The First Week
first week after an ACL reconstruction is usually the worst. Not only
did you just have surgery, but you have lots of questions and worries.
Your knee is painful, swollen, bruised, and unresponsive.
body feels miserable from the anesthesia, and you can't sleep at night.
It hurts to move, and those exercises are really a pain.
sounds awful, but there are a few things you can do in the first week,
or the first few days before you start rehab that can greatly increase
the speed of your recovery, and reduce your pain and swelling.
is the Key
see all of my ACL reconstruction patients prior to their surgery. We
pre-operative visit in which I instruct them in their exercises for
home, fit them with crutches, provide an ice compression wrap, and
answer any questions they have about the surgery, rehab, and recovery.
tell all of my patients that the single most important thing after
surgery is to maintain their knee extension.
I tell them this?
knee extension is the key to many facets of ACL rehabilitation. Your
quadricep muscles cannot fully contract if you cannot extend your knee.
You cannot walk normally if you cannot extend your knee. Your muscles
cannot relax and recover if you cannot extend your knee.
problem is that laying with your knee extended and propped up on a
pillow at the ankle is not comfortable. It hurts.
can always tell which ACL recconstruction patients kept their knees
extended when they were
elevating their leg and recovering. I can also tell which patients
didn't keep their knees extended in the first week.
full knee extension is essential in the first week of rehab after ACL
reconstruction. It sets
the foundation for all that is to come. You can get a jump start on
this by keeping your leg elevated when you are sitting around at home,
putting a pillow under your low leg and heel and letting your knee
straighten out. It isn't the most comfortable position, but it is the
of motion is slow to return after ACL reconstruction. And the first
time you try to bend your knee, it will feel like it is going to
I promise, it won't.
have to keep bending it, despite the discomfort.
Is It Safe?
always ask "Will it hurt the new ACL if I bend it too mcuh?" The answer
is no. You cannot cause damage to your new ACL by bending your knee.
of all, after your ACL reconstruction surgery, before you woke up, your
your knee through a full range of motion. They bent it all the way, and
straightened it out all the way. They wouldn't do this if it could
cause a problem.Once you wake up from surgery, however, you are swollen
and painful, and the muscles are spasming. This prevents you from being
able to bend it.
The more you move your knee, the
better it will start to feel.
sitting in the same position for several hours, without being able to
re-adjust at all. You would get very uncomfortable. You knee is the
same way. It isn't able to "re-adjust" and so it becomes uncomfortable.
You should try to bend your knee repeatedly,
several times a
day. The more you can move it, and allow it to re-adjust, the better it
Ice and Compression
use of ice and compression
is essential to improving your recovery time in the frst week after an
ACL reconstruction. The more you can ice your knee, the lower your pain
levels, and the less swelling. After the first couple of days, you will
actually enjoy icing. It will feel so good.
is the enemy during acl reconstruction rehab. It slows everything down,
and causes much of the pain associated with this surgery. So everythng
you can do to reduce it is going to get you better faster.
is also important, especially to keep the swelling from moving into
your lower leg and ankle. Use an ace wrap or compression sock to keep
your low leg from getting swollen. It will keep your pain down, and
also improve your recovery time.
ACL Surgery Stories
you have had an ACL reconstruction, or are getting ready for this
surgery, I want to hear your story. Whether you have questions you want
answered, or just want to share your experience, this is the place for
after an ACL reconstruction can be frustrating or it can be a time when
you get a head start on your recovery. Formal rehab does not usually
start for at least 3-4 days, sometimes a week after surgery. This time
is a great chance to start working on your recovery by using the tips
Your knee will thank you, your clinician
will thank you, and you will feel better faster.
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