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Return to Running after ACL Tear- Part 2:

People think returning to run after ACL surgery looks like - ⁠ “Well it’s been 12 weeks, let’s lace up and hit a quick 3 miler.”🏃🏻‍♀️ 🏃🏻‍♀️ 🏃🏻‍♀️

In reality, the journey involves initiating proper TRAINING from day 1 of rehab, in order to empower our athletes to confidently and safely run that 3 miler in the neighborhood, dribble past that defender on the soccer field, or cut laterally to swoosh that 3 pointer on the basketball court.🔑

The eagerness to RTR following ACL surgery is something your Made 2 Move physical therapist fully understands- most of us grew up athletes and are still competitive with fitness into adulthood! But we are here to tell you: Don’t rush the process.

⁠Last week’s blog delved into taking a more function based approach in deciding when an athlete is ready to return after ACLR rather than taking the traditional time-based approach. So what does this function based approach include? Let’s jump in!

The Function Based Approach in Returning to Run

At Made 2 Move, we focus on building strength and capacity for running/jogging as soon as an athlete demonstrates adequate range of motion and quad control. Strenth, ROM, quad control are just a few of the many parameters assessed in a function based approach.

Preparing your body for the specific demands of your sport/activity is WHAT WE DO here at the ACL Performance Lab. Returning to run is all about being READY to return to run. NOT just “You’re 12 weeks post-op, let’s start running.” Preparing to return to run starts way before 12 weeks. We’re making sure our athletes are strong and able to absorb force BEFORE we program running intervals.

Once our athletes are demonstrating full quad control AND adequate passive knee extension/knee flexion, we start introducing strength training. In regards to how vital strength training is after ACLR, researchers note, “Deficits in strength would mean insufficient neuromuscular capacity to eccentrically absorb forces during high load tasks, with greater reliance on joint complexes (tendon, ligament and joint structures) for passive force absorption” (Buckthorpe et al. 2020).

This means that returning to run before you have adequate strength puts more strain on the passive structures around the knee (like your ACL), whose primary job is NOT to absorb this load. The big muscles around the knee? It’s THEIR job to help us absorb and produce force during loaded movements like running.

What Will a Return to Running Program Include?

So it’s pretty obvious: One of the main goals prior to running is building up strength, while also maintaining knee extension range of motion and preventing additional swelling. How do we do this?

We start working on and progressing knee-focused exercises to target the quads, glutes, and hammies as early as possible, including movements like:

  • Single Leg Sit to Stands

  • Step Downs

  • Knee Extensions (yes, open chain movements are SAFE and EFFECTIVE after ACL surgery when introduced in a timely and appropriate manner.)

  • Single Leg Hamstring Bridges

  • Single Leg Calf Riases

  • Single Leg Balance

  • Side Planks

  • Single Leg Press

You might look at this and say “ Wow, that’s an awful lot of single leg work.”🥵 Well what is running? It’s simply a series of single-leg jumps that requires force absorption and production with each step.

Additionally, incorporating unilateral (single leg) movements is vital, as it brings any strength deficits and compensatory strategies to light that an athlete may adopt during bilateral (both legs) movements. Bilateral exercises are still a component of a well-rounded program, but unilateral movements will be utilized alongside them to mitigate compensation strategies, in which the non-injured leg often bears a disproportionate load compared to the injured leg.

The goal is that we’re working on returning to run BEFORE we actually run. If our athletes aren’t fully prepared, then running may cause frustrating setbacks and risk reinjuring the not prepared tissue. There’s ONE more thing we train before returning to run- Find out in part 3 of this series!

Interested in working with the Made 2 Move Team in returning to run after an ACL injury? Reach out to today to set up an initial evaluation with one of our therapists!

✅ICYMI: Instagram post for Returning to Run after ACL Tear: Part 2

✅ Stay tuned for part 3 of this series!


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