When can I start running after my ACL surgery?
Returning to running (RTR) after ACL repair marks an important accomplishment. The participation component of the return to sport continuum relies on the RTR. The demands placed on the knee during running are minimal. RTR, however, initiates the shift from impairment-focused tasks in early rehabilitation (such as knee range of motion (ROM) exercises, isometric quadriceps strengthening) to functional, sport-specific tasks that characterize more advanced rehabilitation (eg, sprinting, pivoting, cutting).
Historically, clinicians advice on RTR was predominately time based. Typically suggesting 3 months post-operatively is safe to do so. However, we have recently shifted towards a criteria-based model which helps patients and their treating clinicians to make a more well-informed clinical decision on safely returning to running.
Each patient's RTR decision should be tailored specifically to them. There isn't a single timetable for RTR. Given adequate loading—pain on a visual analogue scale of 2, knee flexion and extension ranges of 95 percent and 100 percent, respectively—as well as the absence of effusion—it may be reasonable to anticipate that many patients will be ready to RTR between the eighth and sixteenth postoperative weeks.
Summary points of return to running post ACLR:
8-12 weeks post-op
Pain on VAS <2/10
Knee ROM 95% of the uninjured side
No knee effusion/swelling
Isometric Quadriceps/Hamstring strength >70% of the uninjured side
Single leg hop test >70% of the uninjured side
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