05/22/2026
Do not return to sport after ACL surgery until you pass these 5 milestones 👇
1️⃣ Minimum 9 months post-op
Returning before 9 months = up to 7x higher re-rupture risk ⚠️
2️⃣ Quad strength symmetry ≥90%
Less than 90% symmetry = 1/3 chance of re-tearing ‼️
PLUS: strength should be >0.7x bodyweight per leg to avoid “false symmetry” from a weak uninvolved side.
3️⃣ Triple Hop Test Distance
Men: ≥2.8x body height distance
Women: ≥2.5x body height distance
AND ≥90% limb symmetry index.
4️⃣ Reactive Strength Testing
Double leg drop jump RSI >1.3 m/s
Single leg drop jump RSI >0.5 m/s
Your knee needs to absorb + produce force quickly for cutting, sprinting, and change of direction.
5️⃣ Sport-specific change of direction testing
You should be able to perform reactive 90° and 180° cuts/pivots with NO pain, instability, or hesitation.
Kyritsis et al (2016) found that athletes that did not meet objective functional discharge criteria had a 4x greater ACL re-rupture rate.
ACL return-to-sport decisions should be based on objective testing not JUST timelines.