Injuries
ACL reconstruction
Nine months is the earliest, not the target, and the evidence on reinjury is unambiguous: every month of delay past six reduces it, until roughly nine. Anyone offering you six is offering you a second operation.
How long
9 to 12 months
An honest timeline, week by week
Reinjury
—
Returning before nine months is associated with a substantially higher reinjury rate. The criteria matter more than the calendar.
The phases
The phases
The honest version. Told on day one, including the part nobody wants to hear.
The honest version. Told on day one, including the part nobody wants to hear.
Limb symmetry
Limb symmetry
Limb symmetry at month nine. Quadriceps is the one that lags and the one most often waved through.
Limb symmetry at month nine. Quadriceps is the one that lags and the one most often waved through.
Return to play
Return-to-play criteria
Decided on measured criteria, not on whether it still hurts. Published here so you can hold me to it — and so your club can.
| Test | Threshold | Measured by |
|---|---|---|
| Quadriceps strength | ≥ 90% of the other leg | Isokinetic or dynamometer |
| Hop battery | ≥ 90% on all four | Single, triple, crossover, timed |
| Time from surgery | ≥ 9 months | Non-negotiable |
| Movement quality | No dynamic valgus under fatigue | Filmed, not eyeballed |
| Psychological readiness | ACL-RSI ≥ 65 | Questionnaire |
Questions
Questions
My surgeon said six months.
Surgeons clear the graft; that is a different question from whether you can play. I will send the criteria to your surgeon and we will agree, and if we disagree I will say so in writing rather than quietly.
Is the psychological measure real?
Yes, and it predicts return better than most physical tests. Fear of reinjury is the single most common reason people never play again after a technically successful reconstruction.