Considerations for Returning to Soccer after ACL Surgery

By Dan Czajkowski, PT, DPT, ATC, CSCS for Athletico Physical TherapyConsiderations for returning to soccer after ACL surgery

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. 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.

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 ACL@athletico.com.

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