What to expect during an ACL tear recovery

After a child experiences a tear of the anterior cruciate ligament, the recovery process requires patience, dedication and support from the athlete’s family.

Norton Children’s Orthopedics of Louisville

Our team helps children heal from their sports injury and return to sports safely.

After a child experiences an anterior cruciate ligament (ACL) tear, the recovery process post reconstruction surgery requires patience, dedication, and support from the athlete’s family and friends. 

Initially, the primary goals of post-surgery rehabilitation are restoring range of motion, activating the quadricep muscle and getting comfortable walking without crutches. Sports nutrition education can help optimize healing and recovery, according to Kait Zagami, MS, MCMSc., PA-C, a pediatric sports medicine physician assistant with Norton Children’s Orthopedics of Louisville, affiliated with the UofL School of Medicine.

“Once those goals are achieved, we then focus on strengthening the leg,” said Kait, who assists athletes in their recovery process. “I also focus heavily on core strength to help with stability during explosive exercises later in rehab.”

When can my child return to sports after ACL tear recovery?

After surgery, athletes will participate in an initial physical therapy program to regain mobility and strength. Regaining normal knee range of motion is incredibly important. 

Six weeks after surgery, children are encouraged to return to the weight room with their teams. Activities can be modified, which is encouraged versus stopping all activities. “The sooner we can get them to be a part of their team again, the better their psychological health,” Kait said. “I spend a significant amount of time discussing what their individual team’s workout program is and modifying it so the patient can participate.”

Seven months after surgery, return to sports programs may begin, which includes more explosive strength movements and an emphasis on correct jumping and running mechanics. Strengthening, balance and form in sport-like situations are areas of focus as well.

Nine months after surgery, athletes may be able to return to game-like situations, which includes performing movements such as cutting and pivoting without the supervision of their physical therapist.

Supporting a child’s mental health during ACL tear recovery
Recovery after an ACL reconstruction isn’t just physical; it can affect an athlete’s mental health, too. There are two components to psychological healing we focus on during their recovery: postoperative depression and fear of re-injury.

“Postoperative depression is difficult to navigate by the patient and their family,” Kait said. “It is very hard for a preteen or teenager to be learning independence and then have an injury that requires them to ask their parents for help on top of having pain.”

Postoperative depression is usually worse during the first two weeks after surgery. It often improves before returning around three to four months later. This typically is caused by the patient noticing the improvements in their physical recovery but still being under restrictions from their sport. Athletes are encouraged to remain active, socialize with friends, spend time outside and work with a sports psychologist.

Fear of re-injury can cause hesitation in game-like situations. This can increase the risk for further injuries. This is discussed before an athlete can return to play. A return-to-sport program and a sports psychologist can help with overcoming any fears of re-injury.