Recovering from ACL Surgery

Recovery after anterior cruciate ligament (ACL) surgery is a structured and gradual process that involves multiple stages, each aimed at restoring knee function, strength, and stability. The timeline for recovery can vary depending on the individual’s severity of injury, the specific surgical technique used, the graft choice, and adherence to rehabilitation protocols. It’s important to note that while returning to sports is a key goal for many patients, premature return to sports increases the risk of re-injury.

Reinjury, Psychological Readiness, and Return to Sport

Studies are clear that the risk of reinjury is significantly reduced for each month return to sport was delayed until eight to nine months after surgery. Psychological readiness includes confidence in the knee and fear of re-injury are important.

Here’s an overview of the typical recovery process:

1. Immediate Postoperative Phase (Weeks 1-2) – For the first two weeks, the focus is on reducing pain and swelling with icing, elevation, laser therapy, and medications. There will be no brace and early weight-bearing for an isolated ACL reconstruction surgery (there are different restrictions if the meniscus is repaired or another ligament is involved). Early physical therapy within 1-3 days of surgery focuses on a range of motion exercises to prevent stiffness.
2. Early Recovery Phase (Weeks 3-6) – During this period range of motion exercises will continue, and patients will begin light strengthening exercises for the quadriceps, hamstrings, and calf muscles. By the end of the week, patients will start doing squats.
3. Intermediate Recovery Phase (Weeks 7-12) – During this period exercise intensity increases progressively to build muscle strength and stability. Balance and proprioception exercises will be incorporated. By weeks 10-12, patients will begin jogging.
4. Advanced Recovery Phase (Months 3-6) – Sport-specific exercises will be introduced for patients who are athletes. Progressive resistance training will improve strength and increase resistance. Exercises to improve agility, coordination and explosive power will be added.
5. Return to Sport (Months 6-9) – At this time returning to sports should be based on meeting specific criteria, not just time since surgery. A functional sports assessment test will be performed by a trained physical therapist. This includes adequate strength, stability, and movement patterns. Initially, non-contact drills and gradually increasing intensity and complexity of sports activities. Regular assessment will ensure safe progression.

What are the factors that influence recovery?

Factors include concomitant injuries, ACL repair vs reconstruction, age, overall health, pre-surgery fitness, and motivation. Adherence to physical therapy protocols is crucial for successful recovery.

Recovery from ACL surgery is a comprehensive process that typically spans 6 to 9 months, requiring diligent adherence to a structured rehabilitation program. The decision to return to sports should be made in collaboration with Dr. Ronak Patel and based on individual performance on functional sports assessment testing. Regular follow-up and continuous assessment are essential to ensure a safe and effective return to physical activities.

Dr. Ronak Patel is a double board-certified orthopedic surgeon and sports medicine physician. He specializes in the treatment of complex knee injuries. Contact him to schedule a consultation to learn more about how he can help you return to the life you love and the activities that make life work. He serves teens and adults in Chicagoland and NW Indiana.

References

1. Waldron K, Brown M, Calderon A, Feldman M. Anterior Cruciate Ligament Rehabilitation and Return to Sport: How Fast Is Too Fast? Arthrosc Sports Med Rehabil. 2022 Jan 28;4(1):e175-e179. doi: 10.1016/j.asmr.2021.10.027. PMID: 35141549; PMCID: PMC8811519.