If you have scheduled a procedure to repair a torn 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’re able to 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 in general, 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 recovery1,2:

The First 2 Weeks After Surgery

This is a critical time during the recovery process because it is when your body is most vulnerable. Surgery is a traumatic experience for your muscles, ligaments, and other tissues, which is why the body responds with inflammation. During the period immediately after surgery, you may experience pain, swelling, and the buildup of excess fluid around the knee joint. The rehabilitation process starts right after the surgery, and you may be given exercises that must be performed daily to support your recovery. During this time, your ability to bear weight on the affected leg may be limited, so plan on using crutches and limiting your mobility for at least 10 days.3

Rehabilitation tips to try4:

  • Elevate the leg, and apply therapeutic cold every two hours.
  • Place the leg over the edge of a bed or chair for knee flexion.
  • Place a prop under the heel when straight for knee extension.
  • Do gait training to prepare for removal of crutches.

2-6 Weeks After Surgery

You may be able to bear weight on both legs during this time, but activity may still be limited as your tissues are actively healing. Depending on the type of car you drive, your medication use, and which leg is injured, you might also be able to resume driving during this time. Your physical therapist will focus on helping you regain full range of motion. Because your knee is still vulnerable at this stage, you may have to wear a protective brace to protect it from unnecessary stress.3

Rehabilitation tips to try4:

  • Perform walking exercises for 15- to 20-minute intervals.
  • Do leg strengthening exercises such as squats, leg presses, and hamstring curls if advised by your PT.
  • Add stationary bicycle and elliptical training.

6 Weeks to 3 Months After Surgery

As the healing process progresses and your knee continues to grow stronger, you may be allowed to do more low-impact activities such as cycling, swimming, and rowing. By the end of this period, you may be able to resume light jogging if your physical therapist thinks you are ready.

Rehabilitation tips to try4:

  • Perform lateral training exercises such as lunges and side steps.
  • Do flutter-style swimming strokes.
  • Avoid cutting or pivoting motions.
  • Continue strength exercises, and begin sport-specific training.

3-6 Months After Surgery

During this time, you may be more eager to return to sports. Your physical therapist may recommend sport-specific activities to help you prepare for your return. He or she might also show you ongoing exercises that may help protect the ACL and help prevent future injury. A knee brace may be recommended during this period, even for low-impact activities.

Rehabilitation tips to try4:

  • Slowly return to running activities.
  • Introduce jumping and agility training.
  • Work toward single-leg plyometric exercises.

After six months, assuming your damaged tissues have fully healed, you can return to athletic activity. Some doctors recommend the use of a supportive brace for 1-2 years after ACL surgery.

ACL Surgery Recovery Tips

Being proactive in your recovery may help you heal as quickly as possible, experience less pain, and return more quickly to your previous activity level.

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 actually 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 are at their peak in the first week after ACL surgery.1 It is especially important to apply cold therapy during this period to help reduce swelling and naturally control pain. Adding active compression with a cold 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.5 Continuing to use cold therapy for the duration of your recovery may help promote healing and control any pain and swelling you might experience after physical therapy sessions.

So how long will you be on crutches after surgery? It depends on a number of factors, but if you are proactive about accelerating the healing process, you may be off crutches as soon as two weeks after surgery.3

If you are about to have ACL surgery, ask your doctor about using cold therapy for your recovery. 

 

 

References:

  1. ACL reconstruction surgery: before and after recovery timeline. UPMC HealthBeat. https://share.upmc.com/2015/04/recovery-time-for-acl-reconstruction-surgery/. Published January 23, 2019.
  2. 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.
  3. Recovery & follow up. Emory Healthcare. https://www.emoryhealthcare.org/centers-programs/acl-program/recovery/rehab-timeline.html. Accessed April 18, 2019
  4. Rehabilitation Guide: Anterior Cruciate Ligament Reconstruction. University of Wisconsin Hospital. https://www.uwhealth.org/files/uwhealth/docs/sportsmed/SM-35549_ACL_Protocol.pdf. Accessed April 19, 2019
  5. ​Treating pain with heat or cold compress. Marshfield Clinic Health System. https://www.marshfieldclinic.org/sports-wrap/ice-or-heat. Accessed April 18, 2019