The First Milestone to Achieve After ACL Surgery
The Rehab Process following ACL surgery is a marathon not a sprint. From your surgery date it is recommended you wait at least 9 months until you return to sport and latest studies suggest if you can wait 12 months that may be superior. Given the length of time you have to commit to rehabbing your knee following ACL surgery it’s easy at times to be unsure where you are in the process. For this reason I like to break ACL rehab down to specific phases and each phase had specific milestones or hurdle criteria to achieve before progressing onto the next. This breaks down the overall goal of return to sport or your chosen physical activity more logical as you can see how you’re rebuilding your knee brick by brick.
So what is the first milestone to achieve after ACL surgery? The Holy Grail in the first 4-6 weeks after ACL surgery is achieving a QUIET KNEE.
How do I know when I have achieved a quiet knee? Good question. There are very specific criteria you must meet to receive the title of a quiet knee.
1.) Restoring adequate Range of Motion
Firstly achieving good range of motion. More specifically being able to bend the knee to at least 120 degrees and being able to fully straighten the knee aka 0 degrees of knee extension. It is almost impossible to overemphasise the importance of regaining a straight knee. If you are lacking a few degrees of knee extension it is very difficult for your quad to fire effectively and normalising your gait is near impossible. Are you struggling with your range of motion? There are strategies you can implement to help. Get in touch with us today to find out more.
2.) Getting Solid Quad Activation
Secondly your quad needs to firing strongly! The quad is notorious for shutting down after ACL surgery and restoring Quad activation and control as quickly as possible is incredibly important. Where do you start to assess if your quad is firing effectively? Perform a straight leg raise. Get someone to video it from the side and then watch it back in slow motion and see if your shin bone is lagging behind your thigh bone as your raise your leg. If there is no lag then you passed the first test. If there is a lag then you have more work to do.
3.) Minimal to No Swelling
Thirdly a quiet knee has to have minimal to no swelling. A swollen puffy knee is by definition not quiet but angry. It’s not tolerating the demands being placed on it. Whether that is the exercises or your daily activities. Swelling management is frustrating post surgery and sometimes despite your best efforts icing, elevating, compressing etc the swelling can be stubborn and hang around. Everyone’s knee is different and responds to the surgery differently. All you can do is control the things you can. Do the right things - use your crutches, ice more than you think, get your quad going, elevate and compress. Then it comes down to patience. Trust the process. You’ll get there.
The swelling is also vital to minimise because the above two criteria are virtually impossible with a bunch of swelling in the knee.
4.) A Normal Walking Pattern
It is very common for people to ditch the crutches too early and adopt a poor walking pattern. Don’t fall for their error. As tempting as it may be you need to earn the right to ditch the crutches. Walking is a skill you need to retrain. Focus on good heel strike with quad control, swing through and reducing pelvis shift during walking. You haven’t achieved a quiet knee until a random at the shops would be none the wiser that you had ACL surgery recently.
To return to our original question - what is the first milestone to achieve after ACL surgery? Well its simple - a quiet knee. Though the answer is simple the method to achieve it is not as simple. You need a clear, structured plan in the post op phase to ensure you achieve a quiet knee as quickly as possible.
If you’re stuck in your ACL rehab and still dealing with pain and swelling be proactive and schedule a free 15 minute phone consultation. We’d love to help you move forward to the next phase of your ACL rehab.
