your training. Some pain regions are common and expected even after a period of time an ACL repair has taken place. Take a break and allow the knee to rest. Pushing through pain can lead to further injury and delay the recovery process.
In conclusion, returning to running after an ACL injury is possible with the right rehabilitation approach. It is important to work with a physiotherapist or medical professional to determine the appropriate timeline for returning to running. It is also as important that you are committed to the rehabilitation with your physiotherapist, be on top of the exercise program prescribed to you, and be vigilant with optimal recovery. By prioritizing proper rehabilitation and listening to your body, you can safely and effectively return to running after an ACL injury.
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