08/01/2026
Why Do People Who Have ACL Reconstructions Struggle to Return To Sports?
Published by Ben Lester
50% of ACL Patients Do Not Return to the Same Level of Sport
The dreaded ACL injury. A dodgy turn on the football pitch, followed by a pop, immediate swelling, and a trip to A&E. For many athletes, it’s a worst-case scenario.
Thankfully, advances in orthopaedic surgery mean that ACL reconstruction is now highly effective. But surgery alone does not guarantee a successful return to sport. So what do the outcomes actually look like?
ACL Injury Statistics: The Reality
In short, the statistics are worrying.
- Around 50% of athletes do not return to their pre-injury level of sport
- Up to 30% suffer a second ACL injury, either to the reconstructed knee or the opposite side
These numbers highlight a major issue in how ACL rehabilitation and return-to-sport decisions are managed.
Can You Prevent an ACL Tear?
There is no one on the planet who can predict exactly who will tear their ACL. However, there are well-established risk factors that significantly increase the likelihood of injury.
Following ACL reconstruction, athletes should complete a structured return-to-sport testing battery before being cleared to play. This helps reduce risk and ensures the body is physically prepared for the demands of sport.
Gold-Standard ACL Return-to-Sport Testing
A comprehensive ACL testing programme should include:
Strength Testing
Single-leg strength testing for:
- Leg extension
- Hamstring curl
- Leg press
- Calf raise
- Hip thrust
Muscle Balance & Symmetry
- Quadriceps and hamstring limb symmetry testing
- Identification of strength deficits between limbs
Advanced Performance Testing
- Isokinetic testing (typically performed in a sports science lab)
- Single-leg counter-movement jump
- Single-leg drop jump
- Detailed movement and landing analysis
These tests provide objective data to guide safe return-to-play decisions.
Take Your ACL Rehabilitation to the Next Level
At LIFT Physiotherapy, we specialise in safely returning athletes to sport after ACL reconstruction using intense support and gold-standard testing.
We don’t guess.
We don’t rush timelines.
And we will not clear you to return to play until the data supports it.
Get in touch today and take your ACL rehabilitation to the next level.
Ready to start your physiotherapy journey?
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