How do I know when I am ready to return to sport after my ACL (anterior cruciate ligament) reconstruction?

Unfortunately, Australia has the highest reported rate of ACL injuries in the world, and this rate has risen by 70% in the last 15 years in those under the age of 25. The reasons for this are complex, and probably a topic for another day! But if you have torn your ACL in your knee, had surgery and gone through the rigours of rehab, how do you know if you are ready to return to sport?
There is most certainly not a black and white answer to this question (and there are major scientific papers written on this). But here are 3 basic rules of thumb we recommend:
1. Clearance from your surgeon:
It is important to have a final check before returning to full contact sport to ensure the graft has held and structurally the knee is intact. This generally occurs at around 9-12 months post-surgery.
2. Good quality hopping mechanics:
Examples of these can be found here. Being able to propel and land with good mechanics are vital for return to sport. Yes is important to achieve the hopping markers in the mentioned tests, but the quality of how you perform these tests is equally as important. Your physiotherapist can assess this and make sure you are on track. We commence hopping drills around 2-6 months post-surgery, depending on the patient.
3. Adequate strength numbers: 
We use comparisons to your other side and also also strength markers that are appropriate for the level and type of sport you play. You can’t go wrong getting strong, and this is most certainly the case with ACL rehab. Having a weak knee after your surgery is not going to help anyone. A few tests we use include the single leg press and the use of electromyography (EMG) to ensure your inner quad muscle is active and strong enough.
Your health and cardiovascular fitness, confidence in your knee as well as your overall movement mechanics (ie. how your body moves as a functional unit) are also vital factors that your physio will help you address when getting back into your chosen sport.
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