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ACL Surgery: Post-Op Rehabilitation

After undergoing ACL surgery, the road to recovery can seem daunting. However, with the right post-operative rehabilitation process, returning to athletic activities is possible. As athletes, the priority is to achieve a full recovery and regain the strength and confidence to play at the same level as before the injury. In this blog post, we’ll look at the post-op rehabilitation process for ACL surgery at Form Recovery and Wellness.

Physio helping patient with posture

Pre-op Phase: Injury recovery & readiness for surgery

The ‘Pre-op’ phase prior to ACL surgery focuses on allowing the knee to recover from the injury and regain strength and function. It’s advised to attain a full range of motion, robust quadriceps and hamstring strength, and reduce swelling before undergoing surgery as this indicates better post-surgery outcomes for patients. This phase involves regular icing, range of motion exercises, low-impact aerobic activities like cycling, and a progressive strength routine. As the knee’s condition improves, strength exercises can advance to include gym weights and hopping drills, but aggressive directional changes should be avoided. 

Goals:

  • Eliminate swelling
  • Regain full range of motion
  • Regain 90% strength in the quads and hamstrings compared with the other side

Phase 1: Recovery from surgery

The first phase of the post-op rehabilitation process involves post-surgical recovery. While it’s tempting to get moving as soon as possible, it is best to allow the knee to rest during the initial 1-2 weeks and just focus on simple range exercises, quadriceps setting drills, ice, and compression. During this phase, typical exercises and management activities include regular icing of the knee and graft donor site, applying compression to the knee and lower limb, basic quadriceps setting exercises, and gentle range of motion exercises to improve knee extension and bending. 

Goals:

  • Full knee extension
  • Reduce swelling down to a ‘mild’ level
  • Reactivate the quadriceps

Physio trainer and recovery

Phase 2: Strength & neuromuscular control

In this phase, you will work with a physical therapist to regain strength and neuromuscular control in your injured knee. Exercises in this phase focus on building muscular strength to support your knee and learning to control the movement of your knee. This phase typically lasts for around 6 weeks and may involve exercises such as straight leg raises, mini-squats, and balance exercises.

Goals:

  • Restore most of your single leg balance
  • Regain most of your muscle strength
  • Perform a single leg squat with good technique and form

Phase 3: Running, agility, and landings 

Phase 3 of the post-op rehabilitation process involves practising running, agility, and landing exercises. The main objective of this phase is to regain your ability to run and jump without the risk of re-injury. This phase usually lasts around 3 months and involves exercises such as leg press, lunges and more. It is important to note that movements with a lot of cutting or jumping may need appropriate assessment to ensure your recovery is not slowed down.

Goals:

  • Progress through hopping training with good technique, distances, and endurance
  • Complete an agility program
  • Regain full strength and balance

Phase 4: Return to sport

Phase 4 ACL rehabilitation is highly individualised, and involves incorporating exercises and training activities that the athlete typically performs when not injured. The focus should go beyond preparing the knee for sports; it should encompass the overall well-being of the individual. For optimal outcomes, the knee should be stable, strong, and exhibit ideal neuromuscular patterns and biomechanics.

During this phase (and continuing into Phase 5), it is crucial to incorporate exercises targeting strength, balance, landing, and agility. However, the primary emphasis of Phase 4 ACL rehab lies in progressively advancing the training, transitioning from restricted to unrestricted activities, and eventually returning to competition when deemed ready.

Determining the appropriate time for athletes to return to sports following ACL reconstruction depends on various factors. While current research suggests a minimum of 9 months, it is important to follow guidance from your surgeon and sports medicine team.

Phase 5: Prevention of re-injury 

The final phase of the post-op rehabilitation process is the prevention of re-injury. This is in many ways the most important step, and it occurs when your rehab program ends. You have to continue to maintain your strength and take care to avoid re-injury. The main components of an injury prevention program are:

  • Plyometric exercises that promote explosive movements that can help train your body to react quickly and safely in high-stress situations. 
  • Balance exercises improve your proprioception and neuromuscular control, helping you maintain control of your movements and reduce the risk of falls and awkward landings. 
  • And of course, strengthening exercises are essential for maintaining the overall health and integrity of your muscles and joints.

To ensure that your injury prevention program is cemented into your routine, it’s important to repeat it before every training session and game. Carve out at least 10 minutes before your workout or game to go through your exercises. This can help activate your muscles and prepare them for the demands of the exercise or game ahead.

Finally, it’s important to remember that prevention isn’t a one-time thing; it’s something that needs to be ongoing. Even after your initial rehabilitation is over, continue to incorporate injury prevention exercises into your routine. As you progress, you may find that you need to modify or adjust your program, but it’s important to keep it at the forefront of your mind.

ACL Surgery Rehabilitation at Form Recovery and Wellness

At Form Recovery and Wellness, we understand your passion and the urgency to get back into the game, and that’s why our primary mission is to guide you safely back to your sport, minimising any risk of re-injury. 

To ensure the highest standard of care and effective rehabilitation, our clinic proudly implements a world-class post-op ACL Rehab Program, curated by specialists from Australia. If you’re keen to access the same program that professional athletes use for their own recovery, look no further. 
For more in-depth information and personalised guidance on post-op ACL rehab, schedule a free consultation today. Together, we’ll pave your path to a successful and safe return to the sport you love.

Form Recovery Team Photo at Clinic

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