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.
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!