ACL Surgery Recovery: What to Expect at Home, Costs, and ACL Rehabilitation Protocols and Exercises
Introduction
Anterior Cruciate Ligament (ACL) surgery is a common procedure for athletes and active individuals who suffer from ACL tears. The surgery typically involves using a graft—often a hamstring graft—to reconstruct the damaged ligament. Understanding the ACL surgery recovery timeline is crucial for returning to full function safely. This guide covers ACL rehab expectations, costs, and essential considerations for a successful recovery.
What to Expect After ACL Surgery
Immediately after surgery, patients can expect pain, swelling, and limited mobility in the affected knee. The first few days focus on managing pain and reducing inflammation, typically with:
- Cryotherapy devices like Game Ready systems (not covered by OHIP)
- Compression bandages to reduce swelling
- Pain medication prescribed by the surgeon
- Limited weight-bearing with the use of crutches
Early rehabilitation begins within the first week post-surgery, emphasizing knee mobility and preventing stiffness.
ACL Surgery Recovery Timeline
Phase 1: Weeks 1-2 (Protection & Inflammation Control)
In the first few days after surgery, prioritizing rest and controlled movement is essential to prevent excessive swelling and stiffness.
- Goal: Reduce swelling, regain knee extension, and activate quadriceps
- Key Exercises: Ankle pumps, quad sets, passive knee extension stretches
- Assistive Devices: Knee brace for ACL injury, crutches (as prescribed), early assisted weight bearing
Phase 2: Weeks 3-6 (Early Strength & Mobility)
After the first weeks after surgery, you will enter phase 2 which marks the transition from passive recovery to active movement, focusing on controlled weight-bearing and increased mobility.
- Goal: Improve range of motion and begin weight-bearing activities
- Key Exercises: Heel slides, straight leg raises, gentle stationary cycling
- Weight-Bearing Progression: Gradual transition to full weight-bearing
Phase 3: Weeks 7-12 (Strength & Neuromuscular Control)
- Goal: Increase knee stability and improve muscle activation
- Key Exercises: Squats, step-ups, balance drills, light resistance training
Phase 4: Months 3-6 (Advanced Strength & Running Prep)
- Goal: Build functional strength and reintroduce impact activities
- Key Exercises: Lunges, agility drills, jogging progression
Phase 5: Months 6-12 (Return to Sport & Prevention)
- Goal: Restore full athletic function and prevent reinjury
- Key Exercises: Plyometrics, sport-specific drills, agility training
- Clearance for Return to Sport: Guided by physiotherapist and surgeon
ACL Rehabilitation Protocol & Exercise Progressions
A structured ACL rehabilitation protocol is essential for full recovery after a reconstruction. Patients follow a progressive exercise and rehabilitation program designed to:
- Regain range of motion
- Strengthen the quadriceps and hamstring muscles
- Improve balance and proprioception
- Prepare for dynamic movements and sport-specific activities
A physiotherapist plays a critical role in guiding progression and ensuring exercises are performed safely.
Bad Signs After ACL Surgery: When to Seek Medical Help
While recovery varies, certain bad signs after ACL surgery require immediate attention:
- Severe, worsening pain despite prescribed or over-the-counter medication
- Excessive swelling or inability to move the knee
- Redness, warmth, or pus at the incision site (signs of infection)
- Persistent instability or knee giving out
- Blood clots (DVT symptoms), including calf pain and swelling
If any of these occur, consult a healthcare professional immediately.
ACL Surgery Costs in Canada (Covered by OHIP vs. Rehab & Additional Expenses)
While OHIP covers ACL surgery, several recovery-related costs are not included, such as:
- Physiotherapy: Essential for full recovery but paid out-of-pocket unless covered by private insurance
- Braces: A knee brace for ACL injury can range from $200 to $1,500
- Game Ready Cryotherapy Systems: Rent or purchase options available ($500–$3,000)
- Assistive Devices: Crutches, compression wraps, and other tools may have additional costs
Patients should budget for these expenses when planning their ACL surgery rehab time.
The Role of Knee Braces in ACL Recovery
A knee brace for ACL injury provides:
- Support and stability in the early rehab phases
- Protection against excessive movements that could compromise healing
- Confidence when returning to daily activities
Conclusion
Recovery from ACL surgery hamstring graft or other graft types requires patience, dedication, and professional guidance. While OHIP covers surgery, additional ACL rehab costs, including physiotherapy, braces, and recovery tools, should be considered.
A structured ACL rehabilitation protocol is key to restoring knee function and preventing future injuries. If you’re recovering from ACL surgery, consult a sport medicine specialist or physiotherapist for a personalized rehab plan tailored to your needs.
