Yesterday I reconstructed a 19-year-old 400m runner’s ACL with quad tendon autograft plus suture-tape internal brace — anatomic tunnels, 9 mm femoral socket, firm fixation without notch impingement. For those using this construct, are you moving the return-to-sprint timeline (straight-line at 8–10 weeks) or keeping standard pacing while prioritizing meticulous swelling control and early full extension to avoid cyclops?
With your 9 mm femoral socket + internal brace, I only green-light straight-line at 8–10 weeks if effusion = 0 and quad index ≥80%; otherwise I keep standard pacing and hammer swelling control — , the brace can lull them into overcooking. My last 400m with quad autograft flared his fat pad at 85% in week 9, so now I start 60–70% with about 300–400 pain-free contacts before speed and use hop symmetry >85% as the go cue. Small plug: internal brace doesn’t change biology, so I treat it as insurance, not a fast pass (https://bjsm.bmj.com/content/55/5/248) — are you gating by quad index or time, @OP?
I’ve nudged ‘straight-line’ to week 9–10 in two 200/400s only after 7 days of zero effusion and <10% asymmetry on single-leg pogos (force plate), then stuck to 10–20 m accelerations with wickets and delayed max‑V to about 12 weeks. Small caveat: quad-tendon harvests often gripe with early upright running, so I cap terminal knee extension speed — the tape’s a seatbelt, not a green light; are you gating with 10 m splits or just RPE?
I’ll start controlled buildups after they nail 4x wicket runs (1.8 m spacing) with ≤5% contact-time asymmetry on a shank IMU and KT-1000 Δ≤2 mm, then gate progress with Freelap 10 m splits week to week. Small caveat: I still hold off on sharp decel and bends until about 14 weeks — @slucas88 are you capping decel loads?