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Physical Therapist, knee injury, patient laying on an exam table with knee propped up

Returning to Play After an ACL Injury


MN Vikings Running Back, Dalvin Cook, left the field during the Detroit Lions game with an ACL injury. Knee injuries are quite common in football, but what happens after the injury on the field? Physical Therapist, Eric Paur explains what to expect before and after surgery. 

A majority of ACL injuries occur without contact from another player but rather with cutting or pivoting. We, Minnesotans, have gone through it before with some of our top players but the good news is, we have also seen them come back to that same high level! Here is what we need to know about what comes next.

Rehabilitation prior to surgery

This is a more important step than you would think. If you rush to have surgery too quickly, your outcome may not be as good as we would like it to be. Doing surgery on a bad knee can sometimes slow your recovery. We like to have good motion, strength, and very little swelling.

Surgery

Prior to surgery you and your surgeon will discuss where to get your ACL. Most common are the patellar tendon, hamstring tendon, or from a donor. Each has its pros and cons and should be decided on for each individual. It is important to have an experienced surgeon that can help with this decision. There are other injuries inside the knee that may need to get repaired or cleaned up which may affect your recovery was well.

Immediate post-operative

The key to this phase of rehabilitation:

  • Get the motion back, especially getting that knee straight
  • Get the thigh muscle firing ASAP
  • Decrease swelling
  • Minimize pain
  • Walk with crutches and a brace

Post-operative: Usually 2+ weeks

We work on getting rid of your brace as your strength improves. We’ll work with you on walking normal again. From here, we’ll progress your strengthening to more weight bearing exercises like squats and step ups. It is very important to strengthen you quads and hamstring as well as your hip muscles for proper recovery. You can start running at 12 weeks if things go according to plan.

Higher level Rehabilitation: 4+ months

Here we focus on good form and not allowing motions that put your ACL at risk

  • Usually around the 4 month mark we work on double leg jumping
  • Start doing easy cutting drills
  • Progress to single leg jumping if no issues with double leg jumping 5-6 months
  • Work on sport specific activities in 6+ months
  • Testing and return to sport in 6+ months

 We will put an athlete through a battery of tests to compare their surgical leg to their non-surgical leg. This is scored and graded then discussed with the athlete and the surgeon. We will usually recommend a high level return to sport program like our TRIA LEAP to help get you back to sports at a high level.

Our philosophy is that we don’t want you the same as you were before your injury, we want you better!

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