An ACL tear doesn’t have to end your sports story. With the right plan, most athletes return to cutting, pivoting, and contact sports in about 9–12 months, using clear milestones—not the calendar alone—to guide the way.
What is an ACL injury?
The anterior cruciate ligament (ACL) is one of the main ligaments that stabilises your knee. It keeps your shin bone (tibia) from sliding too far forward and helps control twisting movements.
Most ACL tears happen during sports that involve:
- Sudden changes of direction or cutting
- Pivoting on a planted foot
- Landing awkwardly from a jump
- Rapid deceleration or a direct collision at the knee
Many athletes feel or hear a “pop,” followed by pain, swelling, and a sense that the knee is “giving way.”
When does an ACL tear need surgery?
Not every ACL tear automatically needs surgery. The decision depends on your goals, your knee stability, and any associated injuries (like meniscus tears or cartilage damage).
In general, ACL reconstruction is often recommended if you:
- Want to return to cutting, pivoting, or contact sports (e.g., soccer, basketball, football, skiing)
- Have repeated episodes of the knee buckling with daily activities
- Have combined injuries, such as meniscus or cartilage damage, that benefit from stabilising the knee
- Are younger or highly active and want to protect the knee from further damage over time
Anterior Cruciate Ligament (ACL) Injuries
Some lower-demand patients—especially those who avoid pivoting sports and can function well with a brace and physical therapy—may do well without surgery. Your surgeon will help you weigh the trade-offs.
What actually happens during ACL reconstruction?
During an ACL reconstruction, your surgeon replaces the torn ligament with a graft—a small piece of tendon that functions like a new ligament.
Common graft choices include:
- Patellar tendon autograft (from your own kneecap region)
- Hamstring tendon autograft
- Quadriceps tendon autograft
- Allograft (donor tissue) in selected patients
The procedure is usually performed arthroscopically through small incisions.
Specialised instruments allow the surgeon to:
- Inspect the knee cartilage, meniscus, and ligaments
- Clean up torn ACL fibres
- Drill small tunnels in the femur and tibia
- Thread the graft into the tunnels and secure it with fixation devices
At Catalyst Orthopaedics & Sports Medicine, Dr Tracye Lawyer is a board-certified, fellowship-trained orthopaedic sports medicine surgeon who specialises in arthroscopic and open surgery of the knee, with a particular interest in cartilage preservation and complex ligament reconstruction. Independent Doctors of Idaho
Dr Kaitlin Neary is a board-certified orthopaedic surgeon with advanced training in orthopaedic sports medicine and foot and ankle surgery, caring for athletes with lower-extremity injuries that affect stability, movement, and performance. Independent Doctors of Idaho
If you’d like to read more about each surgeon’s background and philosophy of care, you can visit Dr Tracye Lawyer’s site and Dr Kaitlin Neary’s site.
ACL recovery timeline at a glance
Every recovery is individual, but most athletes follow similar phases. Evidence suggests that returning to high-risk sports earlier than 9 months raises the risk of reinjury, so your team will focus on meeting milestones rather than chasing a specific date on the calendar.
0–2 weeks: Protecting the knee
- Control pain and swelling
- Begin gentle range-of-motion exercises
- Start early quadriceps activation
- Use crutches and a brace as instructed
2–6 weeks: Re-establishing motion and gait
- Aim for near-full extension and flexion as guided by your surgeon and therapist
- Progress from two crutches to one, then walk without crutches when safe
- Begin closed-chain strengthening (like mini-squats, bridges)
6–12 weeks: Building strength and control
- Increase lower-extremity strength, especially quadriceps and hamstrings
- Add balance and neuromuscular training
- Stationary bike, low-impact cardio, and light gym work as tolerated
3–6 months: Early running and sport-specific patterns
- Transition to jogging, then controlled running, once strength and mechanics are adequate
- More demanding balance, agility, and change-of-direction drills
- Gradual progression, avoiding cutting or contact until cleared
9–12+ months: Return to cutting, pivoting, and contact sports
- Functional hop tests and strength benchmarks that are close to your other leg
- Sport-specific drills at game speed
- Final clearance from your surgeon and rehab team before full competition
These are typical ranges, not promises. Some athletes progress faster, some need more time—especially if there were additional injuries or procedures addressed during surgery.
