When Can I Train After Surgery?

Any time I am asked a question, I feel my most common response is, “it depends”. And other times it’s, “go do physical therapy”. All those years I spent becoming a doctor and my initial answers are often quite simple.

The answer to when it is ok to train after a surgery fits into both categories. Physical therapy plus “it depends”. Although people want an exact number, almost to the date, for when they can get back on the mats after surgery, it is never that simple. Each surgery requires a minimum time for healing and each person’s rehab should be individualized. So, I can give you some average numbers for return but I tell all of my patients that the physical therapist has the final say. These are typically milestones and goals that need to be met, rather than a date on the calendar.

ACL Surgery

The textbook answer is 9-12 months. This does not mean that at exactly 9 months you book your first superfight back. This means that around 9-12 months most people are back to training harder and preparing for their return to competition. This holds true even when looking at the data on professional athletes, such as NFL players.

Our return to sport testing after knee surgery is far better and more studied than the shoulder. 

Meniscus Surgery

This gets tricky. No 2 meniscus are the same. There are many types of meniscus tears, which come along with different treatments. With older “degenerative” tears, the treatment is often a meniscectomy or trimming of the torn area. This return is typically 6-12 weeks. 

When there are more complex tears, especially in young active patients, these are often repaired. This is a slower recovery and takes about 4-6 months to return.

Shoulder Labrum Surgery

This is often done for instability. When a labrum repair is performed the average time back is 4-6 months. Our testing isn’t as solid for shoulders with return to sport. So, I tell my patients not to rush here. Be honest with yourself and your physical therapist. You want to feel strong with a “normal” shoulder before returning.

Biceps Tenodesis

This is a very common procedure. I actually had this done on my right shoulder. It is a quick 30 minute procedure often done on the shoulder for a “SLAP tear” or biceps tendinitis (at the shoulder). The biceps is moved to a new location to predominantly help with pain in the front of the shoulder.

This recovery is roughly 2-3 months, but do not be surprised if it takes several more months to get back to push ups and pull ups.  

Final Thoughts

The goal is to return back with full strength and confidence in your joint. This may take a little longer with the goal of less lingering after your return. Nobody wants to be 2 years out of surgery still complaining of nagging pain, or worse… a reinjury. 

Time lines are only guides. The true test for return to recovery is done with objective strength measuring and even some subjective testing from a solid physical therapist. An excellent physical therapist can see how an athlete moves, along with psychological metrics to assess appropriate timing of return to sport. 

Do not rush it. This isn’t just me being cautious. Research shows that athletes who return before 9 months have an up to 7x greater risk of a 2nd ACL tear.

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Dr. Megan Lisset Jimenez 

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References

Beischer S, Gustavsson L, Senorski EH, Karlsson J, Thomeé C, Samuelsson K, Thomeé R. Young Athletes Who Return to Sport Before 9 Months After Anterior Cruciate Ligament Reconstruction Have a Rate of New Injury 7 Times That of Those Who Delay Return. J Orthop Sports Phys Ther. 2020 Feb;50(2):83-90. PMID: 32005095.

Mody KS, Fletcher AN, Akoh CC, Parekh SG. Return to Play and Performance After Anterior Cruciate Ligament Reconstruction in National Football League Players. Orthop J Sports Med. 2022 Mar 7;10(3):23259671221079637. PMID: 35284583.