Coming Back from an ACL or Multi-Ligament Tear: What Research and NFL Stars Teach Us

Understanding the Tyreek Hill Injury

In Week Four of the 2025 NFL season, Miami Dolphins wide receiver Tyreek Hill suffered one of the most devastating injuries you can see in football: a brutal knee dislocation with multiple torn ligaments, including his ACL. His agent reported that his surgery was successful, that he would not require additional procedures, and that he is expected to be ready for the start of the 2026 season. This is great news for Hill and the Dolphins, but the medical literature shows that recoveries like this are rarely straightforward. Multi-ligament knee injuries often require staged or multiple surgeries, with much longer recovery timelines and less predictable outcomes compared to isolated ACL tears. [1]

Before we break down timelines and success rates, let’s look at the three stages of return to sport. Knowing these stages helps explain what it actually means when someone is said to be “back.”

• Return to Participation (RTPa): The athlete rejoins training in a modified way, doing non-contact drills, conditioning, or limited practice. They are participating, but not yet competing, and restrictions still apply.

• Return to Sport (RTS): The athlete is back in full competition with no restrictions. However, this does not mean they are back to their pre-injury level — they are simply cleared to play.

• Return to Performance (RTPf): The athlete has fully regained — or even surpassed — their pre-injury performance level. Confidence, function, and impact on the game match or exceed what they achieved before the injury.

This framework matters because it helps explain the statistics we’ll review. For example, when research reports an “80% return-to-sport rate,” that does not necessarily mean 80% return to their original performance level.

What the Research Shows About Recovery

Research on ACL and multi-ligament knee injuries highlights common themes: recovery takes time, staged progress, and benchmarks. Here’s what published studies show:

Isolated ACL Tears

• Timeline: Most athletes safely return between 9–12 months after surgery. [2]

• Return to play rate: Between 80–85% of athletes return to some level of sport, but only about 65% return to their pre-injury level.

• Risk if rushed: Returning before 9 months carries a 7x higher risk of re-injury.

Multi-Ligament Knee Injuries (MLKI)

• Timeline: Recovery is much longer, averaging 12–18 months. [3]

• Return to play rate: Only 60–70% return to play, and performance often declines. [4]

• Surgical complexity: These injuries often involve more than just ligaments. There is a risk of peroneal nerve damage affecting foot function, and arterial injury that can compromise blood flow. These factors often make staged surgeries necessary.

Common Recovery Patterns

• Limb Symmetry Index (LSI): Athletes need at least 90% strength in the injured leg compared to the non-injured leg.

• Hamstring-to-Quadriceps Ratio: Balanced strength matters, with eccentric hamstring training emphasized to protect the ACL during deceleration.

• Functional Testing: Hop tests, Y-balance, and plyometric drills are required before clearance. [5]

• Proprioceptive and Vestibular Training: Athletes must retrain their ability to know where their body is in space without relying solely on vision. This "internal GPS" is crucial for safe cutting, landing, and reactive play.

Nick Chubb — A Notable Comparison

Nick Chubb is a clear example of how catastrophic knee injuries can alter a career. He is not just a player who returned from injury, but one who shows us that “returning” does not always mean returning at the same level.

• 2015 (Georgia): First catastrophic knee dislocation, tearing multiple ligaments (PCL, MCL, LCL). Drafted in the second round afterward, his rookie year in 2018 with the Browns started slowly as he worked his way back.

• 2019–2022 (Browns): Returned not only to sport but to performance. Over these four years, he was consistently a top-10 NFL running back, peaking in 2022 as the No. 6 overall RB.

• 2023 (Browns): Suffered another catastrophic dislocation and ACL tear in Week 2, again with multiple ligaments involved. Initially told he would only need one surgery, but required a second.

• 2024 (Browns): Returned to play but lacked his previous explosiveness. The Browns moved on, and he joined the Houston Texans.

The difference between return to sport and return to performance is clear in Chubb’s story. After his college injury, he climbed back to full performance, even excelling. After his 2023 injury, however, he returned to play but as a backup, already replaced by younger talent in Houston. It shows that while athletes can make it back to the field, the level of performance may be permanently altered.

