ACL Reconstruction- When Can I Run?
Capacity Performance Therapy Bend, Oregon
So you just had ACL reconstruction and are already wondering when you’ll be able to get back to the activities you love. Your surgeon may have told you it would be 9-12 months before getting back to sports, but what about other activities? One of the most common questions we get at Capacity Performance Therapy is, “When can I start running?” Most people are usually looking for a time-based answer, but unfortunately it’s not that straightforward. Instead of waiting a certain amount of time before you’re cleared to run, we have a list of criteria that we want you to meet before starting a walk/jog program. These criteria help make sure your knee is ready for the demands of running. So let’s break it down. What are some important prerequisites for running after ACL reconstruction?
The “Quiet” Knee
This refers to the knee’s ability to tolerate the demands of everyday life and exercise. A quiet knee is one that doesn’t swell and is not painful. Acute swelling and pain are an inflammatory response that tells us tissue is being overloaded in some capacity. If you’re experiencing swelling and pain with walking, everyday activities, or rehab exercises, then we would expect running, which is more demanding than these, to also irritate the knee.
Full Range of Motion
To adequately absorb the force from each step with running as well as propel ourselves forward, we must be able to fully straighten the knee. Regaining knee extension should be one of the initial goals after surgery, but in cases where this is delayed, running shouldn’t be initiated until full extension is achieved. Knee flexion motion, or knee bending, can take slightly longer and is somewhat less important unless sprinting so if 95% range of motion with bending is achieved, this criteria is met.
Strength
When we run, the ground produces forces on our body 2-3 times our bodyweight with each step. This means that a baseline level of strength is needed in order to safely absorb the impact of running. Strength takes time to regain and by the time you fully return to sport we expect no strength deficits. However, to return to jogging, our criteria is at least 70% strength of the uninvolved side. Testing quad and hamstring strength as well as looking at functional movements like a single leg squat or step up can help us determine if single leg strength is adequate for the demands of running. Introductory plyometric and force absorption tasks should also be incorporated prior to beginning to run. This allows us to gauge the knee’s tolerance to load and impact to better determine readiness to progress.
Control
The final component of our prerequisites for running involves single leg control and stability. This has to do with quality of movement and involves assessment of knee position and control with strengthening exercises as well as with introductory plyometrics. Because of the increased forces and demands associated with running, if control is an issue with single leg exercises or low level plyometrics, it will likely also be an issue with running.
Patience can be tough after ACL surgery and your knee will likely feel better and like it’s ready for running before it actually is. That’s why these criteria can be helpful to guide progression into return to activity. It’s also important to note that once these goals have been met and you’ve been cleared to return to jogging, that doesn’t mean you take off for a 3 mile run. Utilizing an interval walk-jog program initially is an effective way to progress to longer distances and ensure that you aren’t doing too much too soon. Rehabilitation and physical therapy can be tough, we can help you walk through this process at Capacity.
Since we’re on the topic of running, it might be helpful to think of ACL rehab as more like a marathon than a sprint. Doing the right things early on and keeping a steady pace will set you up for success in the later stages of rehab and decrease the likelihood of setbacks and reinjury. Frustrated with your ACL recovery? Needing more guidance on how to get back into running safely and pain free? Wanting to work with an experienced and specialized PT after your ACL surgery to ensure the best outcomes? We can help! Reach out to Capacity Performance Therapy at info@capacitypt.com or (541) 224-7485.
