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Considerations for Returning to Soccer after ACL Surgery

by Athletico11 Comments

You’re almost there. The initial ACL injury you sustained months ago seems so distant. You’ve endured all the time healing from the surgery, the rehab, and now you are pushing ahead to get better, stronger and faster. You can almost taste the grass, outperforming your opponents, and scoring a goal in the final minutes of the game.

But wait. Despite finishing rehab and being cleared to progress to sports specific activities, you haven’t even run on grass yet. You haven’t tried cutting at full speed. You haven’t practiced your best moves or even shot at a goal, let alone scored against anyone. You can see the finish line of your recovery, but you don’t really know exactly what you need to do in order to get there.

Many soccer players coming back from an ACL surgery don’t always know the best way to get themselves back on the field safely. However, the secret is simple – start small, stay consistent and progress slowly. Here are a few things to take into consideration as you work toward getting back onto the field:

1. Start by getting fit.

Soccer is a unique game that includes sprinting, changing direction and endurance. You need to train all these factors to be successful, especially when coming back from an injury where you haven’t trained in months. You will need to train yourself in a variety of ways. A few examples are listed below:

  • Interval sprinting and jogging progressions (i.e. jogging for three minutes, sprinting for two minute and repeating for 30 minutes total)
  • Deceleration and Acceleration (i.e. sprint 5 yards and back to endline, sprint 10 yards and back to endline, etc)
  • Endurance running (i.e. 2-4 miles long run)
  • Agility (i.e. sprinting in Box Shape, agility ladder, 5 or 10 yard zig-zag sprints with cones)

2. Start small with your ball skills and progress very slowly

Even though this is usually the most fun aspect of training for soccer, your knee will need time and practice to get used to manipulating the ball. Start by doing simple moves (i.e. turning, using in/out of foot, tic tocs, roll-overs, etc). Gradually increase your speed of the movement as well as sprinting a few steps after finishing your move.

The same progression goes with passing, crossing and shooting. Start out with kicking the ball in place or using a wall to perform short one and two touch passing. Gradually increase your distance as you get more comfortable, and then start passing while you jog, followed by passing while you sprint.

3. Always work on and perfect your cutting/jumping mechanics.

Just because you are training on your own does not mean that you neglect your responsibility to progress, which can help to prevent future injury. As you get stronger, you will need to learn to control your body and keep your knee stable. ACL Injury prevention programs that focus on improving landing and cutting strategies as well as neuromuscular control have been shown to reduce the risk of injury.1 The trick with these drills is to land with a soft-landing and maintain a half squat position (i.e. slight forward lean, knee bent and knee aligned over ankles). Practice performing two-leg and one-leg jumping in a variety of directions, including forward, sideways, diagonally and over hurdles. Doing 5-10 reps in each direction can help improve your performance and decrease the risk of injury.

4. Perform SAFE strength training under fatigue.

Soccer is a demanding sport. You will be in situations when your body is tired and fatigued, but you don’t want to let your knee become unstable due to this. Performing strength training after you run or perform a workout that fatigues your body can help improve your knee stability. You can perform a 5-10 minute high intensity sprinting workout and then perform body weight or light weight exercises. Some useful exercises include single leg squat, Bulgarian split squats, side walking with a theraband, or single leg balance on an unstable surface. It is import to make sure you have excellent form (keeping trunk stable, knee aligned forward and behind your toes, etc) when performing these exercises. Keep in mind that strengthening routines can also be performed prior to fatigue and have still been shown to reduce re-injuries as well.1

Getting Back on the Field

The journey to returning to sport is long, tiring mentally and physically, and takes a lot of hard work. However, many athletes are successful in this journey and you can be too!

Make sure to consult your physical therapist if you have any questions about your recovery process or how to effectively return to sport during your journey. For information about Athletico’s ACL 3P Program, which can help athletes minimize the risk of ACL injury as well as help those who have experienced an ACL injury progress after surgery, please email

1. Ardem CL, et al. 2018 International Olympic Committee Consensus Statement on prevention, diagnosis, and management of paediatric ACL injuries. BJSM 2018;0:1-17.

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  1. Amadou Kalle

    Hey thank you very much for this article I am currently 5 months into my acl rehab, I feel very well walking and putting wait on my leg but I still haven’t started running yet 100% or doing any of these tips you’ve shared here.

    But after reading your article today I will start doing all the exercises, I have regained my strength, faith and belief now on my comeback. Now I believe and know I will comeback stronger than ever and I will be the best soccer player in the world one day.

    Thank you very much

  2. Veronica

    Just read ur article, my daughter had surgery 1 month ago, going through physical therapy. Going to try everything you said. And good luck to previous person who left comment, wish you the very best and hope you will be the best soccer player of the world, which I constantly mention to my daughter whenever she feels down. It’s a difficult process, but not impossible!

  3. David Martin

    My daughter is nearly 16 months out from her ACL reconstruction, and then 5 months ago required a surgery for a Cyclops Lesion to be removed. She continued her strength and conditioning and played her first game last night – today there is swelling and pain….is this normal?

  4. Athletico

    David – Congratulations to your daughter on her comeback after her long journey! Mild swelling and some soreness or mild pain is within the scope of normal after new activities like games, even 16 months out. This should resolve within 24 hours. If swelling is significant, pain lingers, or there is any clicking/locking/instability, follow-up with surgeon is recommended.

