Returning to running after Anterior Cruciate Ligament Reconstructions is a significant milestone.

After ACL rupture, surgical repair most usually is carried out with the goal of returning to sport (often involving running and / or change of direction).

A recent review has been undertaken and presented by ‘Physio Network’ – We want to pass this golden knowledge on to you.

The study investigated what criteria is being used in clinical decision making for returning to running and provides information to guide thorough and quality clearance processes.

By far the most common factor that was used to permit return to running after surgery was time.

  • The average time for clearance to return to running was 12 weeks post op

Strength, clinical assessment and performance were used much less often as factors to guide the clinician’s decisions.

Is you’re therapist just using number of weeks post operation to guide when you’re fit to return to certain activities?

The research suggested that the following subjective and objective measures be considered non-negotiable milestones prior to returning to running after ACL Reconstruction:

  • Pain < 2/10 on the VAS scale (Visual Analogue Scale that rates pain from 0-10)
  • 95% Knee Flexion Range of motion of the un-injured side
  • Full Active Knee Extension Range of motion
  • No Effusion (swelling)

Additional criteria the authors made note of were ratios >70% on the Limb Symmetry Index of:

  • Isometric Hamstring and Quadricep function
  • Single leg hop tests
  • Single leg squat test or step up assessment without increase in knee valgus

Take home message is:

‘Traditional’ discharge criteria of ‘time post operation’ and a ‘stable’ knee on clinical examination is no longer best practice

Return to running following ACL Reconstruction is a key milestone if you are wanting to return to sport, as running is often a key component of the sport you might be playing

It is vital that the decision made to allow you to commence a running program is made on you passing clinical, strength and functional criteria rather than being on an arbitrary time point.