How does your team decide when you’re ready to return to sport?
Rather than relying on time alone, your orthopaedic sports medicine team looks at several factors:
- Strength symmetry
Your operated leg should be close to your non-injured leg in quadriceps and hamstring strength, usually measured with objective testing. - Functional testing
Hop tests, balance assessments, and agility drills help check whether your knee can tolerate cutting, landing, and deceleration. - Movement quality
Your team will watch for knee collapse (valgus), poor landing mechanics, or compensations that raise reinjury risk. - Psychological readiness
Feeling confident, rather than fearful or hesitant, is a key part of safely returning to play. - Sport demands
A recreational cyclist has different demands than a varsity soccer player or backcountry skier—your plan is tailored to your sport.
How Catalyst supports you from first visit to full return
At Catalyst Orthopaedics & Sports Medicine, the goal is to blend advanced surgical techniques with a very personal, athlete-centred approach.
Your care typically includes:
- Same-week new-patient access when possible, especially after an acute injury
- Close coordination with physical therapy so everyone—surgeon, therapist, and patient—is working from the same playbook
- A focus on joint preservation, especially when there is cartilage damage or meniscus injury
- Guidance on bracing, cross-training, and the safest progression back to your specific sport
For a broader overview of how the team looks after athletes of all ages, you can read the main Orthopaedic Sports Medicine in Boise & Meridian article on our site.
When should you call sooner?
After an ACL injury or reconstruction, contact your care team promptly if you notice:
- Fevers, chills, or worsening redness around your incisions
- Sudden increase in pain or swelling, especially after a new activity
- A new “pop,” buckle, or feeling that the knee is sliding out of place
- Calf pain, warmth, or swelling that could suggest a blood clot
If you experience severe pain, can’t bear weight, or have signs of infection or blood clot, seek urgent or emergency care.
Taking the next step
If you’re wondering, “Is now the right time for ACL surgery?” or “Am I really ready to go back to sport?”, that’s exactly the type of conversation the Catalyst team has every day with athletes in Boise, Meridian, and across the Treasure Valley.
You can request a visit online through the Request an Appointment page or call the office directly to schedule. Together you’ll build a plan that honours both your long-term knee health and your goals on the field, court, or slopes.
For additional background reading on ACL injuries and treatment options, many patients find the American Academy of Orthopaedic Surgeons’ OrthoInfo page on Anterior Cruciate Ligament (ACL) Injuries helpful.
ACL Reconstruction FAQs
How long will I use crutches after ACL surgery?
Most patients use crutches for 1–2 weeks, gradually putting more weight on the leg as swelling improves and quadriceps strength returns. Your exact timeline depends on your graft type, any additional procedures (like meniscus repair), and your surgeon’s protocol.
When can I drive again?
If your surgery was on your right leg, you typically need to be off pain medications that cause drowsiness and able to safely perform an emergency stop with good control. For many people, this is around 2–4 weeks, but your surgeon will give you specific guidance for your situation.
Is ACL reconstruction safe for teenagers?
Yes. Teen athletes often undergo ACL reconstruction, but growth-plate status, sport demands, and future goals are carefully considered. Your surgeon will discuss options tailored to your child’s skeletal maturity and activity level.
Will I need to wear a brace when I go back to sport?
Some athletes use a functional sports brace for extra confidence in the early return-to-sport phase. Others rely on strength and neuromuscular control alone. There isn’t a single “right” answer; your surgeon will consider your sport, graft type, and risk profile.
What happens if I delay or skip ACL surgery?
Some individuals with lower activity levels manage well without surgery, especially if the knee feels stable and they avoid pivoting sports. However, in cutting or contact athletes, ongoing instability can increase the risk of meniscus tears and cartilage damage over time. A consultation with an orthopaedic sports medicine surgeon can help clarify the pros and cons for your knee.
Important note This article is for general education only. It does not replace a consultation with a qualified clinician. Your injury, medical history, sport, and goals are unique, so diagnosis and treatment decisions should always be made in direct discussion with your orthopaedic surgeon and care team.