Rapid ACL Surgery Recovery
ACL surgery recovery immediately focuses on 3 key areas: inflammation, range of motion and strength. Addressing these will enable achievement of a normal walking gait and ultimately a return to the athletic pursuits enjoyed before the ACL injury. In terms of timescales, my own ACL surgery recovery was achieved by following the MOON ACL rehabilitation guidelines.
Details on the 3 key areas and how to address them follow:
Inflammation
Removing inflammation is the first challenge in ACL surgery recovery. It is important because of the size of the knee joint and the relative lack of space within it. Unless inflammation is removed, range of motion of the joint is going to be inhibited and pain will prevent the muscles around the knee from working properly which, consequently, will prevent strengthening of the knee.
The key to removing inflammation is RICE (rest, ice, compression, elevation). A good exercise to help reduce inflammation is ankle pumps with the leg elevated. This gets the calf muscle working which helps with atrophy and also helps drive blood from the inflamed area. Admittedly ankle pumps are going to help lower leg inflammation and not knee inflammation but both need addressing.
Inflammation of the leg post-surgery can be a major concern and can lead to blood clotting. Controlling it through exercise is one aspect but what you do in daily life can also have a major impact. Avoid sitting with your leg hanging down where possible. This might mean missing out on some dinner dates but for the first 2 to 3 months post-surgery this is a small price to pay for a rapid recovery without complications. Wearing compress socks (knee length) is an excellent way to mitigate swelling.
Diet also plays a major role in speeding or inhibiting ACL recovery. Some foods cause chronic inflammation, some work to reduce inflammation.
Range of Motion
As you would expect, ACL surgery was a big setback in terms of range of motion. I was at 124 degrees pre-surgery and two weeks after surgery had only recovered to 115 degrees. Range of motion in the knee is taken for granted until injury restricts it and then simple things such as walking without a limp or walking up and down hill become extremely difficult.
Inflammation restricts range of motion so removing inflammation is the first step to re-establishing range of motion. Then work on the stationary bike helps get the knee moving. In my case the toughest part to achieve was leg straightness. Knee bend was easy by comparison – reducing inflammation takes you most of the way there. However, leg straightness (which immediately impacts gait) took a lot of work on the calf muscles and hamstring.
There are several ways to stretch the calf many of which I cover in my free mini-course that you can sign up for on the right side of this page. For hamstring exercises, I mainly used an elastic band tied around my ankle with the other end tied to a heavy table leg. I sat on a stool placed at a good stretch length from the table and then alternately straightened my leg and then pulled back, bending my knee and working the hamstring.
Strength
Strength in the knee arises from strength in the leg as a whole and as you move through the MOON ACL rehabilitation guidelines the knee strengthening exercises take on a holistic feel: quad sets, squats, hip adduction/abduction, the use of rocker boards and wobble boards, straight leg raises with resistance, calf exercises, hamstring curls, more bike work, introduction of the Stairmaster and Elliptical Trainer etc.
Woven in across all of these 3 key areas should be walking exercises. Key among these are squats, lunges, step up exercises and balance exercises. These latter exercises always reminded me of Monty Python’s funny walks. One of these involved raising the knee and opposite arm and then alternating with the opposite knee and arm. This was great for making the brain concentrate on something other than the damaged leg during the walk with consequent reduction in limping and improved balance.