Navigating ACL Injuries: Patient Experiences, Expert Guidance

An Anterior Cruciate Ligament injury has long been feared by athletes, both elite and recreational. Once diagnosed, the vast majority of people will require surgery, followed by an intensive period of rehabilitation to reach the levels they were at pre-injury. However, the intense rehabilitation cannot begin immediately post-op, and there can often be a lot of apprehension and nervousness about what can be expected in the first few weeks after surgery. This article aims to tell patients about what they can expect, from the perspective of a Physiotherapist who has recently gone through this experience himself. 

It is important to remember that not all ACL Injuries are massively painful. In the time between the initial injury and the operation, pain can of course be a limiting factor, but other issues, such as swelling, and instability can be just as bothersome. The feeling of the knee buckling or giving way will become a familiar sensation as the integrity of one of the main stabilisers of the knee is now compromised. Swelling after exercise can also be a problem after ACL injury, which may cause pain and a decrease in the mobility of the knee. However, it is important to begin training strength and stability in the knee as much as possible in this phase before surgery, in the hopes of reducing the deficits that may be present post-op. 

After having an ACL reconstruction, a period of time using crutches will be required before a patient is capable of walking independently. This can vary from patient to patient as the rehabilitative process will progress differently. For most, the period of using two crutches would be expected to last 1-3 weeks, and once capable, patients should aim to wean down to use just one crutch, and eventually walk crutch free. The speed of progress should be determined by a few factors, such as pain, mobility, and stability of the knee.

As is to be expected after most operations, there will most likely be pain after the procedure. This is to be expected and isn’t something to worry about. Depending on the patient, pain can last for a few days up to a few weeks post-op. In the acute post-op phase most patients will be prescribed paracetamol, anti-inflammatories, and potentially some stronger painkillers, such as Solpadine. This will help to keep the pain manageable while recovering and will allow you to get your exercises done without aggravating the pain too much. It may be helpful to time your exercises around your pain relief. In the first few days post-op, ice can also be very helpful to manage the pain.

Following the trauma of surgery, the body’s natural instinct is to try and protect the area that has been affected. The easiest way our body can do that is by muscle guarding, which causes the surrounding musculature to tighten up in order to limit the motion of the joint. This can be exacerbated by the fact that during most ACL reconstructions, the surgeon will most likely be taking a tendon graft from either the quadriceps tendon or the hamstring tendon. This can cause the respective muscle to tighten up further. Although the initial temptation may be to go and stretch the muscle, gentle bending and straightening of the knee can often give more relief in the long term as the knee grows accustomed to its range of motion again.

Upon discharge from the hospital, you will meet with a physiotherapist, who will explain and demonstrate a few exercises to start you on your rehab journey. These exercises will all be gentle, but it is important to remember that they can still be difficult after the operation. Exercises will likely include things such as bending and straightening the knee, ankle pumps, straight leg raises, and potentially few others. The physio will likely tell you to do a few sets of these exercises daily. It is also worth noting that in the first few days after the operation, many people will be keen to make as good a start as possible, but there is also such a thing as too much! Take your time with the exercises, aim for the sets and reps instructed by the physiotherapist, and if you find exercises to be very sore, stop, and try again the next day. 

At PMC Physiotherapy, we understand the physical and emotional challenges that come with ACL injuries, and our expert team is here to guide you every step of the way. If you’re facing an ACL injury, whether you’re pre-surgery, post-surgery, or somewhere in between, don’t hesitate to reach out. Our experienced physiotherapists can provide personalised rehabilitation plans, alleviate your concerns, and help you regain your strength and mobility. Your recovery journey starts here – contact us today to take the first step toward a healthier, more confident you.