Recovery After ACL Surgery: What to Expect

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Young Caucasian man at physical therapy
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ACL (anterior cruciate ligament) surgery is minimally invasive, outpatient surgery. But that doesn’t mean it’s necessarily an easy recovery. It involves significant rehabilitation—or rehab—to get you back to normal life and activities. While ACL surgery recovery is different for everyone, it can last up to six months. It may be easier for you to manage and know what to expect by breaking up a typical ACL surgery recovery timeline into chunks—the first two weeks, the third and fourth week, and months two through six.

The First Two Weeks After ACL Surgery

The first couple of weeks after surgery can be the most challenging. It’s when you are likely to experience the most pain. However, ACL surgery recovery pain is manageable. Icing and elevating your knee can help reduce your pain, and your doctor will also prescribe pain medicine. This may include an NSAID (nonsteroidal anti-inflammatory drug) or a narcotic pain reliever. Using your pain medicine will help you move your knee and start rehab. Your pain should improve within a few days of surgery, allowing you to cut back on pain medicine. Talk with your doctor if your pain continues.

With ACL surgery recovery, time off work will also be necessary. For most people, this will mean taking the first few days. However, if you have other knee injuries in addition to an ACL tear, you may need to take more time. As a general rule, you won’t be able to work as long as you need narcotic pain relievers. The total time away from work will depend on the type of work you do. It can take several weeks or months to return to physically demanding work.

During this period of recovery, you will need to keep the incision clean and dry. Your care team will give you information about your dressing and how to keep it dry. You will also be using crutches to keep weight off your knee. Early rehab exercises focus on fully straightening your knee and controlling your quadriceps muscles. Some doctors will have you use a passive motion machine to move the knee through its range of motion. Passive motion means you are not exerting yourself or pushing through the motion—the machine is doing if for you.

The Third and Fourth Week After Surgery

Your pain should improve during this ACL surgery recovery time. Now that you’ve passed the two weeks mark, you shouldn’t need to use narcotic pain relievers anymore. NSAIDs can still help you stay comfortable if rehab exercises cause soreness. If you are still having significant pain, tell your doctor or physical therapist. It could signal a complication. Everyone experiences pain differently, so there’s no need to be embarrassed or hesitate telling your care team if you are in pain. Also, there are other pain management techniques to try.

Any stitches, staples, or steri-strips should be gone by this time. Your team may recommend wearing an ace bandage to help with comfort and swelling.

You will stop using crutches and start bearing some weight on your knee during this recovery period. To support your knee, your team may fit you with a special knee brace. The settings on the brace prevent your knee from moving too far in any direction. You will need the brace for about six weeks.

If you haven’t already started rehab with physical therapy, you will begin it now. The goals of physical therapy are to strengthen your knee and safely restore full range of motion. Your therapist will develop a personal exercise plan to reach those goals. Exercises focus on strengthening the quadriceps and hamstring muscles in your upper leg. You will likely attend physical therapy several times a week.

One to Six Months After Surgery

After the first month, physical therapy continues until you reach your rehab goals. Your knee will return to its full range of motion. You will regain balance, stability, and leg control. Eventually, you will return to normal activities and even sports. Ideally, you shouldn’t need your knee brace when you resume these activities. This process is gradual and can take some time. An average recovery takes about six months, but it can take longer.

If you are an athlete, your doctor may recommend a sports-specific rehab program. Closely follow your therapist’s recommendations and instructions. Pushing yourself too far can hold back your recovery. Give your body the time it needs to fully recover so you can safely return to your sport.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Mar 2
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  4. ACL Reconstruction Surgery: Before and After Recovery Timeline. University of Pittsburgh Medical Center. https://share.upmc.com/2015/04/recovery-time-for-acl-reconstruction-surgery/