Patient Perspective of an ACL Reconstruction: Week 6+

Rehabilitation after an ACL reconstruction is rarely a straight line from surgery to return to sport. Over the course of the rehab journey, there will be peaks and troughs, alongside good days and bad days. It is important that we as physiotherapists, and you as patients understand what to expect. Many people would expect the knee to be feeling great after the initial rehab stage is over, however this will not always be the case. Symptoms may persist, progress may be slow, and this blog post aims to educate patients on what they can expect 6 to 12 weeks after an ACL reconstruction.

After the initial pain post-surgery has subsided, patients may imagine progress occurring quickly and easily. This is rarely the case. When the pain and swelling have reduced to a tolerable level, it gives us the chance to start progressing our rehabilitation. When most people think of rehab after an ACL Reconstruction, they think of hopping, skipping, jumping, and running. However, this is still a long way away. Rehab at this stage will mostly consist of resistance training and stability training. Working on balance and stability at this point is crucial to allow us to move forward onto the more dynamic aspects of rehab. It is important not to get ahead of ourselves at this point. The temptation can be there to start doing more and more now that there is less pain in the knee, however, it is important to remember that there is still a long road to recovery ahead.

In this stage of rehabilitation, progress will be slow. Rebuilding our strength post-surgery is always one of the most time-consuming aspects of rehab after most operations, but it is crucial to allow us to progress. While most patients at this point will be starting to incorporate more strength training into their rehab, for many patients, seeing the first phases of progress can be very challenging. The important thing to remember is that each of these rehab sessions will bring us closer to our end goal of returning to full fitness. Don’t be disheartened if you feel the progress you’re making is slow, try looking at it on a week-to-week basis, instead of a day-to-day basis, and you should start to see the fruits of your labour more clearly.

Most patients will be aiming to return to full fitness post ACL reconstruction in 6 to 9 months. However, many patients will still be dealing with post-op symptoms at this time when you start increasing your rehab load. Some patients may still be experiencing pain, swelling, and sensations of instability. Your physiotherapist will work with you to help limit the symptoms you are experiencing and tailor your rehabilitation to address your residual complaints. It is important to be aware of your own symptoms, especially when exercising. Take note of pain throughout activities, swelling after exercises, or sensations of instability, and discuss these symptoms with your physiotherapist so they can help better tailor a rehab program that suits you best.

Sometimes the most important thing we can do to reduce injury risk is listen to our bodies. For many people before injury comes on there will be warning signs before it blows up into something more. Whether that be the unusual tightness, frequent cramping during sports, general fatigue, or mild pain. These are signs that there may be a weakness present or an injury on the horizon. Listening to our bodies and acknowledging these early signs can sometimes be the first step in preventing further injury to the area. If we are seeing some of these signs, it can be important to modify our load early, cut back on some exercise, start adding in some more stretching before or after sessions, place more emphasis on warming up and cooling down effectively. These early interventions can often be the difference between remaining fit and healthy or spending time out from activities through injury.

In order to progress onto more complex rehabilitation, your physiotherapist will create goals which must be achieved before then. Goals may consist of objective measures regarding your stability, such as a Y-Balance Scale, some may be regarding strength such as a Limb Symmetry Score, and pain may also be used as an objective measure. In the next stage of rehab, patients may expect to begin a gentle and graded return to running, and the introduction of some more challenging exercises, such as hopping, skipping, landing and more. These are important skills to remaster before making a return to sprinting, and eventually, a return to sport.

At PMC Physiotherapy, we are experienced in the complexities of ACL injury rehabilitation and offer comprehensive support throughout your recovery process. Facing an ACL injury can be daunting, but our skilled physiotherapy team will accompany you on each stage of your rehab journey. Whether you are preparing for surgery, recuperating post-operation, or navigating the recovery phase, contact us for a rehab program suited to your specific needs, to best restore your strength and movement.