ACL (anterior cruciate ligament) surgery is one of the most common orthopedic procedures, especially among athletes. While the surgery itself is straightforward, the rehabilitation process is where the real work begins. Understanding what to expect can help you prepare mentally and physically for the journey ahead.
What is the ACL?
The ACL is one of four major ligaments in the knee that provides stability during rotational movements. It’s commonly injured during sports that involve sudden stops, jumps, or changes in direction—like basketball, soccer, and skiing.
The Recovery Timeline
Recovery from ACL reconstruction typically takes 6-12 months, depending on your goals and the demands of your activities. Here’s what to expect:
Weeks 1-2: The Protection Phase
The initial phase focuses on protecting the surgical repair while managing pain and swelling.
Goals during this phase:
- Control pain and swelling
- Protect the graft
- Begin gentle range of motion exercises
- Start weight-bearing as tolerated with crutches
Weeks 3-6: Early Rehabilitation
As healing progresses, the focus shifts to restoring range of motion and beginning strengthening exercises.
Key activities:
- Progressive range of motion exercises
- Quadriceps and hamstring activation
- Balance training begins
- Stationary cycling
Months 2-3: Intermediate Phase
This phase emphasizes building strength and improving functional movement patterns.
Focus areas:
- Progressive strengthening exercises
- Improved neuromuscular control
- Single-leg balance work
- Pool exercises and low-impact cardio
Months 4-6: Advanced Strengthening
Now the real strength building begins, preparing your knee for more dynamic activities.
Activities include:
- Plyometric exercises (jumping, hopping)
- Sport-specific drills
- Running progression
- Agility training
Months 6-12: Return to Sport
The final phase focuses on sport-specific training and clearance testing before returning to full activity.
Tips for a Successful Recovery
1. Follow Your Physical Therapist’s Guidance
Your PT knows the healing timeline and will progress you safely. Pushing too hard too fast can damage the graft.
2. Do Your Home Exercises
Consistency with your home exercise program is crucial. Physical therapy sessions are important, but what you do between sessions matters just as much.
3. Manage Swelling
Ice, elevation, and compression help manage swelling, which can inhibit muscle function and slow recovery.
4. Be Patient
Recovery takes time. Trust the process and celebrate small victories along the way.
5. Focus on the Whole Body
Maintain upper body and core strength during recovery. A strong core supports better movement patterns.
When Can I Return to Sports?
Return to sport isn’t just about time—it’s about meeting specific criteria:
- Full range of motion
- Strength within 90% of the uninjured leg
- Successful completion of sport-specific testing
- Clearance from your surgeon and physical therapist
The Bottom Line
ACL recovery is a marathon, not a sprint. With dedicated rehabilitation and patience, most people return to their pre-injury activity levels. The key is following your physical therapist’s guidance and staying committed to the process.