ACL Rehab Journey – So you’ve torn your ACL… What next?

I am writing about my recovery and rehab after rupturing my ACL last February.

Throughout this, I will cover the pre-injury period, the non-surgical and surgical rehab options, along with the prehab and post injury management for these.

I am a private practice physiotherapist at Be Your Best Physiotherapy in Cranbourne, and a physiotherapist for Port Melbourne Football club. I frequently see patients with sporting injuries (including ACL tears), along with treating those in the community with neck and back pain.

The upcoming section will cover the period directly after my ACL rupture, and the rehab following it.

For the first two weeks post injury, I had firmly believed I could manage this injury conservatively and get back into my normal lifestyle. After seeing my scan results, and speaking to my boss at work, my next step was to book in with a trusted sports doctor, for further opinion and consultation.

Following the consultation, we reached the conclusion that surgery would be the best option.

I was surprised at how easily I had made the decision, after consulting with other physios at work, and with the sports doctor. Looking back, I feel that I was mostly in denial about the injury for the first two weeks, which quickly changed after considering the situation in its entirety.

I went to the surgeon and was placed on a waitlist for an ACL reconstruction and meniscal management (this basically means that they decide during the surgery, if they need to fix the meniscus or not), using a graft from my hamstrings.

At this point I was still uninterested in immediate surgery and was more focused on continuing with work. I was still working at a football club and had taken a short break from running out after injured players, being limited to working from the bench.

I was happy to wait for the ACL reconstruction. I felt that a longer wait would only give me more time to strengthen up and prepare my knee. With so much research showing the benefits of a good rehab period before surgery, I wanted to give myself the best option.

Consider also that we were enjoying a short burst of ‘Covid AND lockdown-free life’ in Victoria at this time (March 2021), so the last thing I wanted to do was go in for surgery!

At four weeks post injury, I started practicing hopping, skipping, and jumping. I was at the gym most days, working on any leg exercises I could safely do.

Leg exercises involved squats, split squats, lunges, Romanian deadlifts (double and single leg), calf raises, step ups and step downs! I progressed my strengthening carefully and gradually, ensuring I used a wide range of exercises, to improve any deficiencies I could find.

By six weeks post injury, I went out onto the track and tried my first run. I recorded a video of myself attempting my first ACL free running effort (it was not pretty). I watched back the footage, rested, repeated, and continued to practice my straight line running occasionally over the following 6 weeks.

At 12 weeks post injury, I was back running 3-4km along beach trails, and in August (5 months post injury) I completed a 10km run along the beach, without an ACL.

There was lots of hard work and training involved with reaching this level post injury. I was running 3-5 times a week and going to the gym 3-4 times weekly, continuing my strengthening rehab.

From day 1 post ACL injury I was doing exercises, and this helped maintain strength and function. I strongly believe that being able to continue working immediately after my injury, was also very helpful in speeding up my recovery.

Finally, I was at a level with my rehab where I had returned to pre-injury levels in almost everything. I was running, working, exercising regularly, and even going for the odd nature hike.

I wouldn’t have felt comfortable going on a very challenging hike or climb, and didn’t feel like I was ready to play any physically challenging sports. For most people, this would be a comfortable level of function, without any need for surgery.

At the start of spring in 2021, I felt adequately prepared for the ACL reconstruction, and I was hopeful that the surgery date would come soon.