When can I return to soccer after my ACL surgery?
Planning to return to soccer? Returning to sport occurs in multiple and progressive phases that start 3-5 months following surgery. At approximately 6 months, it is possible to safely progress to full participation in sport. This timeline can fluctuate depending on the individual and is completely normal for someone to progress faster or slower than someone else. Each ACL journey is unique!
The first step is to assess readiness for initiating early return to sport interventions in the clinic. There are several criteria physical therapists assess to ensure safety for this next step.
There is also an observation done by the National Center for Biotechnology Information of 50 soccer players after ACL.
Criteria to progress to Early Return to Sport (based on Prep Performance Center Specialized ACL Rehab Program)
– Normal gait
– ROM equal to contralateral side
– Symmetric weight acceptance for squats to 60°
– No reactive swelling after exercise or activity that lasts for more than 12 hours
– No episodes of instability
– Maintain quad strength
– 10 repetitions single leg squat proper form through at least 60° knee flexion
– Drop vertical jump with good control
– Functional Assessment
– Quadriceps index >80%; HHD mean preferred (isokinetic testing if available)
– Hamstring, glut med, glut max index ≥80%; HHD mean preferred (isokinetic testing for HS if available)
– Single leg hop test ≥75% compared to contralateral side (earliest 12 weeks).
When cleared to progress to this next phase, the physical therapist will begin to introduce sport specific interventions. Goals for this early phase of return to soccer sport are to progress strength training, initiate a return to running program, progress plyometrics and agility training, and promote proper movement patterns during sport specific activities. It is important during this phase to avoid any post exercise pain or swelling or activities that produce pain at the graft donor site. If, at any point, you experience these symptoms, tell your physical therapist so he or she can adjust the program as necessary to protect your knee!
The next step in returning to full participation in sport (6+ months post surgery) is to assess readiness to begin non-contact practice. There are several criteria physical therapists assess to ensure safety for this next step.
Criteria to progress to Full Return to Sport (based on Prep Performance Center Specialized ACL Rehab Program and MGH Rehab Protocol for ACL Reconstruction)
– Normal jogging gait
– Good single leg balance
– Less than 25% deficit on Biodex strength test
– No reactive swelling after exercise or activity
– Clearance from surgeon
– Completion of run program without pain or swelling
– Quad, hamstring, glute index > 90%
– Hamstring/Quad ratio > 70%
– Hop testing > 90% compared to non-operative leg
– Psych Readiness to Return to Soccer Sport
When cleared to progress to this next phase, the physical therapist will continue to work with you in the clinic focusing on strength, proprioception, symmetrical performance during sport specific drills, plyometrics and agility, cutting and pivoting. Outside the clinic, starting at 6+ months, you will begin to participate in non-contact practice which will eventually progress to full practice and full play as dictated by how your body responds at each level. During this late stage of your rehab, it is extremely important to continue doing the exercises your physical therapist recommends for home in order to optimize function and safety.
Get the green light to play again with our Return to Play Questionnaire. Download it now and ensure a safe return to sports after injury.
Download Return to Play Questionnaire
Remember that not all ACL journeys are the same. This process will be unique to YOU and your body. Your physical therapist and orthopedic surgeon will be the best resources to help you understand where you are at in your individual journey and what to expect along the way.
For more details regarding Prep Performance Center’s goals and interventions at each phase of the specialized ACL rehab program, click here!
6 Exercises Youth Soccer Players Should Do Before Practice
Soccer Players – An effective dynamic warm up will mimic the activities needed to be performed. In soccer, because of the variety of movement patterns that are performed in a multitude of directions, the warm up should mimic these types of movements. The warm up should also focus on the entire body, because of the requirement of the entire body to participate in the sport.
The F-MARC 11+, developed by FIFA’s research center, is a comprehensive warm up program that has been shown to reduce injury risk in the lower extremity in female youth soccer players. It requires only a soccer ball, and can be completed in 10-15 minutes. It is free to download online, or can be done under the guidance of a CD. Visit a blog
A dynamic warmup should consist of running, dynamic stretches of the major muscle groups, and soccer players specific muscle drills. Soccer requires endurance but the ability to sprint, as well as agility and power. The demands of the sport are variable at certain times, so the athlete needs to be able to perform all of these and should be prepared to do so. More insights and warm-up guide by Competitor Spot website.
