From the Guidelines
Physical therapy typically begins within 24-48 hours after ACL surgery. The initial phase focuses on gentle range of motion exercises, quadriceps activation, and controlling swelling. Patients often start with simple exercises like ankle pumps, heel slides, and quadriceps sets while using crutches for walking. As healing progresses, therapy advances to include weight-bearing activities, strengthening exercises, and eventually sport-specific training. This early intervention is crucial because it helps prevent joint stiffness, muscle atrophy, and promotes proper healing of the graft.
- The entire rehabilitation process generally spans 6-9 months before full return to sports, though individual recovery timelines vary based on surgical technique, graft type, and patient-specific factors.
- Your surgeon and physical therapist will create a personalized protocol that balances the need for healing with progressive rehabilitation to ensure optimal outcomes and reduce the risk of re-injury 1.
- Early mobilisation can improve early phase knee flexion and extension range of motion without compromising knee laxity, regardless of the graft type used 1.
- A combination of strength and neuromuscular training should be used in the postoperative rehabilitation, with isometric quadriceps strengthening exercises initiated from the first postoperative week (if not causing pain) and shifted progressively to concentric and eccentric (in closed kinetic chain) exercises 1.
- Early (within first week) full weight bearing is encouraged but clinicians are advised to progress as tolerated, and cryotherapy may be used in the first postoperative week to reduce knee pain without increasing the risk of short-term adverse events 1.
From the Research
Physical Therapy After ACL Surgery
- The provided studies do not specify the exact time frame for when physical therapy (PT) starts after ACL surgery 2, 3, 4, 5, 6.
- However, it is mentioned that rehabilitation protocols for ACL injuries have shifted towards more accelerated and individualized approaches, with an emphasis on early weight bearing and open kinetic chain exercises 2.
- The studies focus on the rehabilitation process, outcomes, and management strategies for ACL injuries, but do not provide a specific timeline for the initiation of PT after surgery.
- One study discusses the use of clinical milestones to determine when a patient is ready for the next phase of a "step-up" rehabilitation program, but does not specify when PT typically begins 2.
- Another study highlights the importance of rehabilitation in the successful recovery of ACL-injured patients, but does not provide information on the timing of PT initiation 3.