REHABILITATION FOR
ACL RECONSTRUCTION SURGERY

Pre-Surgery Rehabilitation
Pre-rehabilitation exercises can help with improving the strength of your knee before surgery.

The Day of Surgery
Rehabilitation should start as soon as you recover from the anaesthetic. You will usually be discharged on the day of surgery.

First Few Days After Surgery
Please expect the pain to increase as the anaesthetic wears off. It is important that you take painkillers to reduce the pain so that you can continue to exercise. For the first few days, the aim of ACL surgery recovery is to reduce swelling and minimise pain.

Take things easy. While resting, ensure your knee is straight and avoid resting the back of your knee on anything (including a cushion or pillow).

Regular ice packs can help to reduce the pain and swelling. You can use frozen vegetables for 15 minutes every hour to help reduce swelling. Alternatively, you may wish to purchase a ‘Cryo Cuff’ or hire a ‘Game Ready’ cold compression device.

Keeping the leg elevated ideally above the level of your heart can help to reduce swelling.

You can bear weight fully through the leg if it is comfortable. Use crutches initially but then gradually wean off altogether when you are able to do so. 

Wool and crepe bandage dressing will be removed within the first 48 hours. A tubigrip can be used during the day time after this. Please keep the dressings on the wounds and keep the knee dry for 2 weeks.

1-2 Weeks
Concentrate on regaining full range of movement at the knee, particularly extension (i.e. being able to fully straighten the knee).  Flexion (bending) the knee, tends to be easier to regain.  

By the end of this stage, the patient should be off crutches and have regained nearly full range of movement in the knee. Formal physiotherapy should have started by 1-2 weeks. 

2-6 Weeks
The emphasis then shifts to strengthening and stability. The physiotherapist will target the quadriceps muscle, hamstrings, gluteal muscles and proprioception exercises. 

At the end of this period, you should have a full range of movement with minimal or no swelling. You should be able to drive and have returned to work, job dependant.

6-12 Weeks
The ACL reconstruction graft is weakest between 6-12 weeks after surgery. Be safe, this is the time when the graft is most vulnerable to failure.

3-6 Months
Phase four on the ACL surgery recovery timeline is all about preparing to return to sports. The physio will work on specific rehab exercises and sports drills appropriate to the patient’s aims and anticipated sporting activities. This will include high level balance and proprioceptive exercises to ensure that the patient regains full knee stability before returning to sports.  

People often feel frustrated in this phase of ACL surgery recovery as their knee may feel “normal” but it is not quite ready for the stresses and strains from sporting activities.  

Avoid kneeling and twisting the knee for the first 4-6 months after surgery. Remember, no contact sports until 9 months after surgery. 

6-9 months
You should have a full range of movement with no swelling. You should be able to hop, jump, run in a straight line at full pace, backwards and in a figure of 8.

9 months+
Discuss returning to professional contact sports such as rugby and soccer with your physiotherapist. Consider a formal assessment.