ACL Rehab Timeline: Month 8

By month 8 of ACL rehabilitation you are likely feeling fatigue, impatience, and a building desire to get back to the sport your love.

There is no doubt that recovering from an ACL tear and reconstruction surgery is a marathon versus a sprint.  It takes discipline to win each day and perseverance to win your recovery.

So, how can you win month 8 of ACL rehab and what are the goals to pursue this month? 

Month 8 ACL Rehab Statistics 

The further along you are in your ACL recovery the more challenging it becomes to stay focused on your rehab goals.  The desire to "just play" starts to nag your mind daily even though there is still work to be done to ensure you return stronger, faster, and with less risk of injury.

According to Grindem et. al, there is a 51% reinjury rate reduction for each month return to sport was delayed after ACL reconstruction surgery.  This stat holds until 9 months post-op when the risk evens out.  Therefore, holding off your return to sport 1 more month from now will decrease your risk of another knee injury by 51%.  Now that is something to wait for!

Additional statistics show that if you are a younger athlete, age 25 or less, your risk of sustaining a second ACL injury (same or opposite side) is around 21%.  That is close to a 1 in 4 chance of sustaining another ACL injury.   Most studies point to the fact that if an additional injury was to occur it would likely happen shortly after returning to sport participation.

As you can see, if you work hard at least 1 more month, your risk of re-injury would decrease greatly.

Keys To Winning Month 8 ACL Rehab

The number one key to crushing this month of rehab is to stay focused, committed, and driven towards your goal.  Don't let up, get complacent, or let distractions keep you from getting the most you can out of everyday.  

Quadriceps Symmetry 

Multiple studies have linked asymmetrical quadriceps strength to a higher risk of injury. To avoid this mismatch of strength, use this month to perform single leg strength drills with your operated leg.  These exercises can include...

1. Single leg squats with weight
2. Single leg presses
3. Single leg step downs/ups with weight
4. Single leg split squat jumps with weight Agility and Speed Drills With Sport Practice  Now that you have been working on agility drills and straight ahead speed work in months 6 and 7, you are ready to add more variability to your training.  One of the best ways to do this is to perform passing, shooting, and kicking drills while going through agility and speed training.

Once you add a ball to rehabilitation training every weakness and compensation starts to show.  I have seen this in training time and time again.  Sport play is very different than doing exercises in physical therapy.

Ideally your therapist will start with easy passes right towards you and then start to change speed, direction of throw, accuracy of throw, and timing of throw.  This will mimic game play and force you to make real-time adjustments.  For a sport like basketball, you could do keep a dribble going while doing small hurdles, cone agility, or ladder drills. 

Increase the speed and complexity of agility drills to progress from what you were doing in month 7.

Get Your Lungs Back 

Another key variable to address in month 8 of ACL rehab is endurance and cardiovascular training.

This factor is overlooked all the time in rehab even though it is crucial to your ability to safely return to sport. 

There is no doubt that cardiovascular fatigue impairs your ability to produce strength and power which affects your lower extremity control and alignment.  Less oxygen and nutrients to your working muscles yields less output and compromised function. 

During this month, get out and start building your cardiovascular base as well as your top end speed.  To build a solid cardiovascular base, think about running 2-4 miles 3-4 times per week.  This is enough to train you heart and lungs back into sports condition. Also, get out to your local track and do sprint workouts.  Consider running 100's, 200's, and 400's with rest breaks as needed.  Speed is the key here so push yourself to the upper ranges of intensity (85% plus).

Onto The End Of 3rd Quarter 

Coming up next is month 9 of your ACL journey.  It will mark the end of the 3rd quarter of your recovery.  It is a huge milestone considering just a few months ago you were learning to walk again and trying to gain full knee flexion. 

Keep the intensity high, push yourself daily, and remember to have fun along the way. This recovery will likely be a defining moment in your athletic life as well as your personal life.  Enjoy the ride! 

If you live near San Jose California and you are looking for a specialized center to help you fully return to sport after your ACL reconstruction then check out how Competitive EDGE Physical Therapy is revolutionizing ACL rehab.


Kevin Vandi, DPT, OCS, CSCS

Dr. Vandi is the founder of Competitive EDGE Physical Therapy — with his background in physical therapy, orthopedics, and biomechanics, he is a highly educated, compassionate specialist. Using state-of-the-art motion analysis technology and data-driven methodologies, Kevin has assisted a wide range of clients, from post-surgery patients to youth and professional athletes. When he isn’t busy working or reading research, he spends his time with his wife Chrissy and their five wonderful children, often enjoying the outdoors and staying committed to an active lifestyle.

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