Getting back into tennis after ACL surgery ... who has done it? Any tips?

[time_fly]

I am 44 years old and had ACL reconstruction on June 24, 2016 for a non-tennis knee injury. My rehab is going very well. I have been doing PT for leg strength and flexibility twice a week, seeing a personal trainer for upper body and core strength twice a week, and going to the gym on my own about twice per week. The only negatives are that I have gained a bit of weight, and I recently started jogging again and realized I need to focus more on cardio conditioning. But overall I am ahead of the curve on strength and balance tests.

Currently I am almost 4.5 months after surgery. I shouldn't be playing any competitive tennis for at least another 3-4 months according to the doc, but on the other hand I can already serve (without jumping) and do some cooperative slow rallying without discomfort (so far I only tried this once). I plan to keep working with the trainers on general fitness and rehab, but I am thinking about how to build back into tennis.

Who has gone through ACL rehab? Specifically for tennis, how did you get yourself back into playing? I am more wondering about the tennis-specific aspects than the general rehab which I feel is already going well.

 

[Scuoteguazza]

I blew out my ACL, MCL, and partially tore my PCL as well as detached a hamstring and other muscles playing soccer 14 years ago when I was 52. I started hitting 7-8 months later but didn't start playing matches for another couple months after that. Started playing only doubles at first. The key for me was being religious about doing physical therapy at home in addition to the sessions with the physical therapist. (Same could be said for recovering from rotator cuff surgery.)

 

[mmk]

I hadn't gone back to playing tennis before I had my left ACL replaced, but even with PT I don't think I could have played singles for almost a year, doubles maybe sooner. I did a lot of machine-based leg presses, using my right leg mostly as a spotter for my left. I had a lot of what I'll call crunchiness in my knee for quite some time until I started taking glucosamine, which I know doesn't work for everyone but it did for me. When I did start playing tennis again a few years later I wore, and still wear, a knee brace. Nothing special, I'm sure I could play fine without one, but I feel more secure wearing it.

 

[Deleted member 23235]

i did, when i was ~30 (44 now).

Some highlights:
* did an allograph (to avoid additional hamstring or patella recovery time)
* focused on recovery, followed PT religiously (especially when it came to stretching, breaking up scar tissue, RANGE OF MOTION, etc...)
* focused alot on swimming leading the first 12mos post surgery, to stay in shape. (ie. zero knee impact, allows for range of motion movements)
* focused alot on losing weight (diet!), dropped 20lbs
* waited 12mos before getting back into tennis (very slowly)
* slowly started rebuilding my leg strength/endurance so i could last longer in an athletic position (want to avoid straightening the leg due to fatigue at all costs,... one straighten & twist incident will damage the acl again)
* take glucosomine, chondroitin, msm supplements daily (it could be a placebo for all i know ) - still do!

Since then (knee has been strong with no issues):
* snowboarded regularly after the surgery for a couple years (eg. >70d)... now have quit due to kids, and moving
* play tennis regularly 3-4x/week
* have run all the long version (12M+) obstacle races (tough mudder, warrior dash, spartan race, etc..)
* completed nyc marathon (and ALOT of shorter races)
* train in bjj (i tap VERY early to anything resembling a leg/knee lock)
* etc...

 

[TCF]

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[NLBwell]

Build up your leg muscles - gym and weights - before going back to tennis. Don't play tennis or do sudden movements/twisting until at least 6 mo after the surgery. If you get it healed up right after 6 months, you should be able to be as good as ever within a year or so after you start back to tennis.

 

[time_fly]

I just passed all of the strength and balance tests to finish medical PT, but on the other hand my doctor doesn't want me playing tennis for 9 months after surgery. :-( I take that to mean "playing competitively" and plan to start doing controlled drills before that. I will probably look for a highly-credentialed personal trainer to help fill the gap between medical PT and sports. It feels like this phase of rehab, in between meeting basic targets for balance and strength and being able to play sports, is much more nebulous than the early rehab stages. I need to continue to build up strength but also starting getting some agility back as well, without doing "too much".

 

[NLBwell]

At least in my case, where the new ACL was taken from my tendon, the ACL itself is not fully strong until at least 6 months after surgery. It's not a matter of how strong your leg is or how your recovery/rehab has gone. I don't know if this is the case for a cadaver ACL. Listen to your doctor. Lots of closed-chain and limited motion exercises to strengthen the leg. You can use this time to also strengthen the rest of your body.

 

[PugnaciousDee]

I got ACL surgery on my right knee in July 2015. I hadn't really done any gym specific training before then and the strengthening program they put me through improved my game and even my movement so much, (Got me from a high 4.0 to a low 4.5.) I am 20 so there is a big age gap, but trust that the gym work you are doing will pay off big time. Also i would recommend getting a custom brace if you can afford it, you're going to be in that thing for awhile so it might as well be comfortable.

 

[Deleted member 23235]

I just passed all of the strength and balance tests to finish medical PT, but on the other hand my doctor doesn't want me playing tennis for 9 months after surgery. :-( I take that to mean "playing competitively" and plan to start doing controlled drills before that. I will probably look for a highly-credentialed personal trainer to help fill the gap between medical PT and sports. It feels like this phase of rehab, in between meeting basic targets for balance and strength and being able to play sports, is much more nebulous than the early rehab stages. I need to continue to build up strength but also starting getting some agility back as well, without doing "too much".

take your time!!!
don't pull a jerry rice!
https://www.google.com/amp/profootb...g-back-too-fast-like-i-did/amp/?client=safari
...and he had a team of paid for PTs at his service.

it's too easy to be impatient, feel good, and start back too soon... take up swimming for your conditioning. tennis is a lifelong sport, it'll still be there a year later. I've taken 1yr breaks and 5yr breaks... tennis was still there when I got back

 

[time_fly]

Jerry Rice tried to come back in 16 weeks, which is nuts. I just passed 19 weeks already. I had a hamstring graft and to be honest I regret it a bit -- hamstring-related pain is my biggest remaining issue from the surgery now. So it sounds like most people here waited a year or more until they were 100%, then just went straight back to hitting and playing matches as normal? I was hoping to get back sooner--hoping for 7 months for doubles, 9 for singles--but work into it with drills at first.

