The Method The knee
When can you lift heavy after ACL surgery?
When your surgeon or physiotherapist clears you. The research says the strength you have matters as much as the date.
StrongGood evidence, with a caveat worth knowing.
Updated . The Vanguard coaching team.
What most people miss
Most people count weeks. The studies count strength too. Six months after reconstruction, quadriceps strength averaged 23% below the other leg, and still 14% below at twelve months.1
That gap matters. In 106 athletes followed for two years, more even quadriceps strength before going back to sport went with significantly fewer knee reinjuries, and so did returning nine months or more after surgery.2 Athletes who returned without passing all six discharge tests had about four times the risk of rupturing the graft.3
These are cohort studies of athletes, so they show what went with reinjury, not proof of what caused it. They still answer the question better than a date does: heavier lifting comes when you are cleared, and when there is strength there to load.
The research
The papers behind the answer
Each one checked against the paper itself. The grade describes the strength of the evidence, never anyone's results.
Lepley, 2015 · Sports Health
Review of the published studies after ACL reconstruction
Quadriceps strength averaged 23% below the other leg six months after surgery, and 14% below at twelve months. The review describes these as the deficits that remain when formal physiotherapy ends.
Read the paper by Lepley, 2015 (opens in a new tab)Grindem, Snyder-Mackler, Moksnes et al., 2016 · Br J Sports Med
Cohort · n = 106 athletes after ACL reconstruction · 2 years
More even quadriceps strength between the legs before going back to sport went with significantly fewer knee reinjuries. So did returning nine months or more after surgery.
Read the paper by Grindem, Snyder-Mackler, Moksnes et al., 2016 (opens in a new tab)Kyritsis, Bahr, Landreau et al., 2016 · Br J Sports Med
Cohort · n = 158 professional athletes after ACL reconstruction
Athletes who returned without meeting all six discharge tests, strength and hopping among them, had about four times the risk of rupturing the graft.
Read the paper by Kyritsis, Bahr, Landreau et al., 2016 (opens in a new tab)
Research describes groups of people. Your coach will tell you how it applies to you.
From the floor
We keep your clearance on file and train inside the limits you were given, alongside your surgeon or physiotherapist. If a set looks wrong, it stops.
The Vanguard coaching team