After ACL surgery you are encouraged to start walking immediately
Begin with the assistance of crutches and take as much weight as your feel is comfortable
- When it comes to an ACL reconstruction a common question that is often asked by patients is when can you walk after ACL surgery?
- After ACL surgery you are likely to experience swelling and soreness in your knee which will limit the amount of pressure you can apply to the bad leg. As a result the majority of patients will require the assistance of crutches to walk after ACL surgery in the first instance.
- Most surgeons will encourage you to start walking on day 1 after ACL surgery and to take as much weight as comfortable. Usually with the aid of crutches. Use the crutches for long as you feel you need them which can vary from one person to another by a couple of days to a few weeks.
- Importantly try to walk normally and take as much weight as you feel is comfortable. To walk normally strike the ground with your heel and lock your knee upon impact with the ground.
10 key tips to progress your walking back to normal levels faster
ACL Walking Normally Tip 1 – walk straight away
You can effectively start walking immediately, as soon as day 1 after ACL surgery
ACL Walking Normally Tip 2 – Use crutches
Try to walk normally after ACL surgery initially with the assistance of crutches as noted below
ACL Walking Normally Tip 3 – Transition to 1 crutch
Begin walking after ACL surgery with 2 crutches and use the crutches for as long as you feel you need them. Most people are off their crutches by two weeks and you may find a good transition is to use 1 crutch.
ACL Walking Normally Tip 4 – Weight bearing
Take as much weight as you feel is comfortable. This applies to when you first leave hospital walking on 2 crutches and progressing to a more normal walking gait
ACL Walking Normally Tip 5 – Heel strike and knee lock
To walk “normally” strike the ground with your heel and lock your knee when you step
ACL Walking Normally Tip 6 – Reduce swelling
Reduce swelling by wearing a compression bandage and regular icing for 15 to 20 minutes at least 4 to 5 times a day.
ACL Walking Normally Tip 7 – Rest and elevation
Ensure lots of rest and elevation of the knee especially in week 1 post surgery. Plus ensuring that your receive sufficient sleep to allow your body to recover from the operation.
ACL Walking Normally Tip 8 – Water walking
To assist with full weight bearing on your bad leg, a good exercise is to start walking in the swimming pool after about 3 weeks once your incision from surgery has healed and there are no complications
ACL Walking Normally Tip 9 – Pre-surgery preparation
If ACL surgery is to be performed preparing the knee is really important. ACL prehab exercises will help rebuild strength and restore range of motion leading into your operation and help improve your recovery outcomes after surgery.
ACL Walking Normally Tip 10 – Post surgery rehabilitation
It probably goes without saying but following through with your post ACL surgery exercises and treatment is key.
Reoccurring problems can occur as a result of poor fulfilment with ACL rehabilitation.
Please read below for more information.
After ACL surgery it is important to aim towards walking normally and improving your gait
Within the initial few weeks after your ACL reconstruction surgery, try to gradually improve your walking each day:
- Start by using two crutches post surgery and take as much weight as you feel is comfortable
- Try to walk normally using crutches where required
- Gradually increase weight bearing whilst walking at a comfortable level, using the crutches for as long as you feel you need them.
- You may require crutches to walk for as little as a couple of days or as long as two weeks.
- A good progression is to just use the one crutch in the opposite hand, when you are ready to progress from using two crutches
- Next step is to walk without crutches. Try to lock your knee and contract the quadriceps when you step. This will assist with developing strength and control back into your injured knee
Ticking off your key goals in the first two weeks after ACL surgery will help progress your walking
There are a number of key goals you need to aim for in the first two weeks after surgery:
- Reduce knee swelling,
- Quadriceps control,
- Locking the knee,
- Leg extension,
- Range of motion exercises, and
- Trying to walking in a normal way within the first two weeks
The initial two weeks after surgery is a very important phase of your ACL surgery recovery timeline. The more you can learn about what Is required, the more likely you are to advance and progress your rehabitation.
Factors that can impact when can you walk after ACL surgery
- The condition of your knee pre surgery including the level of swelling and strength within the quadriceps and surrounding leg muscles.
- To assist with reducing pain and swelling you should employ RICER protocols immediately after the injury
- Plus in the weeks leading up to surgery your surgeon may include treatment to increase strength in your leg and supporting knee muscles, restore leg extension and range of motion
- The technical skill of your surgeon including how experienced they are and the techniques that they use is also a factor which influence your ability to walk after surgery
- The ACL graft choice can impact pain and swelling after surgery. The graft choice is often determined by the preference of your surgeon. You should understand why the surgeon has choosen a particular graft type for your individual circumstances prior to surgery
- Your application to ACL surgery recovery in particularly within the first two weeks after your operation is a big factor in progressing your rehabilitation. This initial two week period is where you are likely to see significant progress with walking and weight bearing on your bad leg
Pre surgery ACL rehabilitation can help progress your walking faster after surgery
If an ACL reconstruction is performed it is essential to prepare your knee prior to surgery including:
- Regularly icing of your knee to reduce swelling,
- Wearing a compression sleeve or bandage after the injury
- Elevate your leg where possible
- Quadriceps strengthening exercises
- Locking the knee out straight with a rolled towel placed under the knee and using the quadriceps to push down
- Riding an exercise bike to improve knee flexion and bending
Post Surgery ACL protocols will also help you walk faster after surgery
- It is very important to rest in the first week after ACL surgery which means spending a lot of the time with your leg elevated on a bed or couch and regular icing to help reduce swelling
- There are also a number of ACL rehab exercises that you should be critically doing during weeks 1 and 2 post surgery (as aforementioned above in your key goals)
- In the first week, it is also important to take care and not to overexert too much pressure on your knee which is likely to be sore and swollen after an ACL reconstruction. That is ensure your knee is well rested and constantly elevated on a bed or couch in the first week
4 stages to restore your normal walking gait after ACL surgery
The timeline for walking with a normal gait after ACL surgery can vary from one person to another as recovery from a knee reconstruction can be highly individualistic.
