Getting Back on Track: How to Start Running After ACL Surgery

how to start running after ACL surgery

ACL surgery, or anterior cruciate ligament surgery, is performed to repair or reconstruct the ACL in the knee joint. The ACL is a crucial ligament that provides stability and support during physical activities such as running, jumping, and pivoting. 

However, after ACL surgery, physical activity is significantly impacted as the knee requires time to heal and regain strength. Starting running after ACL surgery requires a gradual and safe approach. 

Rushing into high-impact activities without proper preparation can increase the risk of re-injury and hinder the recovery process. It is essential to prioritize a progressive and structured plan focusing on rebuilding strength, improving flexibility, and gradually reintroducing running.

This blog will explore the steps and considerations involved in safely returning to running after ACL surgery. From consulting with professionals to strengthening and conditioning exercises, we will guide you through the process of resuming running while minimizing the risk of complications. Let’s dive in!

Consultation with your Doctor and Physical Therapist

Before starting any exercise post-surgery, it is crucial to seek professional guidance. Your doctor will evaluate the surgical site, monitor your healing progress, and ensure the knee is stable enough for running. They may also provide guidelines regarding weight-bearing limitations, potential risks, and additional precautions based on your situation.

Your physical therapist will assess your range of motion, strength, and functional abilities. Through targeted exercises, they will help you regain strength in the affected leg and surrounding muscles, improve stability, and restore proper movement patterns.

It is vital to follow the recommendations and guidelines provided by your doctor and physical therapist. They will outline a comprehensive plan that gradually introduces running while monitoring your progress.

Strengthening and Conditioning

Preparing your body through targeted exercises and conditioning focuses on rebuilding strength, enhancing stability, improving balance, and restoring overall function.

Exercises that target the quadriceps, hamstrings, and glutes are particularly important for rebuilding strength in the affected leg. Squats, lunges, and step-ups are effective in targeting these muscle groups. Start with bodyweight exercises and gradually add resistance as you progress.

Single-leg balance exercises help improve stability and proprioception. Practice standing on one leg while maintaining your balance, gradually increasing the difficulty over time. Other exercises, such as single-leg squats or single-leg deadlifts, can also be incorporated into your routine.

Alongside strengthening exercises, maintaining cardiovascular fitness is crucial. Low-impact exercises such as cycling, swimming, or using an elliptical machine can help improve cardiovascular endurance without putting excessive strain on the knee. These exercises also promote blood circulation and aid in the overall recovery process.

Gradual Return to Running

After ACL surgery, a progressive training program is essential for a safe and successful return to running. This approach allows your body to adapt gradually, minimizing re-injury risk and optimizing your recovery. It involves slowly increasing your running sessions’ intensity, duration, and frequency over time.

The return to running typically involves several phases. Begin with walking, focusing on regaining your natural gait and comfortable stride. As your strength and confidence improve, gradually transition to jogging and then running intervals. Start with short bursts of running alternated with periods of walking or jogging to allow your body to adjust to the increased impact and demands of running.

A sample timeline and guidelines for each phase may vary depending on individual circumstances and the guidance of your healthcare provider. However, as a general guideline, aim for approximately 2-4 weeks of walking, followed by 4-6 weeks of jogging before gradually incorporating running intervals. 

Proper warm-up and cool-down routines are crucial for injury prevention. Prior to running, warm up your muscles with dynamic stretches, such as leg swings and lunges, to increase blood flow and improve flexibility. 

Running Technique and Form

Maintaining good running form is essential to reduce knee stress and lower the risk of injury. Focus on maintaining an upright posture with a slight forward lean, engaging your core muscles to provide stability and proper alignment.

Pay attention to your foot strike and aim for a midfoot or forefoot strike, as landing on your heels can increase the impact on your knees. Strive for a quick cadence (number of steps per minute) to reduce the strain on your joints and improve overall running efficiency.

Consider consulting a running coach or physical therapist for a gait analysis. They can assess your running technique, identify any areas for improvement, and provide specific recommendations to optimize your form. Making adjustments based on professional guidance can enhance your running efficiency and help prevent future injuries.

Preventing Future Injuries

Ongoing strength and flexibility training is crucial to preventing future knee injuries. Focus on exercises that target the muscles around the knee, such as quadriceps, hamstrings, and glutes. Incorporate exercises like lunges, step-ups, and leg presses into your routine to maintain strength and stability.

Cross-training and incorporating other exercises into your fitness regimen can help improve overall fitness. Activities such as swimming, cycling, or low-impact aerobic workouts provide cardiovascular benefits while minimizing the impact on your joints.

Choosing appropriate footwear is important to support your knees and reduce the risk of injury. Look for running shoes that provide adequate cushioning, stability, and support for your specific foot type and running style. In some cases, using orthotics or inserts recommended by a healthcare professional may further enhance your comfort and stability while running.

Listening to Your Body and Patience

Pay close attention to any discomfort or pain during the recovery process. While some soreness is normal, it’s important to differentiate between muscle fatigue and potential signs of overexertion or injury. Consult your doctor or physical therapist if you experience persistent or worsening pain, swelling, or instability.

It’s crucial to listen to your body and make necessary modifications to your training if needed. Take rest days when required, and consider modifying your running intensity or duration to avoid overexertion. Pushing too hard too soon can hinder your progress and increase the risk of setbacks.

Remember, everyone’s recovery timeline is different. Be patient with yourself and the healing process. Focus on your individual progress and celebrate each milestone along the way. Stay positive, persistent, and committed to your recovery journey.


Starting running after ACL surgery requires a thoughtful and gradual approach. Seek professional guidance, follow a progressive training program, and pay attention to your body’s signals. Focus on maintaining good running form, prioritize strength and flexibility training, and take steps to prevent future injuries. 

Remember to be patient, stay positive, and trust your body’s ability to heal and regain strength. With the right mindset and proper care, you can successfully return to the joy of running and embrace an active, healthy lifestyle once again.

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