Returning to Sports After an ACL Injury
An ACL (anterior cruciate ligament) injury occurs when the ACL — the bands of tissue that hold your knee bones together — stretches or tears. ACL injuries usually occur in sports, especially when athletes make sudden stops, sharp turns, or land awkwardly.
ACL tears are most common in high-impact sports like:
- And others
Here’s a recent example:
During Game 6 of the 2019 NBA Finals between the Toronto Raptors and Golden State Warriors — the Warriors’ shooting guard Klay Thompson tore the ACL in his left knee after landing awkwardly on a dunk attempt.
How long will this put Klay Thompson out of commission?
On average, it takes between 8 and 12 months to recover from an ACL tear.
Fortunately, thanks to advances in sports medicine, athletes like Klay Thompson can return to playing form and thrive — despite the seriousness of their injuries.
Some notable athletes who have recently suffered and successfully returned from ACL tears include the Raptors’ own Kyle Lowry, the Patriots’ Tom Brady, and Team USA’s Alex Morgan.
But how do athletes with ACL injuries return to their sport and keep playing?
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What it Takes for Athletes to Return to Sports After ACL Reconstruction Surgeries
First Steps After an ACL Tear
The first aid response to an ACL tear is R.I.C.E (i.e., Rest, Ice, Compression, and Elevation). In short, the process requires you to do the following:
- Stop using your knee (e.g., walking, exerting weight on it, etc)
- Place ice on your knee
- Compress the knee using an elastic bandage
- Elevate the leg by lying down and propping the injured leg on several pillows
If you have a minor ACL tear, you may not need to undergo surgery.
In this situation, your doctor will recommend that you work on rehabilitation with the support of a physiotherapist. The goal of the rehab process is to strengthen your knee muscles and restore your range of motion.
When ACL Surgery is Necessary
In the following situations, your doctor may recommend that you undergo ACL surgery:
- You’ve completely torn your ACL
- Your knee is very unstable due to a partial ACL tear
- You want to return to your sport with a strong and fully stable knee
- You’ve injured other parts of your knee, such as the meniscus
- You’re unable to return to your daily activities without ACL surgery.
ACL surgeries usually take place at least several weeks after your injury. Surgeons will replace the torn ACL with a graft — i.e., a piece of tendon or tissue from another area of the knee.
This graft could come from your shin and kneecap (patellar tendon autograft) or the inner side of the knee (hamstring tendon autograft). When it comes to athletes, surgeons prefer using patellar tendon autografts because they have a lower failure rate (AAOS).
The most common procedure for reconstructing ACLs is arthroscopic surgery. This procedure is minimally invasive in that it involves only small incisions to the knee.
The goal of the surgery is to give the athlete a fully functional and stable knee. In addition, the surgery aims to reduce the risk of meniscus and cartilage injuries in the future. The success rate following ACL surgeries is typically between 85-90%.
What Does the Post-Surgical Rehab Process Look Like?
Because an ACL surgery replaces the torn ligament with a graft, it can take weeks (and in some cases, months) for your knee to regain its mobility. Following surgery, you will also be expected to wear crutches for 2-4 weeks, after which you will begin the rehabilitation process.
The ACL rehabilitation process typically focuses on 2 main goals: alleviating pain and restoring your knee’s range of motion.
1. Alleviating Pain
You’ll have to work through some pain following surgery. Your physician will likely prescribe painkillers to help you get through the inflammation and swelling.
In addition to standard pain relief treatments, you might also work with a sports medicine clinic to speed up healing and decrease pain in other ways. You could explore shockwave therapy, Platelet Rich Plasma (PRP) injections, massage therapy, and other proven treatments.
Your physician and physiotherapist may also suggest using a custom knee brace to help with stabilizing your knee during the rehabilitation process.
In addition to relieving pain, these treatments help accelerate the healing process.
For example, in a study, ACL patients using PRP injections showed faster healing and graft maturation.
2. Restoring Range of Motion
Restoring your knee’s range of motion is a vital part of the rehabilitation process.
First, it helps lower the chances of chronic, lifelong impediments such as osteoarthritis (OA). Second, it gives your knee an opportunity to rebuild muscle strength, bringing you closer to game readiness. Third, it also helps reduce pain.
Because of these reasons, modern physiotherapy methods recommend introducing a range of motion exercises considerably early in the ACL rehabilitation process. Your physiotherapist will tailor an exercise program for your unique needs.
Don’t Let Pain & Swelling Slow Your ACL Rehab Process
What’s the ACL Recovery Time for Athletes?
Like mentioned earlier in the article, it takes about 8 to 12 months for athletes to restore their full range of motion and remove all swelling and pain. In fact, 65-88% of athletes return to their sport in the first year.
However, a specific timeline will depend on the seriousness of your injury, the type of surgery you underwent, and the sport you’re returning to.
For basketball players, the recovery period varies relatively greatly. For example, UNLV’s Kendall Wallace recovered from a “simple” ACL tear in as little as 6 months. However, the Warriors’ Klay Thompson is expected to miss 9-10 months.
On average, it takes 9-12 months to return playing soccer after ACL reconstruction surgery.
This is a longer turnaround period than basketball, but the severity of the player’s injury, the pitch grass they most often play in, and other factors go into determining the player’s return.
ACL tears are not as common in hockey as they are in basketball or soccer — hockey players are exerting less pressure on their knees (NHL). However, hockey players will typically need at least 6 months to recover from an ACL surgery.
To reduce your recovery time and lower the risk of reinjuring your ACL down the line, consult with a sports physician before starting your rehabilitation process.
Athletic Edge Sports Medicine combines traditional and innovative strategies to help athletes return to playing form as soon as possible. Call us today to get started on your rehabilitation
and recovery process.