Can I Run Again With An ACL Tear?

The Question Is: Can I Run Again With An ACL Tear"

By: Matt Paulus, MS, ATC, LAT

Many people think that ACL tears occur mostly in contact sports such as football or soccer. However, 85% of ACL tears occur in non-contact-sudden deceleration or change in direction injuries (Renstrom et al, 2008).  

Females are more prone to an ACL tear due to factors like anatomy, muscle imbalances, and hormones. 

ACL tears and running Image of Woman with ACL Tear
When is Surgery Necessary?

If an ACL tear has occurred, you may wonder if surgery is required and ask, "can I run again with an ACL tear? This should be discussed on a case by case basis with an orthopedic surgeon. Some factors to be considered include how unstable the knee is and what your activity level is. 

A stable ACL tear means that even though there is a tear, the muscles and other ligaments are able to stabilize the knee during normal activities. This will be discussed in more detail below.

If you are experiencing frequent buckling, your knee is unstable and may be an indicator that surgery is necessary to stabilize the knee. Activity level can be a determining factor for surgery. 

As mentioned earlier, one of the most common factors for an ACL tear is a quick change in direction. Sports that involve rapid changes in direction such as basketball, football, soccer, rugby, hockey, or tennis would be difficult to compete in with an ACL tear but may be done with proper strengthening and use of an ACL functional knee brace. 

Running with an ACL tear

If you are wondering, "Can I run again with an ACL tear?" Rest assured, running with an ACL tear is possible if the knee is stable and has proper strengthening to allow the muscle to support the knee.

To decrease the risk of further injury to the knee you can wear a knee brace while running and run on even surfaces such as:

  • A Track                                                                                                                                                                         
  • A Sidewalk                                                                                                                                                                 
  • A Treadmill 

Running on uneven surfaces such as grass or dirt may cause unexpected twists resulting in increased stress to the knee or cause you to fall. 

Knee Joint AnatomyKnee Joint Anatomy

Running or Playing sports with ACL Reconstruction

Athletes also often ask, "Can I run again with an ACL Tear?" Unfortunately, If you have ACL reconstruction surgery it does not guarantee you will return to sports at pre-injury level. Proper rehabilitation for ACL injuries and tearsis key to returning to full activity. The first phase of recovery focuses on regaining knee range of motion (ROM) and improving quad strength. 

During this time, you want to allow the new ACL to heal. Physical therapy will help you know which activities are appropriate and how to safely progress strengthening exercises.  

A generalized timeline for recovery following ACL reconstruction is as follows:

  • 3 months after surgery begin a walk/jog program 
  • 4 ½ to 6 months add agility and running 
  • Return to sports can occur at the earliest 8 months after surgery but more commonly occurs between 10 and 12 months. 

When returning to running or sports activity your MD may initially recommend the use of a knee brace to prevent re-injury. This will allow more stability as the knee adapts to the increased activity. 

Recovery does vary from person to person. Factors include:

  • The body’s healing
  • Response to therapy 
  • Strength 
  • A person’s compliance with a home exercise program

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