 

[Deleted member 23235]

Jerry Rice tried to come back in 16 weeks, which is nuts. I just passed 19 weeks already. I had a hamstring graft and to be honest I regret it a bit -- hamstring-related pain is my biggest remaining issue from the surgery now. So it sounds like most people here waited a year or more until they were 100%, then just went straight back to hitting and playing matches as normal? I was hoping to get back sooner--hoping for 7 months for doubles, 9 for singles--but work into it with drills at first.

i went with allograph, to avoid additional patella/hamstring recovery.
just curious, why'd you go with the hamstring graft? when i was given the option(s), the cadaver option seemed like the only real option.
the issue with going back at all (until you're 100%), is that you'll (I was) be tempted to go for shots i had no business going for... and my competitive juices start kicking in...

 

[time_fly]

I consulted with two surgeons, a local one in CT and a better-known one at HSS in NYC. The local one recommended allograft because of my age (44) but the HSS surgeon who ultimately did my surgery gave me a choice. He said that he leans towards hamstring grafts in active athletes even at my age because the chance of graft weakness or complications is lower, and in his opinion the hamstring recovery isn't a big deal since it should be completed before the graft is fully fixated. My PT focused more on quad strength and balance than the hamstring and the hammy needs more work. On the other hand my single-leg leg press is already nearly identical already between the two sides.

 

[time_fly]

the issue with going back at all (until you're 100%), is that you'll (I was) be tempted to go for shots i had no business going for... and my competitive juices start kicking in...

Yeah, that's why I was thinking to stick to the ball machine, lessons, and cooperative rallying at first, then progressing to clinics where there is some coached point play once I am completely comfortable hitting. No real competition for several more months.

 

[Deleted member 23235]

article i thought you might find interesting as you suffer through recovery.... there is a light at the end, and stuff you can do in the mean time!
http://www.mensjournal.com/health-f...mail&utm_content=daily&utm_campaign=110816_11

 

[RogueFLIP]

The strength and cardio issues will be the easiest to overcome. What will be a difficult hurdle is the mental aspect of regaining confidence in your leg. Being away from the court for so long plus rebuilding the leg, it's lost its proprioceptive sense regarding tennis movements. That loss will take some practice and time to regain even with a fully strong leg. Exactly how long will depend on the individual.

Go slow, take your time, play within your comfort zone but don't be afraid to test the uncomfortable waters every once in awhile.

Tore mine in Oct 1998
Surgery March 1999 with autograph patellar tendon

I remember light hitting that fall but I was playing at a very poor recreational level (not much better nowadays lol) and when I came back to it in the spring; I'd say it took a full year for me to feel confident in the leg.

Now I also had a custom knee brace that I know I wore too long 2-3 yrs afterwards (again, mental aspect).

18 years later, no brace, no issues. Only thing I can't do is sit on my heels if I'm kneeling as it's too much pressure on my knee.

If you have any questions feel free to ask. I've got a lot of experience professionally treating ACL injuries.

Good luck.

 

[SystemicAnomaly]

Yeah, that's why I was thinking to stick to the ball machine, lessons, and cooperative rallying at first, then progressing to clinics where there is some coached point play once I am completely comfortable hitting. No real competition for several more months.

Good idea. In case you hadn't noticed, there is a Health & Fitness forum here. RogueFLIP (above) provides feedback there quite often.

 

[time_fly]

Good idea. In case you hadn't noticed, there is a Health & Fitness forum here. RogueFLIP (above) provides feedback there quite often.

Yeah I did notice that. I was looking for specific strategies to get back into tennis more than general rehab advice, so I decided to put it under "tennis tips" but it's on the borderline I agree.

 

[LeeD]

Doesn't matter what the injury is, you have to come back slow, be prepared to let some shots go, play stronger O while allowing the D to take a rest.
Being physically weaker makes you allow to the handicap. If you don't, you risk aggravating your injury for a double time recovery.

 

[RogueFLIP]

Yeah I did notice that. I was looking for specific strategies to get back into tennis more than general rehab advice, so I decided to put it under "tennis tips" but it's on the borderline I agree.

Couple of rambling thoughts:

Start hitting against the wall all aspects, groundstrokes, serves, volleys....progress to doubles then singles.

Lots of single leg stuff, not just strength and conditioning, but agility stuff as well, like hopping and jumping but landing 90degrees from where you started for example. You really want to tax your knee in practice (when the time is appropriate) as I mentioned before to gain your sense of proprioception.

Flexibility and elasticity of the soft tissue is equally as important as the strength and endurance. Joint mobility and full ROM of ankles and hips can take stress off the knee.

Listen to your body and rest when needed. Lots of people develop some tendonitis bc they're trying to work too hard to make their recovery faster.

 

[NLBwell]

Don't be doing hopping and stuff until 6mo after your surgery. Your ACL itself is not strong yet - even if you can hop to the moon.