How To Run After ACL Surgery In 6 Simple Steps

According to statistics, about 1 in 1,700 people will experience an ACL injury at one time or another in their lives. Sports including running are among the highest risk of ACL injuries. (1) If you have had an ACL surgery, you need to be extra careful before you get back to running. In this article, we will discuss the safest way to start running after ACL surgery.


A Little About ACL Surgery

anterior cruciate ligament rupture

ACL (Anterior Cruciate Ligament) surgery is used to treat injuries of the ACL by the use of grafts. The ACL is responsible for keeping your tibia in place. During physical activity, this ligament can get torn causing the need for surgery. (2) In most cases, this happens when there is a sudden change of direction during a physical activity.

In most cases, a graft is taken from your own body such as one of the tendons in your hamstrings and used to as a replacement. Depending on the kind of ACL surgery used, you will need physical rehabilitation for several months to a year.

Although the amount of time required before full recovery varies from person to person, it takes about 6 months before one can return to activity. (3)

Considering the seriousness of an ACL surgery, you need to be extra careful before deciding to return to running.

Get The Facts Straight

Photo: Brace Hemmelgarn, USA TODAY Sports

You may have heard about famous athletes who were able to return to running less than a year after ACL surgery. For example, Adrian Peterson of the Minnesota Vikings won the 2012 NFL MVP award just 9 months after ACL surgery. (4)

Does this mean that you can achieve the same? Well, we don’t want to be pessimistic but having your facts straight is always the best course. Consider the following:

  • According to research, there are 3 times higher risk among those who have had ACL reconstruction surgery to get a rupture within the next five years. (5)
  • The risk of getting an ACL injury on the opposite knees within the next two years is also high (6)
  • Female athletes have a 2-8 higher chance of getting an ACL injury (7)
  • Approximately 80% of athletes are able to return to their sport at least year after their surgery (8)

The facts should give you both inspiration and caution. Inspiration in the fact that you can get back to running after an ACL surgery but caution that with higher risk, you ought to be careful.

6 Stages To Return To Running After ACL Surgery


The faster you recover, the faster you will be able to get back to running. Although the pace of recovery varies from person to person, you can take practical steps to boost your recovery. (9)

Important Note

Whenever you start doing any kind of exercise after surgery, make sure you always follow the right technique to avoid further injury.

It is important to also take a day of rest in between workout days to help your muscles require and avoid overuse.

  • If you overuse your tendons, bones or muscles, you are at risk of developing extensor tendonitis.

Day 1 - 14 After Surgery


  • Control swelling and pain and achieve full knee extension

Things to do:

  • Practice with a towel under heel to achieve full knee extension
  • Ice your leg regularly to reduce swelling and pain
  • Take care of the operation wound by propping your legs and regularly changing bandages
  • Aim at achieving a full knee extension by the end of two weeks
  • Always use crutches when walking



From Two To Six Weeks


  • Decrease swelling as much as possible

Things to do:

  • Be careful not to overdo knee extension exercises
  • Rest, rest and rest. This is the most critical part of your recovery and pushing yourself at this stage will only prolong your problem.
  • Exercise your upper body to keep fit



From Six To Twelve Weeks


  • Walking without limping

Things to do:

  • Incorporate bike riding at 1k distance
  • Wobble boards can be incorporated at this stage



From Three to Six Months


  • Focus on strengthening exercises

Things to do:

  • Follow the PEP program designed for ACL surgery athletes
  • Do glute muscle exercises
  • Running in straight lines can begin at 4 months



​From Six To Nine Months


  • Preparation to get back to running

Things to do:

  • You can start more challenging strengthening exercises such as swimming
  • Since your graft is most vulnerable during this period, you need to exercise extra care during this phase
  • Use a soft tissue knee brace. You could find some suggestions in this article.
  • If you are planning to run, this is the time you may consider going back. You can start by jogging at about 40% your normal pace and stick to a straight path.



​From Nine to Fifteen Months


  • Begin actual running not just training

Things to do:

  • At six months, your graft is about 50% of normal breaking strength and 80% at 8 months.
  • Your goal at this stage is to complete multi-directional activities
  • Some of the exercises you can accomplish during this period are power step-ups, lateral lunge walks and pop hops


​More Tips for Fast Recovery

Eat The Right Food


​It is safest to stick to organic food that doesn't contain GMO's during your recovery period. Here are some vitamins and minerals that should be on your list:

  • Fiber - get this from leafy greens, beans, and mushrooms. Fiber helps your body absorb more nutrients.
  • Vitamin C -according to studies, vitamin C causes greater gains in leg strength after surgery. This is because of the anti-inflammatory qualities of the vitamin. (10) Make fruits and vegetable a main part of your diet.
  • Vitamin A - because of its ability to speed up collagen production. You can get this from carrots, sweet potatoes, melons and red peppers.
  • Vitamin E - this vitamin helps minimize oxidative stress and knee inflammation to build greater strength. (11) Eat tofu, avocados, almonds and other nuts

Know When To Try

​The main reason it takes time before it is safe for you to try getting back to sports is because the graft has to be fully attached to you first. It generally takes a year before your tissue can repair itself. The problem with getting into physical activity too soon is that it stretches the graft which may affect its effectiveness and stability. (12)

To help prevent this from happening, follow the following suggestions:

  • Don’t rely on pain as a marker. Not feeling any pain does not mean your tissue is ready to take stress and strain. (13) Never do something very physical simply because you don’t feel any pain.
  • Focus on getting good blood flow during recovery. Before you decide to run, try to focus on balance exercises that enhance mobility. (14) Work along with your therapist to achieve this.

Take It Easy

Inasmuch as you would love to be on your feet and running your next marathon as soon as possible, it is better to be safe than sorry. Keep in mind that those professional athletes who are on their feet in a few months have the money to afford a lot of therapy and medication. Remember these final tips:

  • Always consult your doctor before returning for a run
  • Make sure you pass all the phases of recovery before running (15)
  • Listen to your body and act accordingly

Final Notes

Although having an ACL surgery is a life-changing experience for a running, you can get back to your routine if you make the right choices. Remember to keep the facts in mind, be careful when you try to run, take steps to boost your recovery, get the right diet and lastly make wise choices.