The first thing to learn about ACL reconstruction is that what you do BEFORE surgery matters.  Find a physical therapist and talk to them before surgery.  If needed, participate in some PT prior to surgery to regain your motion, regain strength, control swelling and regain as much coordination (neuromuscular control) as possible.  You will also gain trust in your PT, develop a rapport and gain some familiarity with what will be expected after surgery.

After any surgery, some pain or discomfort is expected.  This should be controllable with pain medications, rest and ice.  You should contact your surgeon if you have severe or uncontrollable pain.  If you are not experiencing much pain and do not want to take pain medication, please talk to your surgeon (his assistant or nurse) prior to stopping as they may have safety instructions or have other non-prescription drug alternatives. If you have unused opioid pain medication, please dispose of properly, most police stations are drop off sites. Saving for a “rainy day” can lead to someone other than you taking it. Opioid abuse is an epidemic and the fastest growing drug taken by middle-schoolers.

After a few days, you should be able to take a shower and let water run over the incision. Baths, Jacuzzis and swimming pools should be avoided until the stitches or staples are removed and the incision is well healed.

Outpatient physical therapy is usually started within a few days of surgery.  When you arrive to PT, your therapist will remove your surgical dressings if they are still on.  The first goal is swelling control. Yes, you have to wear the ugly white hose 24hours a day for 7 days if your surgeon gave them to you. Second goal is full knee extension.  You may be wearing a brace or using crutches. Typically, your PT weans you off fairly quickly once you have established the muscle control.

As your strength and motion improve, your therapist will progress your activities.  Progression back to your sport or activity level requires meeting certain goals at each level.  You must be able to move safely at a certain level before your therapist allows you to progress.  Progression is NOT based on how much time has passed since your surgery. And I know you are thinking that you can do it in 4 months like Adrian Peterson. However, he is a professional athlete and a grown man who has all day every day to work with his medical team. In addition, he is just a freak of nature.

Occasional flare-ups occur as you progress back to your sport, but remember that you are not going it alone.  If you have questions, ask your PT.  They have seen many of these surgeries and are experts at handling the ups and downs after ACL surgery.

If your goal is to return to sport, it is recommended to seek out a PT who is a sports specialist (has an SCS after their name) or an SCS on staff at the clinic. They specialize in return to sport testing and rehabilitation of the athlete. There are some unique challenges an athlete has following this type of surgery and it is best to work with a PT who understands those challenges.

Most athletes require a minimum of 6-10 months to return to their sport.  Returning too soon can lead to re-tear or more commonly tearing of the non-surgical side. The rehab can be tough and will require perseverance. However, our goal would be for the athlete to be higher performing and more injury tough than before the injury. You can do it!

Resources

The following article is from MikeReinold.com.

What is the Best Graft Choice for ACL Reconstruction?

Tearing an ACL can be a devastating experience.  Fortunately you are not alone as more than 250,000 people will tear their ACL in the United States and over 80% of people will have that tear reconstructed.

When the injury does occur, the person has some serious decisions to make including which graft to choose for the reconstruction. Often times, the person will leave that decision up to the orthopedic surgeon and blindly go with that decision.

All too often, the graft choice for that person may not be the best option for their age, goals and for their lifestyle, amongst many other things.  Consideration for the current research should play a big role in this decision-making process on which graft to use for ACL reconstruction.

So, what graft choices are out there and why may one be better than another one?

Well, as I normally say ‘it often depends,’ but I usually coach my clients and start with the gold standard, consider the pros and cons, then move onto the next best option.

ACL Reconstruction Graft Choices

What are the options and why choose one over the other?  First, I want to clarify the difference between “autograft” and “allograft.”  Autograft means using your own tissue.  Allograft means using tissue from a cadaver.

The most common choices available are:

  • Patellar tendon autograft
  • Hamstring autograft
  • Quadriceps tendon autograft
  • Patella tendon allograft