How to get back to skiing after an acl tear

Ski season in North America is upon us, and for many of us, that means that we need our bodies to be ready for the wear and tear that comes from skiing and snowboarding on a consistent basis.

For some, that means doing some extra squats in the gym, and for those lucky folks who have excellent conditioning habits, it might just mean re-upping the season pass in preparation for another epic season of powder-slashes, tree runs, and leg-burning descents.

But what if you're recovering from an ACL Tear?

Good question! If you are recovering from an ACL Tear, you’ll have a whole different set of factors to consider as you get back into the great sport of skiing. Let’s go over some of them here today, and talk about how you can get back to doing what you love in a healthy way.

When Can You Get Back on the Slopes After ACL Surgery?

When can I get back? 

This is what people really want to know if they have the ski-fever. And with a new focus on Activity Preservation, we are putting more and more focus on getting you back to participating in the activities you love, quicker and better.

"Ok doc," you're saying, "Get to the point. When can I get back to shredding the gnar, dude?"

There are two factors that we need to take into consideration here.

• Your biology

• Your rehab.

Biology and Returning from the ACL tear

This is a graphic of an Anterior Cruciate Ligament Tear

From a biology standpoint, we need the ACL to "remodel", or grow new blood vessels after it is replaced.

While this is occurring, we are left with a weakened scaffold. Then, new ACL Cells are deposited upon the scaffold, creating a stronger ACL graft.  

The timeframe for this: less than 9 months.

However, we must remember that the scaffold phase is the time when the new graft is at its weakest. The new ACL many be less than half of its original strength from 8-12 months after surgery.

Now Let’s Talk About Rehab

The next step is Rehab. The good news, here: we can have you back to full strength at around 3 months after surgery.

Not bad, right? 

Hold on, though. We'd really prefer not to rush you back after surgery, because we want to give the knee time to re-model on it's own time. 

Let's talk About Returning to The Slopes

“If there are any problems with the knee accepting a load, I want to know about it in the controlled environment of a therapistʼs office, rather than on the hill!”

— Dr. Sterett

When we consider whether high-level athletes (in my specific case, World Cup Skiiers) are on track, we use what is called the SPORT test.

Here is the functional SPORT Test that we use for the ladies on the U.S. Alpine Ski Team...

1. Forward Running with Cord resistance - 1 minute

2. Backward Running with Cord resistance - 1 minute

3. Side to Side Agility with Cord Resistance- 1 minute

4. Single leg knee dips with Cord - 3 minutes

Determining Return to Snow after ACL

We have modified our functional SPORT test over the years, but this functional testing is currently utilized to determine when their athletes are able to start a "return to snow progression" safely. 

If there are any problems with the knee accepting a load, I want to know about it in the controlled environment of a therapistʼs office, rather than on the hill!

I imagine you want to feel comfortable on the knee before you hit the slopes, as well. We want you to be able to go "all-out" and enjoy your time on the mountain.

What's The Verdict?

Finally, here’s my short answer when people ask what the timeframe for return to the slopes after an ACL Tear.

Recreational Sports (skiing) can typically start at 4-6 months after surgery, while competitive sports average 6-9 months. 

See you out there, and good luck!

Dr. Sterett

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