Stages of Recovery from ACL Surgery

It’s a heavy load – even at our most fit – that our legs must carry each and every day. Thus, it should come as no surprise that so many people face injuries to ankles, knees, and feet every year.

Among the more common injuries – especially among athletes – is the torn ACL.

The ACL, anterior cruciate ligament, resides just behind the knee. It can be strained, sprained, or physically torn as the result of excessive physical activity, old age, or arthritis. In order to repair the damaged ligament, a doctor must surgically graft new tissue over the affected area. When ‘torn’, the ligament actually pulls away from the knee joint. The repair takes a skilled hand and requires a long recovery period. Often it can take a longer time to heal than a total knee replacement.

Once the surgery has been performed, the patient should expect to be fully or partially laid up for six full weeks. This means very limited – if any – use of the knee is advised during that time. This span may vary slightly from patient to patient, but the doctor’s advice should be followed strictly; failure to do so could lead to repeat – often worse – injury.

After those six weeks have passed, it is likely that the doctor, or a physical therapist will being to recommend light exercises in order to retrain the muscles around the knee and to begin lightly stretching the new tissue. In week seven and eight, the focus will be primarily stretching, actually because during the rest and recovery period, the muscles, tendons, and other tissue will have stiffened. The first efforts will be made to begin bending the knee again and training it to support weight.

For the ten weeks following – weeks nine through eighteen – efforts of the patient should be aimed at regaining normal strength, flexibility and balance of the joint. A full knee extension to 130 degrees is among the goals, as is walking without the aid of crutches. By the end of this period, it is assumed, that the patient should be capable of performing a feel squat, as well as leg presses, mini lunges, step-ups and a variety of other leg-related exercises. These training movements will be incorporated into a regular plan for recovery, which will likely involve continued PT once or twice per week, so exercises and improvement can be monitored. It is important to discuss any shortcomings during this time, so the plan can be modified to address them. Any unusual, sharp pains or lasting discomfort should be discussed with your physical therapist or doctor. The aim is to encourage recovery not re-injury. Doing the exercises as often as directed with the correct posture and form can decrease recovery time and get you back to the things that you enjoy faster, but rushing the process too much can also lead to unwanted set-backs.

By six months post-op, the leg, knee, and ACL should be very near full strength again. The patient should have the ability to change direction quickly when walking or running, should be able to easily jump. In order to get clearance to return to full normal activity levels, most doctors or physical therapists will require at least ninety-percent use of the leg. Within a year, the injury should have healed fully and life should have resumed as usual. At this point, most athletes will have returned to the sport of choice. Of course, each and every patient differs and it is always best to abide by the recommendations of your medical team.