Straight Leg March “Tin Man”
How To:
– Start standing facing forward, both legs hip width apart.
– Swing one leg forward until a slight stretch is felt in the hamstrings (back of the upper leg). Try to touch that foot with your opposite hand.
– As soon as the stretch is felt, pull the leg back down to the ground, and contract the glutes (your bottom).
– Repeat on the next side. You can keep walking throughout this stretch.
Things to avoid:
Try not to round the back while performing this exercise. Keep posture as aligned as possible.
Targeted Muscles:
Improves flexibility in the hamstrings, glutes, and lower back.
Reps:
10 repetitions each leg
Spider-Man Walks
How To:
– Take a lung step forward. Try to make this motion bigger than a normal lunge. This involves placing the front foot in front of you, keeping the back leg extended behind you. Your front leg should be bent.
– Place both hands to the inside of your front foot – this should be next to your front foot and not in front.
– Keep the back straight, and pull the hips to the ground.
– Then switch legs in place, or place the opposite leg forward to move forward.
Targeted Muscles of Soccer Players:
Mobilizes the hips, ankles, and thoracic spine
Things to Remember:
Breathe in this position
Reps:
1 set over 20 meters
Jog Forward and Circle Arms Forwards/Backward
How To:
– Begin with a light jog
– Either alternating arms or together keep the arms straight and start to bring the arms forward in a circle.
– Once completing one rep, circle the arms backwards.
Tips:
Try to keep the arm circles controlled. Uncontrolled arms will place stress on the shoulders.
Target Muscles:
Shoulders while also jogging to warm up the body for the slow demands of soccer.
Reps:
20yds with forward arm circles, 20yds with backwards arm circles. 2 times.
Backdrop Ground Touches of Soccer players
How To:
– Begin facing forwards with feet shoulder width apart.
– At a 45 degree angle, begin to shuffle low to the ground, backwards.
– Shuffle 5 times, then switch directions, continuing to shuffle backwards.
Tips:
– Try to stay low, in a high squat position.
– Try to do this quickly to practice moving and changing directions, but also in a controlled manner.
Target muscles:
Quads, and agility of the lower extremities.
Reps:
20 yds, alternating sides … 3 times.
Carioca
How To:
– Start with feet further than shoulder width apart.
– Slightly squat
– Push off with the L foot and bring it towards the R foot.
– Cross the L foot behind the R foot and plant it on the ground.
– Move the R foot to the side so you return to the original position.
– Cross the L foot in front of the R foot and plant it on the ground.
– Move the R foot to the side so you return to the same position.
– Reverse the steps to perform the drill in the other direction.
Target Muscles:
– Hips, groin, lower back
– This is also more of an agility exercise, that mimics the quick feet demands needed of soccer players but also working in a lateral direction since soccer players are required to move in multiple directions.
Target Movement:
Moving in a lateral direction.
Tips:
Start Slow to get the pattern down, then increase the speed.
Reps:
3 sets over 20m on each side
Run-Through Sprints of Soccer Players
End with run-through sprints
How To:
– This involves the acceleration to build up to the sprint, and also involves a deceleration.
– The sprinter will have a measured distance, and will plan to “run through” the end meaning the player doesn’t start to slow down until they cross the line.
– The player can also determine the speed, and should estimate about the maximum pace and then the percentage that they are working.
Target Movement of Soccer Players:
This gets the player ready for the sprinting and power phase of soccer. Because the game involves quick transitions from walking/jogging to sprinting, practicing that quick acceleration and deceleration is important.
Reps:
– 2 sets x 20 m at 70% of maximum pace
– 2 sets x 20 m at 80% of maximum pace
– 1 set x 20 m at 90% of maximum pace
The above is a mix of exercises that can help the athlete in a total body warm up mimicking the different movements required of them in soccer.
Contact us today!
Are you ready to perform at your optimal level? Contact Doctor of Physical Therapy, Mary Kate Casey at our Chicago, IL clinic today! Through our movement analysis, we can assess jumping and landing mechanics and help you improve performance and reduce your risk of injury. Give PREP Performance Center a call at 773-609-1847 for more information on our movement analysis program!
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