ACL Rehab Part 4: Healing Takes Time

If you missed Part 1 and Part 2 or Part 3 click the links to catch up.

Where were we? Oh yes, that’s right! Like I mentioned in Part 3, I thought I had re-torn my ACL 2 weeks after the surgery. Luckily that wasn’t the case. I had to keep reminding myself that I just had a major operation! My body was and will be in recovery mode for a number of months. The one thing I repeat to myself and my clients still rings true: “stay patient, stay active.”

Progress During Placement

Over the next month my progress was very slow. Being on placement all day meant that my strength rehab was close to non-existent. By Week 5 post op I was still quite bruised in the lower leg and had pitting odema around the inside of my shin, the whole way down to the ankles. The swelling was still profound in the back of my knee and it looked quite bulbous when the leg was straight. I was still icing every day and using the AirRelax, fighting hard to get that pesky swelling down.

The muscle wasting was still very apparent in my whole leg. There I was looking at myself in the mirror, with my little pin of a leg compared to other staring back at me. It was a funny sight! But man, oh man did it frustrate me!

How Long Healing Really Takes

One crucial thing I needed constant reminding of was that the real strength and bulk gain only comes around the 6-month mark. By then the graft has taken hold, the bone is all healed up from the drill sites, and your body can really start adapting to loads. So again – patience, patience, patience! I can certainly admit this ACL reconstruction sure is testing mine.

My walking pattern still wasn’t 100% normal, but it was definitely improving. As my range and strength gets better so too will my walking. I was still getting occasional patella tracking issues and feelings of my knee locking out which was no fun. It was also frustrating having feelings of stiffness, either in the morning or just when staying still. My knee would feel so locked up at times, but it definitely improved as I started moving more. So, if you’re experiencing similar symptoms don’t be alarmed! Just stay active!

The Bad and The Good

Now, it feels like I’ve been whining this whole time. I’ll be honest, that first month or so was really hard and incredibly challenging. But it wasn’t all bad news I promise! The swelling was decreasing in my lateral knee, so it didn’t look quite like a plum anymore… maybe just half a plum. Progress was taking place, just incrementally.

I managed to make it to my 6-week post op check-up in one piece, Huzzah! All looked good. I was mostly on track. I told the surgeon all my concerns with swelling and my limited ROM and he responded “Get that strength up and the swelling will go down. Your knee flexion is still limited, so really push that. Next time I see you that knee range should be full.” Pressure’s on!

Then Europe Happened

There I was, ready to roll and start pushing the strength rehab. Then my one-month Europe trip happened. Ah well, I’m walking every day, that still counts right? Yes it does! The big strength gains come later remember. But it’s also important to know that with strength work, muscle bulk increases, swelling goes down. As such I would squeeze in a small strength session whenever I could. Results come over time, not overnight. Remember, progress not perfection!

Eventually It All Falls Into Place

Fast forward to one month later and I’ve just arrived back in Sydney. I had limited knee flexion the whole trip, terrible swelling after getting on and off the plane and soreness after walking all over the place. But then something amazing happened.

After my first sleep back home I wake up, and all of a sudden, my knee magically can bend fully with no restriction or pain! ACLs are funny like that. You feel like you are making no progress for weeks at a time and then you get these random huge jumps in improvement. Why does it happens like that? Who knows, the important thing is to just roll with it!

But now I’m back. No placement to deal with, no travelling, no excuses. It’s time to focus, set the goals, and get this rehab program properly underway. TO THE GYM!

Joel Adelman

Joel Adelman

Joel has 7 years combined study and has gained experience and developed skills across a broad range of areas including sports, orthopedic rehabilitation, neurological rehabilitation, geriatrics, pediatrics and cardiopulmonary. Joel uses a combination of exercise therapy, manual techniques and evidence-based practice to help his clients return to optimal health and to prevent further injuries.


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