Do ACL Injuries Recover With Time?
Many injuries that have a long recovery time are often accompanied by a time-based rehabilitation protocol. For example, some ACL protocols say you can unlock your post-op brace at 3 weeks, start running at 12 weeks and return to play somewhere between 6 and 9 months after the surgery.
Basing ACL rehabilitation on time alone gives the impression that time is a primary factor in the healing and recovery process following the injury. For some injuries, like a minor ankle sprain, this may be true. For ACL injuries, the research is indicating that, while time is a factor, the passage of time alone will not allow an injured athlete to regain full function.
A recent research review looked at cases of patients who were at 6 months after their ACL reconstruction surgery. At this interval, 35.7% of patients had achieved 90% symmetry on their quadriceps strength, 47.3% had achieved 90% symmetry on their hamstring strength and 67.9% had achieved 90% symmetry on a single-leg hop test. So, 180 days of elapsed time did not result in full recovery from the injury, and yet, many athletes have already been discharged from physical therapy and are looking to return to their sport around 6 months after their surgery. This research indicates that the vast majority of athletes still have significant deficits that would benefit from a structured program before they return to sport.
This research also indicates that while time is definitely a factor in return-to-sport, it should not be the only criteria. For example, if I asked how your soccer/basketball/lacrosse team was doing, you would not say, “we are doing great, we are 8 weeks into the season.” Or if I asked how you did on your test, you wouldn’t say “I did great, it took me 48 minutes to finish.” Sports, school, business, etc. use hard, objective metrics to define success or failure. You should hold your rehabilitation to the same standard. There are a variety of metrics we can use to track your progress in rehabilitation and your preparedness to return to sport including, but not limited to, your quadricep strength, hamstring strength, lower extremity power, single-leg hop test distance, rate of force development, etc.
If you have sustained an ACL injury you can learn more about our 5 step process to ACL rehab on our ACL page. We also have a FREE downloadable scorecard that you can utilize in your rehab to help track your progress and readiness to return-to-play. This is very similar to the testing we perform on over 30 team sport athletes each year in our office.