Will Tyreek Hill’s Speed Still Exist?

Tyreek Hill’s entire game is built on speed, explosiveness, and deep-threat ability — the exact traits most at risk after a multi-ligament injury.

Research shows that sprinting and cutting ability are the hardest skills to regain. Even if Hill returns on the shorter end of the 12–18 month recovery window, his trademark ability to outrun defenses may never fully return. The Dolphins could face a version of Tyreek Hill that is different from the one we’ve known.

What Does It Look Like When a Player Comes Back?

We don’t have to look far to see examples. The New Orleans Saints currently have two players in the early stages of return: Taysom Hill and Foster Moreau.

• Taysom Hill: Suffered an ACL tear with “additional knee damage” in December 2024. Already having a history of knee issues, this counts as a reinjury case and makes his recovery more complex.

• Foster Moreau: Tore his ACL in January 2025. His was an isolated ACL tear, giving him a clearer path to return.

Both have just been activated from the Physically Unable to Perform (PUP) list, starting their 21-day window to prove readiness. This means they are currently in the Return to Participation stage, which means they are back at practice, but not yet cleared to compete or on the active roster. If not activated within that window, they will move to season-ending IR.

This gives us a rare side-by-side look: two athletes, on the same team, recovering from similar but different injuries. Moreau’s clean ACL tear suggests he may be back sooner, while Taysom’s added damage and reinjury history could slow his timeline.

The Mental Side of Recovery

Coming back from an ACL or multi-ligament injury isn’t just physical, it’s mental. Athletes need discipline, determination, and grit to endure the long rehab process. Many stop short not because their body fails, but because the mental toll becomes too heavy.

Building mindfulness and proprioception is critical. Practices like meditation, visualization, and controlled movement training help athletes reconnect their mind and body. Learning to trust the knee again is as much psychological as it is physical.

For high school athletes, weekend warriors, or anyone recovering from injury, this mindset is just as important. Recovery takes consistent effort, but with determination, it is possible.

Performance Nutrition and Recovery

Nutrition is not an afterthought, it is performance fuel. Healing tissues require energy, protein, and anti-inflammatory support. Here’s what matters:

• Protein: Critical for muscle repair and growth post-surgery.

• Omega-3 fatty acids: Reduce inflammation and aid joint health.

• Micronutrients: Eating the rainbow ensures key vitamins and minerals are covered. A daily multivitamin can help fill gaps.

• Supplements: Protein powders, omega-3s, creatine, and amino acids can support recovery when diet falls short.

Food is always the foundation, but performance supplementation helps close the gaps. It’s called performance supplementation for a reason: it supports recovery and performance when life makes perfect nutrition difficult.

Building Integrated Recovery

Professional athletes work with surgeons, physical therapists, coaches, and nutritionists. But too often, those people don’t fully coordinate. True recovery requires an integrated approach where each piece of the puzzle fits together.

That’s what we do at MaxWell Nutrition: build holistic recovery plans that connect strength training, rehab, nutrition, and mental preparation. It’s about the big picture, not just the pieces.

If you’re in New Orleans, you can work with me directly. If not, we offer one-on-one virtual coaching tailored to your schedule, plus MaxWell Nutrition Unlimited for those who want the tools to do it at their own pace.

The Path Back

Recovering from a serious injury like an ACL or multi-ligament tear is never easy, whether you’re an NFL athlete or a recreational player. But the path back is possible. It takes focus, purpose, and intent, not just going through the motions.

You don’t just train to recover, you recover so that you can train. Every step of the process matters: rebuilding strength, restoring confidence, and aligning your efforts with your goals. As I often say when working with special forces members that I work with, you train like you fight, and fight like you train. Bringing that mindset into recovery is how you come back stronger, how you refuse to let setbacks define you, and how you move forward with resilience.

👉 If you’re ready to start your journey back, join the waitlist for one-on-one coaching or sign up for MaxWell Nutrition Unlimited today.