ACL – Return to running

So my 6 month ACL check-up was a success! The graft is strong and intact, hooray! There is still some swelling inside the knee but very minor. That lump in the back of my hamstring I spoke about last time was a Bakers cyst. Very common post surgery and more often than not will just go away on it’s own over time. My right quad is still 2cm smaller then my left, but again, with continued training that will improve.

I heard a bit of a horror story from a friend the other day about her ACL journey which really hit home for me and I wanted to share. At the one year mark post reconstruction she returned to sport without doing much in the way of strength training or any progressive agility and coordination training for her return to sport. The result: re-torn ACL on her first attempt to change direction during her first soccer training back. To me this is just devastating! Especially going through this long journey myself and thinking about having to start it all over again would be one of the toughest things to have to do. But this to me is also a very important lesson. If you wish to return to sport you MUST get your knee ready and prepared for the exact type of load and forces it will have to go through in your chosen sport. You need to go through the process to make sure your knee undergoes the correct rehab with strength, endurance, power, agility, and specific return to sport work.

So that leads us to my next rehab phase which to be honest I’ve actually been putting off for longer then I should have. It was her story which kicked me into gear and made me realise I must stay on top of all aspects of my rehab. Strength alone is not enough. It was time to introduce running and agility training. Up until know I really hadn’t given running a proper crack yet. To be honest it was mostly out of fear! I was terrified. Being in the gym setting for strength with the feet stationary is one thing. But starting to run and put my knee through that repetitive impacting load felt like a different ball game. But just like the strength program you have to start small, then build! You’re not going to be sprinting day one. So start basic. I did a few jogs at first, nothing major, and it actually felt fantastic. Despite still feeling as if my hamstring and quad strength was lacking I think it was important to start the running process. I only wish I had started it sooner!

After a number of sessions I decided to be a bit adventurous. It was time to add in some change of direction. That’s right. I was going to sprint and make a cut. I didn’t go straight into it though, I slowly build up with curved runs. But then it was time… and I can tell you now that this was to date one of the most terrifying things I’ve ever done. The physical aspects of return to sport are one thing.. but the psychological barriers are another key component of rehab which are often overlooked. Let me say this, you are allowed to be scared. It’s nerve racking! But it’s important to not let that hold you back from doing your rehab. Face that fear! Just remember, it’s always a process. You don’t have go all out at once. And you shouldn’t! Start simple. Straight line work only, walk 50 metres, jog 50 metres, and repeat. Build up to running longer and for further. Then start to introduce curves into your run, build your confidence. Do lateral footwork. Build up to that change of direction. You don’t need to get there quickly… just get started!

Remember what we say. Persistence persistence persistence. Start small, work up to it. But whatever you do just start! My biggest regret was waiting as long as I did before I started running again. It feels magical!

Joel Adelman

Joel Adelman

Joel has 7 years combined study and has gained experience and developed skills across a broad range of areas including sports, orthopedic rehabilitation, neurological rehabilitation, geriatrics, pediatrics and cardiopulmonary. Joel uses a combination of exercise therapy, manual techniques and evidence-based practice to help his clients return to optimal health and to prevent further injuries.

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