ACL reconstruction-recovery

An anterior cruciate ligament (ACL) reconstruction grafts part of your hamstring tendon, feeds this tendon through the knee before tensioning and securing it to your shin bone. This is designed to mimic an undamaged ACL and provide better stability and balance mechanisms within the joint, thereby allowing you to return to higher level activities such as sports involving impact and rotation.

Phase oneThe first phase of your recovery will be focused on managing your swelling and pain and early mobilization to prevent excessive knee stiffness.

You will be provided with elbow crutches to help with balance and stability when weight bearing and walking. But under normal circumstances we will encourage you to take full weight through the knee as your pain and strength allow.

Regular icing and compression of the knee is encouraged at this stage to improve swelling and bruising.

Your physiotherapist will guide you through some initial activation exercises for your quadriceps and hamstrings which will help to support your knee and prevent excessive muscle wasting post-operatively. Regular stretching of the knee, particularly into extension is encouraged.

Phase two

The second phase of your recovery will focus on enabling you to be able to walk with a more normal gait pattern, increase your knee range of motion as quickly as possible and strengthen your hip and knee muscles, particularly your hamstrings.

Weaning off your elbow crutches is normally completed two-three weeks after surgery

Regular stretching of the knee into extension and flexion is encouraged to regain full range of motion by 12 weeks post-surgery.

Once any acute pain from the surgery and significant knee joint swelling has recovered, your physiotherapist will prescribe more appropriate strengthening exercises. These exercises will involve gentle resistance/loading of the hamstring muscles to encourage the tendon graft site to heal more quickly and to increase hamstring strength and control to support the ACL graft.

Weight-bearing exercises such as wall slides, squats and lunges may commence gradually to begin strengthening your operated leg muscles in weight bearing positions.

You will need to refrain from any rotational weight bearing exercise or impact exercise until 12 weeks post-surgery, at which time your ACL graft should have secured itself and developed new capillary (blood supply) networks needed for longer term tissue strength.

Phase three

The third phase of your recovery will begin at 12 weeks after surgery. Typically, the initial part of this phase will involve commencing light impact work such as jogging on the treadmill and increasing the vigour of existing exercises such as specific hamstring strengthening movements, squats, lunges and leg press.

Your physiotherapist will guide you as appropriate but under normal circumstances once the strength of your operated leg is equal to your non-operated leg, activity or sports specific rehabilitation exercises can be commenced. This may include progressing to sprinting, jumping and rotational movements depending on the sport desired.

The Game Ready Ice Machine, electric muscle stimulator, AlterG anti-gravity treadmill, Hydro Physio aqua-jogger, 3D Gait Analysis, sports exercise equipment such as the Concept2 rower plus Circle’s Return to Sport Assessment Service may help rehabilitation following an ACL reconstruction

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Circle Health Group, 1st Floor, 30 Cannon Street, London, EC4M 6XH