The length of ACL (Anterior Cruciate Ligament) rehabilitation varies depending on factors such as the patient’s age, overall health, the extent of the injury, and adherence to the rehab protocol. However, a general timeline for ACL rehab is as follows:
Immediate Post-Surgery (Weeks 1-2)
- Goals: Reduce swelling and pain, protect the graft, regain knee extension, and improve quadriceps activation.
- Activities:
- Use of crutches and a knee brace as needed.
- Gentle range-of-motion exercises.
- Isometric quadriceps exercises (e.g., quad sets).
- Ice and elevation to manage swelling.
Early Rehabilitation (Weeks 2-6)
- Goals: Achieve full knee extension, improve range of motion (up to 90-120 degrees flexion), enhance quadriceps strength, and begin weight-bearing as tolerated.
- Activities:
- Continued use of a knee brace if prescribed.
- Range-of-motion exercises.
- Weight-bearing exercises such as mini squats and heel raises.
- Patellar mobilizations.
- Stationary cycling (as soon as range of motion allows).
Intermediate Rehabilitation (Weeks 6-12)
- Goals: Restore full range of motion, improve strength, enhance balance and proprioception, and begin functional activities.
- Activities:
- Progressive resistance exercises for quadriceps, hamstrings, and hip muscles.
- Balance and proprioception exercises (e.g., single-leg stands, wobble boards).
- Walking without a limp.
Advanced Rehabilitation (Months 3-6)
- Goals: Regain strength and endurance, improve neuromuscular control, and begin sport-specific drills.
- Activities:
- Strength training with an emphasis on lower body and core stability.
- Balance
- Neuromuscular control.
Return to Sport (Months 6-12)
- Goals: Achieve pre-injury level of function, ensure graft and knee stability, and safely return to sports or high-level activities.
- Activities:
- Continued strength and conditioning.
- Working toward full participation in sport-specific training.
- Gradual return to full sports activities, often starting with controlled practice sessions before competitive play.
Key Milestones
- 3 Months: Walking and basic activities of daily living should be almost pain-free, with improved strength and range of motion.
- 6-9 Months: Many patients can begin sport-specific training and light practice sessions.
- 9-12 Months: Full return to sports is based on individual progress and surgeon/therapist recommendations.
Important Considerations
- Individual Variation: Rehab timelines can vary widely. Always follow the specific protocol provided by your surgeon and physical therapist.
- Rehabilitation Compliance: Adherence to rehab exercises and guidelines is critical for a successful recovery.
- Avoiding Re-injury: Gradual progression and proper technique in exercises and sports activities are essential to prevent re-injury.
- Professional Guidance: Regular follow-ups with a physical therapist or healthcare provider are crucial to monitor progress and make necessary adjustments to the rehab plan.
By following a structured rehabilitation program and maintaining open communication with healthcare professionals, patients can optimize their recovery and safely return to their desired level of activity.
Author
Dr. Catherine Logan, MD, MBA
Catherine Logan, MD, MBA, MSPT, is a sports medicine orthopaedic surgeon specializing in complex knee and shoulder surgery at Colorado Sports Medicine and Orthopaedics (COSMO) in Denver, Colorado. As a former physical therapist & trainer, Dr. Logan provides a distinct expertise in sports injury, prevention, and surgical management.