For simplicity, below we include an indicative timeline for when you can reasonably expect to be walking again normally.
Stage 1: Start By Walking With Crutches After ACL Surgery
Day 0 to week 1 – upon leaving hospital after surgery you are likely to require the use of crutches to walk. Take as much weight as is comfortable and use the crutches for as long as you need them. This may be as little as a few days or as long as a few weeks.
- Most surgeons agree that you can start to walk almost immediately after surgery with the assistance of crutches as soon as you leave hospital.
- The use of crutches can help assist you to make the transition back to normal walking with as minimal pain as possible
- In terms of walking, most people will be unfamiliar with how to use crutches especially if you injured your knee playing sport and are used having full use of both legs
- Your hospital physio or local physician will provide guidance and instructions on how to use crutches
- You need to be mindful of the level of weight bearing force applied to your knee in the early stages and essentially be guided by the level of pain and swelling in your knee.
- Take as much weight as you feel is comfortable
- To begin walking after surgery your crutches and upper body will take the majority of your body weight on the stride favouring your bad leg
- The pressure applied by your bad leg to the ground will continue to increase on a daily basis.
- If you are concerned about a lack of progress in your ability to walk without crutches then you should speak to your surgeon or physician
Stage 2: Progress To Walking With One Crutch After ACL Surgery
After a couple of days to 2 weeks transition from 2 crutches to 1
- Within about a few days of leaving the hospital you are already beginning to take more weight on your knee and progress your walking
- Noticing that constant icing and elevation of your knee, strengthening and flexibility exercises within the first week, plus the very nature of crutch assisted walking, all combine to gradually improve your ability to absorb more weight on your bad leg
- A good progression is to just use the one crutch in the opposite hand when you are ready to progress from using 2 crutches to 1
Stage 3: Transition to Walking Without Crutches After ACL Surgery
By about the end of week 1 to week 2 transition to walking without crutches
- Whilst the use of crutches can vary from one person to another to as little as 2 days after surgery, most people will need the use of crutches for at least 1 to 2 weeks
- Once you reduce swelling, regain quadriceps strength, restore leg extension and mobility in your knee and leg muscles than the crutches can be discarded
- When you are ready to walk without crutches try to strike your heel on the ground and lock your knee plus contract the quadriceps when you step. This will assist with developing strength and control back into your injured knee
- In order to walk without crutches you need about 100 degrees of flexion and reduced swelling in the knee enough so that you can fully extend your leg
- Walking without crutches is a gradual progress and your normal walking gait will progress as your leg continues to regain strength
- Infrequently some people are not comfortable enough to walk without crutches for up two to three months. If you are concerned about your rate of progress then you should raise this with your surgeon and physio
Stage 4: Aim To Walk With A Normal Gait After ACL Surgery
Weeks 3 to 5
- Generally speaking walking with a normal gait and without a limp can take 3 to 5 weeks – As previously mentioned progress will vary from one person to another.
- Walking without a limp and returning to a normal gait will be dependent on a number of different factors including how you progress with restoring your quadriceps function and achieving full leg extension,
- To progress with full weight bearing walking, include swimming and water exercises at about 3 weeks post surgery as long as the incision from surgery heals in a proper manner and there are no complications
- Start with walking in the water at approximately waist height
Crutch Walking Technique Tips
To assist with walking from day 1 after ACL surgery
Immediately proceeding ACL surgery crutches will almost invariably be required to reduce weight bearing on the bad leg for about the first 1 to 2 weeks (as forementioned).
There are some simple crutch walking technique tips that may assist with using crutches in your first few weeks post-surgery including:
- Try to put your body weight on your hands rather than on your underarms when standing and walking
- When resting on your crutches place them a short distance in front of your feet and lean slightly forward otherwise you risk losing balance and falling over
- The proper sequence for walking on a flat surface is “crutches, bad leg, good leg”. Being careful not to put weight on the bad leg. Once you become more comfortable using crutches, and strength and control is starting to develop in your knee than the crutches and bad leg can move together
- To walk upstairs the movement is: Good leg, bad leg, crutches
- To walk downstairs the movement is: Crutches, bad leg, good leg