What to Expect During ACL Recovery: A Week-by-Week Timeline (Part 1)
An ACL injury is one of the most challenging injuries to recover from, whether you're an elite athlete, a weekend warrior, or a regular gym-goer. Marcus, a physiotherapist three months into his own ACL replacement recovery, shares a week-by-week guide based on his personal journey and professional knowledge.
Disclaimer: This timeline reflects my personal recovery and may vary for others. Always consult your physiotherapist or healthcare provider for personalized advice.
Dressing around the knee immediately post-surgery
Day of Surgery
After waking up from surgery, expect to feel tired, with pain in your knee and calf muscles. You may also experience an urge for more pain relief, which is entirely normal. Many patients, including myself report feeling like they have little to no control or strength in their quadriceps, calves, and hamstrings—but don’t worry, this is temporary and will improve with time.
Bruising and swelling are also common, and their location depends on the type of surgery performed. I was provided with some gentle exercises to start, including calf pumps and light quadriceps activation exercises with the towel
Day 1 to Day 7 Post-Op
The first week post-surgery can be one of the toughest phases of recovery. For me, the pain and swelling peaked around Days 1 to 4 before it gradually began to subside. During this time, keeping your leg elevated and using ice consistently can help manage both pain and swelling. Pain medication prescribed by your surgeon or doctor is crucial in maintaining comfort and improving your ability to move around.
Walking and Weight Bearing
Your ability to walk will depend on the type of surgery performed and your surgeon’s instructions. If your meniscus was also repaired, you might be instructed to avoid weight-bearing entirely. Otherwise, most patients are encouraged to start walking with the help of crutches either on the day of surgery or Day 1 post-op.
For me, putting weight on my operated leg was initially painful, especially when walking or navigating stairs. Using forearm crutches helped me move around, but it took some time to adjust. Even with assistance, basic activities like showering, climbing stairs, or getting into bed were challenging during the first few days.
By Day 7, walking with crutches became more tolerable for me, though this timeline can vary widely between individuals depending on factors like pain tolerance, swelling, and overall healing progress.
Managing Daily Activities
Returning home after surgery required a lot of planning and support. On my first day home, I struggled with tasks like showering, but using a shower stool allowed me to sit down and made the process more manageable. Having family members assist with daily tasks was incredibly helpful during this period.
Staying Active (Gently!)
Most of my time in the first week was spent resting, icing, and elevating my leg, alongside having friends over and visiting friends to break-up my day. However, I also incorporated the gentle exercises recommended by my amazing physiotherapist Ebru and Adrian, such as calf pumps and quadriceps activation exercises.
Incision sites healing after removal of dressings, still fairly swollen and bruised (10 days post surgery)
