ACL reconstruction, week 0 to year 2
Your knee will feel ready months before it is ready
That gap is where second ACL injuries happen. This site is built around the numbers that close it: time since surgery, quadriceps symmetry, hop test symmetry, and confidence. Every figure here is traceable to the study it came from, and the studies disagree in places. We say where.
No sign-in, no quiz funnel, nothing you enter leaves your browser. See every source.
The four numbers that decide return to sport
Delaware-Oslo cohort: reinjury fell 51% for every month return was delayed up to 9 months, and 38.2% of athletes who failed these criteria were reinjured versus 5.6% of those who passed.
Start here
Three questions, then read the right page
This site covers everything from the day you tear it to the day you get cleared. Tell us where you are and we will send you to the four pages that matter now, instead of the forty that do not.
Where are you right now?
Roughly how far past surgery are you?
What are you aiming at?
Guides
Start where you are
An ACL reconstruction is one of the most standardized operations in American sports medicine, and one of the least standardized recoveries. Two athletes with the same graft, same surgeon and same insurance can be 30 percentage points apart in quadriceps strength at six months, and neither of them will know it unless somebody measures.
So the pages here are organized the way the decisions actually arrive.
The timeline, week by week
What is supposed to happen at week 2, week 12, month 6 and month 9, and which parts are gated by criteria instead of dates.
ReadA criteria-based rehab protocol
Five phases, with the entry criteria for each one. The clinical practice guideline is explicit that progression should be criterion-based, not calendar-based.
ReadReturn-to-sport testing
The battery your physical therapist runs, what each test is measuring, and what the thresholds do and do not predict.
ReadQuadriceps strength
The single most predictive number in the whole recovery, and the one most often estimated by feel instead of measured.
ReadCost, insurance and prior authorization
Deductible, coinsurance, out-of-pocket maximum, visit caps, in-network anesthesia. The arithmetic that decides what you actually pay.
ReadSecond injury risk
Close to one in four young athletes who return to high-risk sport tears an ACL again. Here is what moves that number.
ReadEvidence
What the numbers actually say
Those four numbers are the reason this site exists. They are also the reason we publish the counter-evidence: a 2019 meta-analysis of four studies found that passing return-to-sport criteria was not significantly associated with a lower second injury risk, at very low quality of evidence. Testing is the best tool available, not a guarantee, and anyone who tells you otherwise is selling something.
Tools
Four tools, all in your browser
Nothing is uploaded, nothing is stored, no account. Close the tab and it is gone.
Readiness check
Nine criteria, grouped the way a clinic groups them. Produces a printable summary and a shareable link for your physical therapist.
ReadTimeline calculator
Enter your surgery date and get real dates for every milestone, including the 9-month mark.
ReadSymmetry index calculator
Operated leg divided by other leg, with the thresholds that matter and the trap that flatters your result.
ReadOut-of-pocket estimator
Runs your plan's own numbers: deductible, coinsurance, out-of-pocket maximum, PT visit cap.
ReadThe app
What the app does
Closed beta. The waitlist is the only thing on this site that asks for an email address.
Everything on this site is a piece of one year of your life, and right now that year is scattered: the protocol on a folded sheet in your gym bag, the measurements in your physical therapist's notebook, the isokinetic report in an email, the scar photos lost in your camera roll. The app puts all of it in one place. Every day you know what to do. Every week you can see it moving. On appointment day your PT and your surgeon have the whole picture in front of them.
Your road map on day one
The six phases, what actually unlocks each one, and a real date for every milestone computed from your surgery date. Not a countdown, a plan.
Today's session
What to do today, with the cue, the load, the sets and a timer. It opens offline, because the gym in the basement has no signal.
56 guided movements
One library, three axes of progression, and a movement that unlocks on a clinical criterion rather than on a calendar date.
Same-day and next-day rating
Two questions in the evening, two more the next morning. The gap between them is the earliest honest signal that a session was too much.
Your measurements
Range of motion, thigh circumference, pain, effusion, logged in under three seconds and plotted from week one.
Strength and hop tests
Your numbers, your limb symmetry index computed for you, and the distance left to the threshold instead of a raw ratio you have to interpret.
The questionnaires
SANE from the beta, then IKDC, KOOS and ACL-RSI as licensing allows, prompted on the dates where the score actually changes a decision.
The scar, month by month
Same framing every time, side-by-side with last month, in an album that does not live in your camera roll.
The medical file
Operative report, MRI, X-rays, isokinetic PDFs, insurance letters: stored next to the rehab, not in an inbox you search at 11pm.
Appointments and paperwork
The next surgeon visit, the month to book the isokinetic test, work restrictions, short-term disability, prior authorization, and the clearance your school or league wants.
A one-page report
Printable, or shared through a link that expires. Your PT sees your curves, not your account.
Where other people were
Anonymous reference bands from people with the same graft at the same week. It appears when there is enough data to be worth reading, not before.
The app never issues a green light. It shows the criteria you have met and the ones you have not, and the decision stays with you, your physical therapist and your surgeon. That is a product rule, not a legal one: an app that clears athletes to play is a different, regulated object, and a worse one.
Health data is never sold and never used for advertising. The closed beta opens in French first, with the patient product; the English version is the next language to ship, and the waitlist is what sets that order. Pricing principle is already settled: you start for free, and when you pay, you pay once for the whole recovery instead of a subscription you will forget to cancel. Join the waitlist.
Recovery tracking app
Get told when the beta opens
We are building the thing this site keeps pointing at: a tracker that records your strength numbers, your hop tests, and your ACL-RSI over time, and shows you the gap between where you are and where the testing thresholds sit. Two emails at most before launch, unsubscribe in one click.
References cited on this page
Every figure on this page comes from one of the publications below. The level of evidence is stated: a national guideline, a meta-analysis and a case series do not carry the same weight.
- Kotsifaki R, Korakakis V, King E, et al. Aspetar clinical practice guideline on rehabilitation after anterior cruciate ligament reconstruction. British Journal of Sports Medicine, 2023;57(9):500-514. Read the publication. Clinical practice guideline built with the GRADE method: progression driven by objective criteria rather than the calendar alone, early strengthening, explicit criteria for returning to running and to sport.
- Grindem H, Snyder-Mackler L, Moksnes H, Engebretsen L, Risberg MA. Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study. British Journal of Sports Medicine, 2016;50(13):804-808. PubMed 27162233. 106 pivoting-sport patients, prospective two-year cohort.
- Ardern CL, Taylor NF, Feller JA, Webster KE. Fifty-five per cent return to competitive sport following anterior cruciate ligament reconstruction surgery: an updated systematic review and meta-analysis including aspects of physical functioning and contextual factors. British Journal of Sports Medicine, 2014;48(21):1543-1552. PubMed 25157180. 69 papers, 7,556 participants.
- Wiggins AJ, Grandhi RK, Schneider DK, Stanfield D, Webster KE, Myer GD. Risk of secondary injury in younger athletes after anterior cruciate ligament reconstruction: a systematic review and meta-analysis. American Journal of Sports Medicine, 2016;44(7):1861-1876. PubMed 26772611. Systematic review and meta-analysis, 19 studies.
- Poulsen E, Goncalves GH, Bricca A, Roos EM, Thorlund JB, Juhl CB. Knee osteoarthritis risk is increased 4-6 fold after knee injury: a systematic review and meta-analysis. British Journal of Sports Medicine, 2019;53(23):1454-1463. Read the publication. Systematic review and meta-analysis, 53 studies, close to one million participants. Knee osteoarthritis risk is 4.2 times higher after an ACL injury and 6.3 times higher after a meniscal injury, with at least two years of follow-up.