Objectives of your ACL surgery recovery
Following an Anterior Cruciate Ligament operation (otherwise known as a knee reconstruction) in the first two weeks your injured knee will be swollen and largely immobile. Once the surgery is completed a hospital therapist will be on site to guide you through the initial ACL knee exercises that you need to commence immediately. It is very important that you follow these exercises recommended by your surgeon and therapist to ensure that sufficient progress is made on your ACL surgery recovery in the early days. The first two to three weeks are considered to be one of the most important within your ACL recovery timeline. By adopting a disciplined approach to your rehabilitation program you will give yourself the best chance of a full recovery.
The main objective of your ACL surgery recovery within the first two weeks of rehabilitation post surgery is to reduce the amount of pain and swelling within the reconstructed knee plus performing weight baring, muscle toning and flexibility exercises. We recommend six key steps (as discussed below) to follow in the early weeks post ACL surgery that will provide the foundations of a strong rehabilitation going forward.
Whilst the long term target is ultimately to return your newly reconstructed knee to full control and function as soon as possible (importantly with minimal risk to rupturing your new ACL graft), it is critical to restore full knee range movement and normal walking within the early weeks following your ACL reconstruction surgery.
Your goal within the first few weeks is to achieve full leg extension, increase quadriceps muscle function and at least 90 degree flexion. Excessive motion or bending of your repaired ACL knee is not recommended as to limit risk and prevent your new ACL graft from rupturing. It is also important that you educate yourself on appropriate ACL rehabilitation exercises and protocols (which can also start prior to you going in for surgery).
In order to achieve these initial goals, we list below 6 key steps for you to action immediately post operation.
6 key steps in the early phases of ACL surgery recovery
- Commence ACL surgery recovery and rehabilitation immediately post operation: Exercises commence almost as soon as you wake up after the surgery. A hospital physiotherapist will be available to instruct exercises in the first 1 to 2 days. The main emphasis immediately will be beginning flexibility and mobility movements as soon as possible as advised by the physiotherapist or surgeon.
- Follow RICE principles to reduce swelling in the knee for improved ACL surgery recovery
- Rest – limit any sudden movements or twisting. As not to aggravate or risk re-injuring your new ACL graft
- ICE – At least 3 to 4 times a day and preferably before and after exercise
- Compression – keep your knee wrapped in compression sock or similar type of bandage
- Elevation – Keep your injured leg elevated as much as possible by lying on the floor/couch with sufficient support under the knee such as a towel or pillow
- Perform ACL surgery recovery exercises 3 to 4 times a day as recommended by your physician: Initially your surgeon or therapist will provide exercises for you to follow at home in the first one to two weeks post surgery. The frequency of exercises required for post ACL surgery is 3 to 4 times per day at a minimum. If you are experiencing ‘any pain’ with any of the exercises you have been recommended it is advised that you stop and choose an easier or abbreviated exercise to perform. It is important to protect the new ACL graft at all times and if you are experiencing pain with exercising then there is potential that you are doing damage. Within the first two weeks following surgery you should focus on performing the following daily exercises:
- Achieve full knee extension and locking of the knee (straightening out)
- Achieve full flexion of the operated knee to the same degrees as the non-operated knee. This may be limited by swelling hence the importance of regular icing to reduce this as much as possible
- Active strengthening of the quadriceps muscles
- Support knee at all times: Important to ensure that all exercises and movements have minimal pain in your reconstructed knee. You should also ensure that your knee is well supported at all times and avoid any sudden movements or twisting. Your new Anterior Cruciate Ligament graft is vulnerable in particularly within the early weeks and months following your operation. If an activity is causing discomfort then stop immediately and choose an activity that is more comfortable.
- Wear a protective knee brace: It is advisable for you to wear a protective knee brace for the first few weeks of your ACL rehabilitation to assist with walking and to provide a level of comfort and safety for your knee. Using crutches to assist with walking is also recommended. You should continue to use a brace and crutches until you feel comfortable enough to walk without them however this is likely to be a gradual process over one to two weeks. Generally speaking you will be using crutches anywhere from a couple of days to a couple of weeks.
- Self-Education is also important in the early stages plus the long term: It is important that you become highly informed on the ACL surgery recovery protocols as soon as possible to ensure the best opportunity for a successful ACL rehabilitation. Your education is an ongoing process and needs to continue into the long term for the best results.