Returning to football after ACL surgery

Returning to football after injury and major surgery takes time. Find out what to expect in the months following your ACL surgery with this ‘return to sport’ timeline.

Rupturing the anterior cruciate ligament (ACL) is a common injury among footballers at all levels. Premier League players have demonstrated good recovery with their successful ACL comebacks, including Manchester United player Zlatan Ibrahimovic1 and former Newcastle United striker Alan Shearer2.

If you are due to have, or have recently undergone, ACL reconstruction surgery on your knee you're probably focusing on your recovery. Returning to the beautiful game after a serious injury and major surgery takes time, patience and rehabilitation with physiotherapy.

Mr Deepu Sethi, Consultant Orthopaedic & Knee Surgeon at BMI The London Independent Hospital says, “A good physiotherapy rehab program is just as important as having had a successful operation when it comes to ACL surgery. The emphasis is on the footballer taking an active part in the rehab program to ensure a safe and successful return to sport.”

Dr Ali Khavandi

Mr Deepu Sethi is a Consultant Orthopaedic Surgeon with a specialist interest in sports knee injuries and knee replacement surgery. Mr Sethi's interests cover the range of knee surgery including arthroscopic anterior and posterior cruciate ligament reconstruction for the unstable knee. He collects data on the outcome of his surgery and registers his patients on the National Ligament Registry, which is dedicated to analysing and improving the outcome of cruciate ligament reconstruction.

First two weeks post-ACL surgery

Your knee will be very swollen immediately after the operation. Phase one of your rehabilitation will focus on reducing this swelling as quickly as possible with ice and compression, which can also help to manage the pain.

Once the swelling has sufficiently gone down your physiotherapist will give you some light exercises, which work the muscles around the knee without you having to move your leg3.

Two to six weeks after surgery

By phase two of your rehabilitation the swelling around your knee should have disappeared. However, the tissue graft inserted during your ACL reconstruction surgery is usually weak around this time meaning the ligament may only be able to handle very light therapeutic exercises. You should be able to walk normally within six weeks of your operation.

Six to twelve weeks after surgery

A few months on from your surgery your knee will be stronger and able to handle more pressure and more strenuous exercises. You will probably be able to do non weight-bearing sports such as swimming and cycling. This will enable you to build up the muscles in your knee without putting too much strain on the ACL. It will also help to counteract the loss of conditioning as a result of taking time away from regular training.

Three to six months after surgery

This phase of your recovery is about you getting back to full strength - the pace needs to be set by you. By this point your physiotherapy return to sport exercises should have given you improved use of your knee with a good range of movement, but there may still be some pain that you need to manage.

Many footballers will feel able to return to running at this point, but your physiotherapist may ensure you can pass further functional tests before giving you the go-ahead to run.

The point at which you are ready to return to playing football depends on the strength and stability of your knee.

Your physio will want to make sure you don’t feel pain in your knee when you run and that there is no swelling. You will be cleared to play when you have an acceptable range of motion with good stability, and when your injured knee is as strong as your other knee.

The risks of returning too soon

It’s important that you only return to sport when your body is completely ready. There’s a high risk of re-tearing your ACL if you demand too much of your knee before it’s ready. For many people there are risks involved in returning to football less than 12 months after surgery, but you should be able to do some gentle exercise and sport around six months after ACL surgery. The precise length of time it takes to recover varies between individuals, and an important thing to consider is whether you feel ready to start playing again.

Our Sports Injury Clinics offer specialist services for amateur and professional athletes to diagnose, treat and rehabilitate a range of sports-related injuries, including ACL tears. 

To find out more about how our Sports Injuries Clinics can help you, call us on 0808 101 0337 or make an online enquiry.


Sources
1http://www.bbc.co.uk/sport/football/40679002
2https://www.theguardian.com/football/the-agony-and-the-ecstasy/2017/jan/16/footballers-long-term-injuries-gundogan-manchester-city
3 https://www.nhs.uk/conditions/knee-ligament-surgery/recovery/#rehabilitation

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