  5. mark

    My daughter had acl surgery 15 months ago. She plays Div 1 soccer and is struggling to get back into form. She worked out all summer running, weight lifting, stretching and just generally working on getting soccer fit. Still many physiological connections being made on the return trail. Getting the mind and movements back in the game, speed, agility and endurance specifically. Pushing the knee a bit now after 15 months, really adding stress to it with mile sprints, full field scrimmages etc… Still experiencing numbness from the hamstring removal and then pain in the knee after stressful workouts.
    To all parents and players after seeing this all first hand if you’re playing a high level sport remember those muscles will need to be used again at the highest levels. Pushing them is a painful remedy but asking the tendons to do 100% during a game when they are only worked 50% in practice is not going to work. It will hurt sometimes, it will swell sometimes, it will be numb sometimes.

    It will be interesting to see how she does after a 1 season of college sports training.

  6. Mez

    I’m 4 months into my surgery and cleared by my surgeon to run after 3.5 month. Still no confident but emotionally up there. 3 gym sessions a week and 3 runs of 2.5km. I’m hoping after 8 months but after my surgeon’s clearance. that time. He initially said 12 months but was happy with 4 month progression. Is that correct ACL becomes mature after 10 months not earlier?
    And Yes I can smell the grass. Thanks 🙂

  7. Josue Sa

    I got surgery last year on March 15 2021 and it’s been almost 10 months and I feel like right now I’m at 73% recover from my acl surgery , I want to know , how many months more I need to be at 100% on the knee , so I can be able to play soccer at 100% without no problem , the sport that I love so much 🙂

  8. Lewis Fowle

    I had surgery on ACL 11 months ago and I am back training in my football team but not with any contact from my teammates, I feel good but I feel like I can’t go into a tackle or put my foot in as I’m scared I might re tear or injure it, is there any way I can improve this?

  9. John

    Hi doctor,

    I sustained an ACL tear in 2018 and within six months, I under went a supposed Reconstructive surgery. However, during the operation, the surgeon performed stability tests concluding that the knee was stable: Thus, he could not justify reconstruction because it spontaneously healed. He proceeded to remove cyclops and trimmed the meniscus that was also torn. He then cleared me to return to play in about a month of rehabilitation. However, I was apprehensive and just did a bit of running, at one point running 5 kms in 21 minutes. I’m now thinking of returning to soccer, and I was wondering what’s the probability of a re-rupture. The Knee is stable and I have played a basketball scrimmage at about 60% of effort pivoting sparingly over the last 6 months. I have scheduled an MRI but I don’t know if that will be of any help in the decision. By the way my surgeon is well respected and regarded one of the very best in Australia, he was a leading surgeon for a national team sport as well as professional sports clubs. But he’s now working in private practice. Thank you for your time.

  10. Kunal Nand

    Kunal football player from New Zealand
    Bit of a rundown on my journey so far 6months post op.
    Did 2months prehab with my physio and PT .
    Complete acl rapture ,medical/lateral miniscus and cartilage chip on femur bone. Graft used was a combination of hamstring and quad tendon.
    Started rehab within 24hours after my surgery I had 2 sessions a week with my physio, 3x a day everyday with my basic rehab exercises to regain ROM.
    Cleared to use the gym 2weeks post op
    PT introduced week 2 3x a week together with 2x physio sessions within 12weeks I had full ROM. Heat and cold therapy helped with inflammation . Had little bit of laxcity in the knee when my surgeon checked 3months visit but nothing concerning.
    3months post op Started stationery bike from 2mins all the way up to 45mins 5x a week as I got better.
    3.5months post op chiropractor 3x a week and sports massager 2x a week Introduced in the rehab now these 2 is a real booster in my rehab they both helped me perform better in my rehab in my opinion.
    On my low weeks I have minimum of 6 session and as I progress over the week each month on my high rehab week I have minimum of 10 session with proper rest days and active recovery and that’s excluding the chrio, physio and sports massager.
    6months check up surgeon is very happy 9months mark I’ll be doing return to sport test.
    6months post op I’ve done the hop test with my physio to see where I’m sitting currently on 78/84% on operated leg, 95% needed to pass.
    Physiologically I was bit scared in my first 3months but as I progressed and did some challenging sessions I got over it really quickly. Now I don’t even think about it at which helps me do single leg work alot, knee is very stable and can do pistol squats on operated leg.
    Few keys points I got told was:
    Hot and cold therapy
    Eccentric , concentric and fatigue training of muscle groups
    Lose unnecessary fat around core area and quads and transform to muscle.
    Healthy eating habits.
    Do not neglect all other muscle groups work/train them all for a better/healthy outcome.
    Don’t rush to get back but instead perfect your form and techniques first than all will fall in place.

    So far these things are helping me so I’m looking at fully competing again in 4/5 months.
    Wish everyone the best in their journey.
    Aim to be better than you were before for good and don’t dwell on negative thoughts.

  11. Marcos jauregui

    Greetings from Fresno, Ca. I’m 4 months into my ACL and Meniscus reconstruction surgery and I just started to run and do many of these drills you listed and let me say things have never felt better. I play D1 soccer as well and for a full year I played with a fully torn ACL and and no meniscus in my left Knee. Still managed to play a full season and score 18 goals. My coaches and teammates never new until I went to the doctor and got my MRI. After the winter season. I never new my ACL was gone at the time. But my mind wasn’t going to except it. I breath , live and will die playing soccer. If you love the sport in the same way, keep on fighting. Many pro athletes have suffered multiple ACL injuries and go on to have Hall of fame careers. Why can’t we?
    – Marcos jauregui

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