Avoiding Re-Injuring Your ACL

The acute cruciate ligament (ACL) is a small but mighty part of the human body. Located in the knees, it connects the thigh bone to the shin bone, stabilizing the leg and allowing the shin bone to slide forward smoothly. Tearing this ligament can be both painful and debilitating, and ignoring the injury can lead to bigger problems down the line.

An ACL injury is most common among athletes — they also have a bigger chance of re-tearing their ACL, especially if they fail to follow rehabilitation guidelines, which begin as early as the day of the ACL surgery.

What to Do After ACL Surgery

Generally, ACL surgery is an outpatient procedure, which means you don’t have to stay in the hospital overnight. The surgery itself is fairly simple and uses a graft from the patient’s body to replace the torn ligament. General anesthesia is used and, once you’re awake, the medical staff will help you practice walking on crutches. You may also be fitted with a splint or knee brace.

You’ll be given instructions regarding cleaning and dressing your wound, which you should follow precisely. Failing to properly clean and dress the wound can lead to infection, which will only prolong healing. 

The R.I.C.E. method is the most common recommendation to help the injury heal faster:

  • Rest your leg and avoid putting any pressure on it.
  • Ice the knee to help reduce swelling. Approximately 20 minutes of icing the knee ever two hours is recommended. 
  • Compression is another way to help the swelling go down. Wrap a compression wrap or an elastic bandage snugly around the knee.
  • Elevation helps the blood flow away from the knee. Simply lie down with the injured knee propped up on a pillow.

The two goals immediately after surgery are to get any swelling to go down and ensure the wound heals quickly and properly. Avoid heating pads during this time, since heat will increase the swelling. Avoid putting any pressure on the injured leg until a doctor says you can.

Generally, you’ll be told to start putting slight pressure on the leg a few weeks after surgery. This is dependent on which type of ACL injury you had, such as a partial tear or a complete tear. 

You’ll be expected to attend physical therapy to get the muscles around your knees stronger, so your knee can stabilize once again. If you’re an athlete, physical therapy will be crucial, but the timeline for when you can return to playing sports can vary greatly, especially since athletes tend to have a higher chance of re-tearing their ACL. 

What to Avoid After ACL Surgery

Tearing the ACL means your knee’s range of motion is limited. Physical therapy works to help you regain that range of motion, but it’s important to be patient and follow the physical therapist’s guide. Doing too much too soon can result in a re-injury. 

Physical therapy usually starts with gentle exercises to move the knee. As the wound heals, tougher exercises will be introduced. Because the ACL graft is still healing, it’s important to avoid stretching it. The physical therapist will show you ways to exercise the area without risking the ACL graft.

The goal of physical therapy is to help you begin to put pressure on the injured leg safely — this takes time and patience. It also requires you to abstain from activities that are risky for the ACL, such as running or swimming. Swimming can be beneficial, but it requires the muscles to work a bit harder against the pressure of the water. Tearing the ACL a second time is very possible if you return to swimming or running too soon. 

Recommended Activities for an ACL Injury

From day one of your rehabilitation, you’ll be expected to begin exercising your injured leg. The best way to avoid re-tearing your ACL is to follow your physical therapist’s instructions. In the first few months, you’ll need to take it slow, working to strengthen the muscles around the ACL. Exercises such as riding a stationary bike and doing gentle leg presses are good for building up nearby muscles without straining the ACL. 

If swimming is something you want to do, it’s best if you stick to activities that don’t require pumping your legs. Paddling with your arms is okay, but avoid paddling with the legs. The physical therapist will be able to tell you when you can begin swimming, based on the type of ACL injury you had and how your rehabilitation is coming along.

The full recovery time varies from person to person. However, studies have shown that those who wok on strengthening the muscles around the ACL and wait at least nine months before returning to sports are less likely to re-tear their ACL.

What to Do If You Re-Tear Your ACL

Knowing how to avoid re-tearing your ACL is important, but since the rate of re-injury is high, it’s beneficial to know what to do if you do re-tear it. 

First, you need to be able to tell when an injury occurs. Hearing a popping or cracking sound is common with an ACL injury, and it is usually followed by pain that is mild or severe. Swelling or tenderness is also likely, and there may be some redness around the knee.

If you’re unable to move or extend the knee, it’s a sure sign that there’s an injury. Contact your doctor right away and follow any instructions they give you.

The doctor will examine the knee and decide whether it’s an ACL re-tear or something else. If surgery is necessary, you will repeat the process from the initial ACL tear until the new injury heals.

Get ACL Help at OIP

The Orthopedic Institute of Pennsylvania exists to help you with any orthopedic injuries, whether they’re from playing sports or the result of an accident. With several locations across the state and walk-in clinics for orthopedic emergencies, we’re convenient and available to help. 

Contact the urgent care clinic for 24/7 emergency advice by calling 855-OUCH-OIP or request an appointment by calling the main line at 717-761-5530. 

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