Returning to Sport After ACL Surgery: A Checklist
Getting back to your sport after ACL surgery is the moment many athletes dream about from day one of rehab. But rushing the process can set you back. A proper return-to-sport decision should be based on objective tests, not just how you feel. Get to know our ACL Rehab Program.
This checklist will walk you through the key markers that need to be met before you safely re-enter the field, court, gym, or track. Whether you're a weekend warrior or competitive athlete, ticking off these boxes can lower your risk of re-injury and help you return with confidence.
✅ Full Range of Motion in the Knee
Before returning to sport, your injured knee should have full extension and flexion equal to the opposite side. Lack of motion can lead to compensations and higher injury risk.
The best way to check this box is simple: move the knee! Keep it moving so that the joint is fluid and able to get to the end ranges of motion pain-free.
✅ Strength Symmetry
You should have at least 90 to 95 percent strength in your quads and hamstrings compared to your uninjured leg. Testing should include isometric strength tests, single-leg squats, and hop testing.
Make sure to test this with a practitioner that can use objective measurements to ensure you are strong enough in both legs.
✅ Minimal Swelling and No Pain With Activity
Persistent swelling after workouts is a sign the knee is not ready for full intensity. Your joint should respond well to high-level training without pain, swelling, or stiffness the next day.
Continue to manage swelling and pain after exercises if you are not yet adapted to higher-level training. Monitor your signs and symptoms after each workout to track your progress.
✅ Single-Leg Hop Tests Passed
There are several common hop tests used to evaluate readiness:
Single-leg hop for distance
Triple hop
Crossover hop
Timed hop
You should perform within 90 percent of your non-injured side on each test.
✅ Good Movement Mechanics
Your jumping, landing, squatting, and cutting mechanics should be clean and symmetrical. Poor control or visible compensation (like knee valgus) can be a sign of lingering deficits.
This is extremely important to correct because it can directly lead to re-injury of the ACL if not addressed properly.
✅ Agility and Sport-Specific Drills Completed
Before returning to competition, you should complete a phase of sport-specific drills. That means cutting, sprinting, shuffling, or deceleration patterns that mimic the demands of your sport.
It’s crucial that you are able to perform these movement patterns prior to competition. If you can’t meet the demands of the sport on the sideline, you can’t do it during the game.
✅ Psychological Readiness
Mental readiness matters. Tools like the ACL-RSI (Return to Sport after Injury) questionnaire can help measure your confidence, fear of re-injury, and psychological preparedness.
If you hesitate to cut, jump, or push hard, it could affect performance or increase risk of re-injury.
✅ Clearance From Your Rehab Team
Your physiotherapist, athletic therapist, or orthopedic surgeon should give you the green light before returning. They’ll consider all functional tests, medical imaging (if needed), and your mental state before making the call.
✅ Time Since Surgery
Most athletes return to sport between 9 to 12 months post-op, but this varies. A timeline alone should never be the only factor. Objective measures matter more than the calendar.
Following a general guideline can be helpful to track progress, however the other boxes in this list must be checked-off first.
Bonus Tips for a Safe Return
Ease back into competition with controlled exposure (like practice sessions or limited minutes).
Continue strength and conditioning as maintenance.
Schedule regular check-ins with your rehab team to track progress and catch any issues early.
We Help Athletes Come Back Smarter and Stronger
At Elevate, our ACL rehab program is designed to help you progress in the crucial 6–12+ months post-op, providing you with the guidance, motivation, and testing you need to safely return to sport.
When you're ready to return, we want you to return at your best!
📍 710 Dorval Dr Unit 520, Oakville, ON
📞 (289) 835-2949
💻 https://www.elevaterehabilitation.com/
