This blog was originally written on June 24, 2019, and has been updated since.
If you have scheduled a procedure to repair a torn anterior cruciate ligament (ACL), you’re probably wondering, “How long will I be out of my normal routine?” Although this is an important question, there is much more to ACL surgery recovery than just getting back on your feet. Even after you can walk without crutches or other assistive devices, your body is still healing, and the recovery process continues.
For most people, it takes 2-9 months to fully recover from ACL surgery.1 A 2016 study of 80 amateur athletes found that, on average, athletes returned to their sport after eight months.2
Your doctor can provide specific recommendations based on your unique situation, but the following timeline and rehabilitation tips may help you recover as quickly and safely as possible from ACL surgery.
ACL Surgery Recovery Timeline
Although every individual is different, you can expect the following rough timeline for ACL surgery recovery:1,2
The First 2 Weeks After Surgery
This is a critical time in the recovery process because it’s when your body is most vulnerable. However small, surgery is another form of injury to your tissues, so your body responds to it with inflammation. Right after surgery, you may experience pain, swelling, and fluid buildup around the knee joint.
Though you may not want to, it’s important to start moving your muscles within a few hours of surgery. These will be passive movements, such as gently bending and extending the knee joint. Your doctor will likely tell you not to put weight on your knee yet, and you may have to use crutches or other walking aids for 10 days or more.3 Most importantly, follow your surgeon’s instructions and don’t try to do too much too quickly. The last thing you want to do is reinjure your knee.
Rehabilitation Tips to Try:4
- Elevate the leg above the level of your heart, and apply therapeutic cold every two hours.
- Place the leg over the edge of a bed or chair for knee flexion (bending).
- Place a prop under the heel when straight for knee extension (straightening).
2-6 Weeks After Surgery
By this time, you may be able to put weight on the recovering knee, but activity might continue to be limited as your tissues are still healing. Depending on the type of car you drive, your medication use, and which leg is injured, you may also be able to resume driving.
You will likely be referred to a physical therapist, who will give you exercises. Your physical therapist will focus on helping you regain full range of motion. Because your knee is still vulnerable, you may have to wear a protective brace when you’re not exercising to protect it from stress.3
Rehabilitation Tips to Try:4
- Perform walking exercises for 15-20-minute intervals.
- Do leg strengthening exercises, such as squats, leg presses, and hamstring curls, if your physical therapist assigns them.
- Add stationary bicycle and/or elliptical training.
6 Weeks to 3 Months After Surgery
As the healing process continues and your knee grows stronger, you may be allowed to do more low-impact activities. By the end of this period, you may be able to resume light jogging if your physical therapist thinks you are ready. Always talk with your healthcare team before starting a new exercise or resuming one you did before. Some professionals recommend not running or swimming for five months or more after surgery.
Rehabilitation Tips to Try:4
- Perform lateral (side-to-side) training exercises, such as lunges and side steps.
- Do flutter-style swimming strokes.
- Avoid twisting or pivoting motions.
- Continue strength exercises and begin sport-specific training.
3-6 Months After Surgery
You may be eager to get back to your sport or other everyday activities. If you’re returning to a sport, your physical therapist may recommend sport-specific activities to help you prepare. The physical therapist or coach might also show you exercises to do even after you heal that can help protect the ACL and prevent future injury. Continue to wear a knee brace if your healthcare team recommends it.
Rehabilitation Tips to Try:4
- Slowly return to running activities.
- Introduce jumping and agility training.
- Work toward single-leg plyometric exercises.
Assuming your damaged tissues have fully healed, after six months, you can return to athletic activity. Some doctors recommend the use of a supportive brace for 1-2 years after ACL surgery.
More Helpful ACL Surgery Recovery Tips
Being proactive in your recovery may help you heal, experience less pain, and return to your previous activity level as quickly as possible.
Be Patient During Physical Therapy
It can be tempting—especially for athletes—to push your body to the limit when doing physical therapy. Although it is important to perform the recommended strengthening and stretching exercises, doing too much too soon can slow down the recovery process. Follow your physical therapist’s recommendations about which exercises are appropriate and how much you can do. If you think you can do more, check with your physical therapist before attempting to go further.3
Use Cold Therapy to Control Inflammation
Pain and swelling peak in the first week after ACL surgery.1 It is especially important to apply cold therapy during this period to reduce swelling and naturally control pain. Adding active compression with a cold and compression therapy device may further reduce swelling by helping your body pump away excess fluid and enabling the cold to penetrate deeper for a longer-lasting therapeutic effect. The clinically proven Game Ready System integrates cold and compression therapies to help reduce pain and edema (swelling), outperforming conventional rest, ice, compression, and elevation methods.5
If you are about to have ACL surgery, ask your doctor about using cold and compression therapy for your recovery.
References:
- ACL Surgery Recovery: What to Expect Before and After Reconstruction. UPMC HealthBeat. https://share.upmc.com/2015/04/recovery-time-for-acl-reconstruction-surgery/. Published December 15, 2021.
- Notarnicola A, Maccagnano G, Barletta F, et al. Returning to Sport After Anterior Cruciate Ligament Reconstruction in Amateur Sports Men: A Retrospective Study. Muscles, Ligaments and Tendons Journal. 2016. doi:10.11138/mltj/2016.6.4.486.
- Recovery & Follow Up. Emory Healthcare. https://www.emoryhealthcare.org/centers-programs/acl-program/recovery/rehab-timeline.html. Accessed Sept. 17, 2024.
- After ACL Surgery. UCSF Health. https://www.ucsfhealth.org/education/after-acl-surgery. Accessed Sept. 17, 2024.
- Murgier J, Cailliez J, Wargny M et al. Cryotherapy with Dynamic Intermittent Compression Improves Recovery from Revision Total Knee Arthroplasty. J Arthroplasty, 2017;32(9):2788-2791.
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