Preventing Reinjury After ACL Reconstruction
Reinjury is common after an ACL reconstruction. Summit physical therapists Kyle Hall and Jenny Blade explain the risks and share techniques that can help prevent a second injury.

Summit physical therapists Kyle Hall and Jenny Blade have firsthand experience with ACL injuries. Both women underwent ACL surgery as student athletes, and both suffered second ACL injuries following their surgeries. Now they work in Summit’s ASCEND program, which is designed to reduce the risk of recurrent ACL injury.
“Reinjury following ACL surgery is a real risk,” says Kyle. “And fear of reinjury is another factor that can increase an athlete’s risks. After one knee has been hurt, we have a tendency to try to protect our surgical knee—and that puts more stress on our other knee, increasing the likelihood of a second ACL injury.”
Reinjury Risks
Kyle and Jenny review some of the factors that lead to reinjury once athletes return to sport following ACL reconstruction.
- Muscle weakness
- Impaired balance
- Fear of reinjury
- Returning to play too early
“It takes time to recover after an ACL reconstruction,” says Kyle. “Most reinjuries occur between three and nine months after an ACL surgery.”
“Research also tells us that fear of reinjury is the No. 1 reason that people do not feel ready to re-enter their sport,” Jenny points out. “They might test out with plenty of strength, but still feel nervous about pivoting on their surgical leg, even though they can do it with good form.”
Prevention Tips
Summit’s ASCEND program was designed for injured athletes who want to get safely back to competition. The program uses rehabilitation techniques shown to reduce reinjury risks.
- Respect the healing process. Because full graft healing can take 8 to 12 months or longer, patients aren’t eligible for the ASCEND program until they’ve completed their functional rehabilitation following surgery. “If your surgeon used a donor allograft to repair your knee, expect healing to take even more time,” Kyle explains. “When you return to sport too soon, you aren’t strong enough—and your surgical repair may not be strong enough—to handle the physical stress of competition. Studies have shown that deficits can remain up to two years after an injury or surgery.”
- Reclaim neuromuscular control. “Graft strength is important,” says Kyle, “but graft strength alone isn’t enough to prevent reinjury. Studies tell us that rebuilding neuromuscular control is an accessible and effective way to reduce the chance of a second ACL injury. The ASCEND program addresses four neuromuscular imbalances, because we know that this approach reduces injury risks by 30 to 80 percent.”
- Make warm-ups a habit. Active warm-ups have been shown to reduce injury by 88 percent.
“We help our patients safely regain strength through techniques supported by research,” says Jenny. “That’s what ASCEND is all about. When our athletes step onto the field, we want them to feel confident, focused, and ready to play.”
Summit Orthopedics offers comprehensive sports medicine expertise
From Olympians to pro athletes to kids in youth sports and those that just want to be more active—Summit Orthopedics delivers expert care by fellowship-trained sports medicine physicians. If you are recently injured or concerned about ongoing pain, Summit Orthopedics sports medicine specialists have the expertise to evaluate your discomfort and develop a plan to quickly and safely help you get back to being active.
Start your journey to stronger, healthier athletic condition. Find your sports medicine expert, request an appointment online, or call us at (651) 968–5201 to schedule a sports medicine consultation.
Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Vadnais Heights, MN, Plymouth, MN, and Woodbury, MN, as well as several additional community clinics.
Additional resources for you
- Check out the condition guide: Knee Ligament injuries: Tears of the Anterior Cruciate Ligament
- Check out our injury prevention QUICKGuides for sport-specific tips
- More on Summit’s Sports Medicine services
- From Santa Monica Sports Medicine Research Foundation (trusted external resource): PEP Training Program
More resources on ACL
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Jennifer Blade, PT, DPT, CAFS
The difference between the possible and the impossible lies in a persons determination.
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Kyle Hall PT, DPT, Lead Physical Therapist
The stronger your hips and core, the less knee injuries you’ll have.
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