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Accelerated ACL Rehab After Surgery

February 5, 2024

The ACL or anterior cruciate ligament, is an important ligament in your knee that is commonly injured. It prevents your shin bone from sliding forward from your thigh bone. It also provides stability for rotational movements about the knee.

The mechanism of injury is usually a cutting movement or changing direction suddenly that over-stresses the knee through too much rotation and high forces (a common cause in sports like football) or landing from a jump incorrectly.

If, after discussions with your doctor, surgery is deemed the most appropriate treatment for your ACL tear, then it is essential that you commit to a period of rehabilitation afterwards. Rehabilitation starts immediately post operation and in general consists of 5 phases:

1: Acute Post-Op Care: decreasing pain, swelling and preventing infections setting in.

1: Acute Management: regain early movement and strength (2-4 weeks post op)

2: Foundation Rehab: basic strength, balance and muscle control (3-6 weeks post op)

3: Higher level: strength, dynamic drills and co-ordination (6-12 weeks post op)

4: Sports specific training and preparation for return to play (24 weeks post op onwards)

Timelines for the above phases are guidelines only. Some people will progress quicker or slower. Each phase will consist of a series of exercises to work on regaining normal range of movement (ROM)/flexibility of the knee, strength and stability. As you progress, the exercises will get more challenging, more functional, and will be tailored to suit your lifestyle and sport.

One of the most common questions we get is ‘When can I go back to play?’ Return to sport should always be based on meeting key performance criteria rather than arbitrary time frames. Generally it can start at a basic level from 3 months onwards but to return to pre-injury level sport can take anything from 6-9 months or onwards.

Recent studies published in 2016 and 2017 involving competitive athletes have concluded that the risk of re-injuring your ACL after reconstructive surgery reduced considerably when you wait to return to sport after 9 months. Those that met the return to play criteria (such as appropriate quads strength) also have a much less likely chance of re-injuring their ACL.

Seems like a long time? Well, 9 months is still better than if you return to sport after 3 months, re-injure the ACL and have to start all over again. ACL rehabilitation is challenging, but it’s also an extremely rewarding experience when you can see all the gains you are making. Bottom line: do your exercises, do your time, and meet the criteria for returning to the sport you love!