How to Get Hiking Again After an ACL Injury

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An ACL injury is quite common among hikers. While it’s not grievous, it can limit your ability to move for the rest of your life. Your day-to-day movement will not be hampered if properly treated regardless of the severity of the injury. But sports, hiking, or other activities that involve the knee joint can be hindered.

To get back to hiking after an ACL injury, you must undergo proper treatment followed by rehabilitation, exercise, and physiotherapy. The severity of the injury is diagnosed by X-ray, MRI, and other imaging scans, and then proper treatment measures are decided by the doctor. Once your knee joint and associated muscle regain proper strength, you can get back to hiking.

There’s a lot to know about ACL injury and its treatment. Your doctor will guide you through the treatment plan and rehabilitation program to get you back to the proper shape.

So, this guide aims to give you a heads-up on what to expect following the injury. If you are wondering “When can I hike after ACL surgery?” follow the rest of this article for an overview of your queries.

Man with his leg wrapped after knee surgery

What is An ACL Injury?

ACL is the short form of the anterior cruciate ligament. It originates from the medial wall of the lateral femoral condyle and attaches between the tibial spine located between the tibial plateaus. It is one and a half inches long and half inches wide. It is one of the four ligaments that connect the tibia with the femur.

It prevents the displacement of the tibia backward anterior to the femur. It also prevents rotation of the tibia. When the ligament is torn or sprained due to sudden movement or sharp turn, it is called ACL injury.

The ACL injury occurs due to sudden movement of the knee. The sudden stop and changing direction contribute to the injury. That’s why it’s common among athletes and hikers.

A mild popping noise can be heard, followed by pain, swelling, and knee movement limitation.

How to Hike Again After an ACL Injury?

An ACL injury can be treated both surgically and non-surgically. Minor injuries do not require any extra attention, and the sufferer can go back to normal activities after 2-3 months.

Even complete ACL ruptures can go without surgery and get back to a normal lifestyle. But depending on your level of activity might require surgical intervention and post-surgical rehabilitation.

The international knee documentation committee has adopted a questionnaire to assess patients’ level of activities to determine whether surgery would be helpful or not. The level of activities has been divided into four categories:

  • Level I: Jumping, pivoting, and intricate cutting.
  • Level II: Heavy manual labor or intense sports that involve the knee joint.
  • Level III: Light manual work and mild sports like walking, cycling, etc.
  • Level IV: Sedentary lifestyle.

The anterior cruciate ligament is involved in complex movements of the knee joint. If the ACL is injured, the movement of the knee is impaired.

So, anyone who wants to get back to level 1 and 2 activities are recommended to have surgery. For inactive lifestyles or moderate activities which are level 3 and 4, non-surgical treatment can be undertaken.

After non-surgical treatment, physiotherapy and exercise are required to get back to regular shape and regain the knee’s strength.

After surgery, regular physiotherapy is recommended for anyone who wants to get back to an active lifestyle, like hiking.

Post-surgical physiotherapy is divided into a few categories: (Always consult with your doctors prior to exercising though, don’t extend your injury through pushing too hard!)

Week 1

Regular icing and elevation of the knee to reduce swelling. Multidirectional strengthening of the patella and exercise of the calf muscle, quadriceps, and hamstrings.

Week 5

The patient must try to reduce dependency on crutches. Tonification exercise can be undertaken.

Week 10

Forward, backward, and lateral exercise of the knee.

3rd Month

After three months, the patient can move on to jumping, walking, and jogging.

4th to 5th Month

Finally, the patients can return to regular sporting activities, but not in a competitive manner. The target here should be enhancing the knee joint’s strength and endurance and achieving greater control over movement.

If the post-surgical therapy options can be adequately followed under the supervision of an expert physiotherapist, you should be able to get back to hiking. I strongly recommend strictly following the doctor’s advice.

Causes of ACL Injury for Hikers

An ACL injury is mainly seen among those engaged in sports that involve the body’s intricate movements. However, it is also common among hikers for the following reasons:

Heavy Packs

Hikers usually carry heavy backpacks. They require a lot of food and water to stay hydrated and energized. So, I can’t say that it’s unnecessary and should be scrapped off.

But the weight of the backpack can be a reason for ACL injuries. So, the weight of the backpack should be reduced as much as possible.

Using Poles

Using poles is very common when hiking. It helps to climb up steep places with less effort. But it can also contribute to ACL injury.

When using poles, excessive forward leaning can put extra stress on the knees, leading to ACL sprain. Instead, use the pole for extra balance and assist in lowering your body.

Going Downhill

When going downhill, the knee joint is subjected to an extra force beyond its endurance capability. Ever seen a cow going downhill, maybe from a back of a pickup truck, and how they lose balance

It is because their knee joint cannot carry the extra force applied there. The force is measured to be 7-8 times the body weight.

So, no wonder why ACL injury is highly likely when going downhill.

ACL Injury Treatment Options

As far as treatment of ACL injury is concerned, there are only two. Non-surgical and surgical. Let’s discuss the two below:

Non-surgical Treatment

If there is a minor sprain in the ACL, you can get away without any surgery. If your activities are limited and do not include the knee joints’ intricate movements, no surgery is required.

Non-surgical treatment is indicated in the following cases:

  • Partial tears and no instability
  •  People who are willing to give up high-demand sports (even if there is a complete rupture of the ligament)
  • Light manual worker and those who lead a sedentary lifestyle
  • Children

Non-surgical treatment includes:

  • Application of ice and cold water to the injured area.
  • Apply pressure to the injured area by bandage or wrapping.
  • Take anti-inflammatory drugs to reduce pain and swelling.
  • Reduce activity.
  • Bedrest.

Surgical Treatment

The treatment option for ACL injury doesn’t depend on the severity but rather on the patient’s lifestyle and the risk-benefit ratio.

If the patient is a full-time athlete and wants to continue, surgery is a must for him.  ACL surgery doesn’t include suturing.

Instead, it is replaced by grafts made from tendons from other body parts that include:

  • Patellar tendon.
  • Hamstring tendon.
  • Quadriceps tendon.
  • Allograft is taken from the body of a deceased person.


Hiking is an adventurous activity adored by many. And leaving behind such a beloved outdoor activity can seem to be impossible by many hobbyists. An ACL injury can be the sole reason to give up hiking once and for all.

In this article, I have explained the aftermaths of ACL injury and specific treatments in an attempt to answer your question, “When can I hike after ACL surgery?”.

I also explore the treatment options so that you can get an overview of what’s coming. I believe this article was somewhat of a help.

Good luck with making a full recovery, the trail lives on and you’ll be back better than you probably ever believed!

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