ACL Rehabilitation Timeline: Month Eight

Welcome to month 8 of ACL rehabilitation — about 3/4ths of the way through your recovery!

As you continue to progress through these last few months of training, you’ve probably been experiencing both improvement and impatience with wanting to get back to your sport. And trust us, we get it; the further along you are in your recovery, the more challenging it is to stay focused on your rehab when all you want to do is play again.

It takes loads of discipline and perseverance with every passing day, but you’ve already made it this far into your journey, right? All this time taken to thoroughly train and recover will pay off handsomely when you’re back to your sport playing stronger and faster, and with a lower risk of reinjury.

And just like the previous months, we’re here to help you maintain that mentality with the goals and expectations of month 8.

So let’s get down to it!

Statistics for Month 8 of ACL Rehabilitation

Okay, before we do that, we thought it might be helpful to provide some extra context.

The reason why we have athletes work well past the 8 month mark isn’t just to “play it safe” (though safety is, of course, a vital element to your recovery) — there is actual data that backs up the importance of this timeline.

Following surgery, your risk of reinjury starts out high, but the risk maintains a consisten rate of decrease with every month you delay returning to sport. More specifically, the odds of reinjuring yourself decrease by 51% each month! (Pretty amazing how your body can reduce its risk of reinjury by half just within one month, right?)

This rate of reduced likelihood consistently drops by 50% well into your rehabilitation, typically up until month 9. (That’s around the point where your chances of reinjuring yourself start to plateau.) So, whenever you start feeling antsy about your return to sport during month 8, just remember: in only 1 more month, and you’ll have finally reached a point where your risk of reinjury is as low as possible. (Though, you’ll still need some continued work to make sure that’s a sustainable low risk of injury.)

Physical Therapy During Month 8

The main key to this month is to stay committed — be deliberate in your training, and don’t let up or get complacent.

You’re now closer to the end of your rehabilitation, so while you may not feel like you’re making as much noticeable progress as before, this is no time for slacking! This last stretch of rehab requires you to make the most out of your training every day; it may feel tedious, but this is where you build the foundation for biomechanically safe movement.

And here’s what that looks like for month 8.

Achieve Quadriceps Symmetry

While you’ve been putting lots of work into your quadriceps for the past few months, it’s not quite enough to build up their strength alone; it’s just as important to make sure you’re building symmetrical strength between both sides.

Multiple studies have linked asymmetrical quadriceps strength to a higher risk of injury. So, in order to avoid mismatched strength in your thighs, focus this month on performing those single-leg drills with your operated leg. (You probably remember some of them from last month’s rehab.) For single-leg work specific to the quadriceps, here’s a handful of our favorite exercises we like to recommend at this point in your recovery:

  1. Single-leg squats with weight
Single Leg Squats

2. Single-leg presses

Single-leg presses

3. Single-leg step-downs/ups with weight

Single-leg step-downs/ups with weight

4. Single-leg split squat jumps with weight

Single-leg split squat jumps with weight

Practice Agility Drills — with Sport Practice

This portion is also a continuation of that past couple of months, but with a little more challenge: now, we’re adding in an element of variability.

Often, this comes in the form of either passing, shooting, or kicking a ball while working through your usual agility and speed training. Which may feel exciting at first, but remember: this is likely the first time you’re truly emulating motions of sport play, so it’s not going to be the same as what you were once used to…

In fact, adding a ball to your rehab training will reveal a lot about your movement and form. (Namely, any remaining weaknesses or compensations.) While your exercises during physical therapy are great for recovery, they’re completely different from sport play, so there’s still quite a bit of training left to ensure a safe return to sport.

So, to start off this month, your physical therapist will begin with easy, direct passes. As you grow more comfortable, they’ll start to adjust the speed, direction, accuracy, and timing of their throws, mimicking gameplay and forcing you to make real-time adjustments. With more and more practice, you’ll also continue to increase the speed and complexity of these drills to further progress your training and familiarity with sport-like movement.

Focus on Rebuilding Your Endurance

Because you’re now rebuilding your athletic movement and intensity, you have another key variable to address during month 8: endurance and cardiovascular training.

If you weren’t expecting this as a facet of ACL rehabilitation, you aren’t the only one — rebuilding endurance levels is constantly overlooked by most rehabilitation timelines. Which is extremely unfortunate, as it’s a crucial aspect of being able to safely return to your sport.

There’s no doubt that cardiovascular fatigue impairs your ability to produce strength and power, which then interferes with your body’s ability to maintain proper control and alignment in your lower extremities. With insufficient or decreased levels of oxygen and nutrients, your muscles will yield significantly less output and will have to perform with compromised functionality.

So! For month 8, make sure you start building up that cardiovascular foundation again (as well as your top end speed). To do so, think about running 2-4 miles about 3-4 times per week; this is typically enough to retrain your heart and lungs back into sports-like activity levels. 

This is also the month to head out onto your local track and practice some sprint workouts! Consider running 100’s, 200’s, and 400’s with rest breaks; to truly hone in on your speed, make sure you’re pushing yourself to high levels of intensity (anywhere from 85% or more maximum effort).

Another Month Down — On To the Next!

Exciting times, right?

You’ve made fantastic progress to have gotten this far in your rehabilitation (and you’re probably feeling some anticipation now that you’re practicing drills closer to actual gameplay!). And, next month is your 9th month of ACL rehab, soon marking the end of the third quarter of your entire rehab timeline.

Perhaps it’s felt like forever since you started up, but think of it this way: you’re already at a huge milestone just months after your injury. (Not too long ago, you were still relearning how to walk and gain full knee flexion again.)

So keep that intensity up, fellow athlete! Push yourself daily, and allow yourself to have fun along the way. This last leg of recovery requires a whole lot of hard work, but it should also feel productive and invigorating — it’s a defining time for both your athletic and personal life, so make sure you enjoy the process where you can!

ACL Month 8

By Dr. Kevin Vandi DPT OCS CSCS

Dr. Vandi is the founder of Competitive EDGE Physical Therapy — with his background in physical therapy, orthopedics, and biomechanics, he is a highly educated, compassionate specialist. Using state-of-the-art motion analysis technology and data-driven methodologies, Kevin has assisted a wide range of clients, from post-surgery patients to youth and professional athletes. When he isn’t busy working or reading research, he spends his time with his wife Chrissy and their five wonderful children, often enjoying the outdoors and staying committed to an active lifestyle.

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