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Made to help you from the day you get injured until you're back to 100% - gathered from interviews of doctors, physical therapist, recovered patients and personal experience
While there are many informational pages on ACL tears, this site is meant to be a clear step by step guide of what happens from the day you get injured to post-surgery as of April 2022.
After my own injury this year I spent countless hours taking detailed notes after talking to patients/friends, doctors and physical therapist which provided valuable insights that are not easily found online.
I've gathered all this information into a simple guide below which I hope helps you or someone you care about going through this journey
Stages of Recovery
1 - Day of Injury
2 - Orthopedic Evaluations
3 - Pre-Hab PT
4 - Pre-Op
5 - Surgery
6 - Post-Op
Day of Injury
Day of Injury
Whether you believe right away that you tore your ACL or are diagnosed with a suspected tear by a physician the guidance is generally the same:
R.I.C.E. (Rest , elevate, compress and ice)
Isolate in a knee brace
Likely guidance will be to take Advil for swelling and pain and/or Aspirin or anti-coagulants if they believe you are at risk of a blood clot
Learnings/Insights (What I found to make this phase more comfortable):
Buy a compression ice brace with the easiest removable ice pack (tried a few and this was my preferred): Knee Ice Wrap
Buy a leg pillow to elevate - Elevation Pillow
Wear a knee brace (until you see your orthopedic surgeon) - ACL Brace
Use shoes with toggle lacing which slip on/off, are water resistant with extra cushion and rubber/storm wet grip/anti-slip - Pegasus Shield is my preferred
Compression full leg sleeves and socks for both legs will help to reduce swelling/blood clots - Sleeves | Socks
Shoe assistance bar helps getting your shoes on and off - Shoe Horn
Putting your socks on will be tough at this point and especially after your operation, this is the standard tool to assist - Sock Aid
Orthopedic Evaluations
Orthopedic Evaluations
Reach out to your network or research to find the best orthopedic surgeon in your area as you won't be able to travel far after the operation. At this point the process is usually as follows:
Manual evaluation of your knee to determine if ACL is still there, fully/partially torn
X-Rays
MRI pre-authorization (might take up to 5 days to get cleared by your insurance provider)
Wait until swelling is gone to undergo MRI (2 weeks post-injury usually)
Pre-hab PT
Pre-hab PT
Getting your injured leg and knee into the best shape possible before the surgery will make a huge difference post-op.
Twice a week of PT to work on increasing the range of motion in your knee
Biking and swimming are good ways to get cardio while increasing range of motion further
Many of the at-home exercises will be similar post-op, invest in the straps, bands and other tools you need at this point and master the form
Learnings/Insights:
Get the therabands from your physical therapist but also buy a belt/strap like this to help with many of the exercises: Belt with foot strap
Pre-Op
Pre-Op
You will be asked to complete a list of tests prior to your surgery, get hold of your primary care physician ASAP to schedule these:
Blood labs
EKG and general physical
Depending on the results of the above they may ask you to schedule an echo of your heart (even if you're a really healthy athlete), and this is the hardest to schedule in a timely manner
Learnings/Insights:
Order a knee cryo-compression machine. This is one of the most important things to buy (unfortunately not covered by insurance, cost is around $300) - your surgeon's team might reach out to you about renting or buying one - Game-Ready is the machine people rent, however it's cheaper to buy one like the Bregg Polar Wave (I've tried both and not much of a difference) - Bregg Polar Care Wave Knee Machine
Surgery
Surgery
The big day arrives, however here is where you're more dependent on the surgeon and team you chose as well as your caretaker. There are still are few important things
Fasting - midnight before the surgery is your last chance to have anything, load up on electrolytes - coconut water/pedialyte/liquidIV and lots of water
Get some high fiber and protein snacks, Quest Hero Bars, almonds for after the surgery
Wear really comfortable loose fitting clothes
Make sure you get the instructions and prescriptions down with your caretaker present in the event you are still drowsy post op
Learnings/Insights:
When receiving your medication prescription:
Ensure you get a printed copy of your prescription
Make sure they send the order to the right pharmacy
Make sure the pharmacy is open (especially if you had a late operation time)
Call ahead to check if the pharmacy prepared your order
Hopefully you're lucky like some of us and don't need any meds ;) (seems to be quite rare)
Post-Op Recovery
Post-Op Recovery
This phase will vary by person quite a bit - factors include, having a meniscus repair, the type of graft you received or other work done on your knee (LCL, MCL etc..)
Regardless of the type of surgery you will be in a brace with bandages covering the many stitches underneath and hopefully your knee cuff for the cryo-compression machine above the bandage for easy icing.
For those who received meniscus repairs you will not be allowed to bear weight for at least a week on the operated leg.
Go for a high fiber, high protein diet to help with your recovery and prevent constipation
Wear full leg compression stockings on both legs to prevent blood clots and reduce swelling
Utilize a CPM (continuous passive motion) machine to keep leg bending while you're lying down - covered by insurance
Use your cryo-compression machine throughout to reduce swelling and pain
Wear loose clothing and tear away ideally on the lower body
Brace - the locked extension brace is very hard to stop sliding down when outside and walking, some remedies include special non slip pants or leggings
Learnings/Insights:
See if you can switch to a soft brace like the Bregg Roadrunner when it is allowed to be unlocked (covered by insurance)
Get tear away post-op shorts like these
Buy crutch pads to take pressure off your armpits and hands
If you work on a laptop and don't have a table to use while laying flat, get one of these desks
Post-Op Physical Therapy
Post-Op Physical Therapy
You will be spending the next 6+ months working with the physical therapist you choose. Make sure you find one that is not only convenient but that you trust and really enjoy working with.
In addition check for capabilitles and licenses that your therapist and their facility has:
The first two weeks are more limited with the physical therapist doing manual work on your knee and just some basic exercises for you to do at home, not much to worry about at this point
Pool - Aqua training starts at week 4 usually, having a facility where you're able to do exercises in the pool will help especially with walking gait/patterns early on
EMS handheld unit - buy to use at home in order to activate quad which is one of the tougher parts earlier on, have your therapist configure the machine for you
BFR - Blood flow restriction training is newer however has been able to increase quad strength faster and has helped quite a bit as you're able to do bodyweight exercises with the gains you usually get with heavy weight (get them to train you on it if they are licensed only) - BSTRONG and SMARTCUFFS are the two best BFR training kits
Alter-G (Anti-gravity treadmill) - Made with NASA technology, these very expensive treadmills take up to 80% of your bodyweight off so you can start to run earlier on with less impact on the joints
BioDex - Another very expensive computerized machine to test the strength of your ACL through various tests in order to track your progress, test against your good knee and clear you for return to sports
Full list of products to order on Amazon
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