A very common and difficult question that patients often ask post-ACL surgery is, "When will I be able to get back to __?" Clinically, best evidence recommends using performance-based criteria combined with time-based criteria to determine if a patient is ready to return to activities like running post-ACL reconstruction. 

In a recent review published in the British Journal of Sports Medicine, less than one out of five studies reported using such measures. Nevertheless, authors reported that the median return to running timeline was 12 weeks post-op, and the most common decision-making criteria were:  

  1. full knee range of motion or >95% of the non-injured knee plus no pain or pain <2 on visual analogue scale 
  2. isometric extensor limb symmetry index (LSI)>70% plus extensor and flexor LSI>70% 
  3. hop test LSI>70%

It is helpful to have clinical, strength or performance-based criteria for our own decision-making, as well as to educate our patients. It is important that patients understand that recovery will be active and will involve achieving certain benchmarks, rather than simply waiting to heal.

Read the article here.