What Should I Do Before My ACL Surgery?
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First off, if you are reading this, I assume that means you recently tore your ACL, and I know this is disappointing. But, rather than get down, let’s look at this upcoming journey as an opportunity to improve, learn about your body, and overcome adversity. As your surgery approaches, there are four key things you need to do to prepare for ACL surgery.
- Pick your support team
- Do Prehab
- Prepare for after your ACL surgery
- Take care of our lifestyle habits
Pick Your Support Team
This rehab is a long and grueling process to not only return-to-sport, but to return while performing at a high level. You will need various experts to support you at each phase of your journey over the next 9-12 months.
You are going to want to find an expert sports medicine orthopedic surgeon that performs a minimum of 20 ACL surgeries per year. This person will be who gets your ACL journey started, helps you choose the correct ACL graft, gets you a stable knee with a solid ACL reconstruction and helps manage any additional injuries (meniscus tears, bone bruises or MCL damage).
You are also going to need a physical therapist that specializes in ACL rehabilitation and works with athletes (not just treating general injuries, such as hip replacements or back pain). This professional can help you prepare for surgery, and then will be key in guiding your process every step of the way.
Initially, the PT you choose will help you restore your motion, build up your quadricep strength and re-learn to walk. Later on, they will help guide your return-to-practice progressions, help you reintegrate into performance training, and determine your readiness to get back on the field or court.
Your physical therapist should be utilizing objective measurements throughout your rehab process, and they especially should be measuring your strength. Without this, they are simply guessing at your progressions throughout your rehab.
Additional team members might be your athletic trainer, your sport or skill coach, a performance coach, a dietician, and a sports psychologist or mental performance consultant.
Each athlete is unique for their needs during the rehab process and each team will be unique to support them.
Do Prehab!
There is emerging evidence to support improved outcomes from ACL surgery for patients that go through a progressive prehab program at both 12 weeks and 2 years!
Some key goals to hit to prepare for ACL surgery are:
- Full range of motion with both bending and straightening
- A strong quadriceps muscle contraction
- No swelling in your knee
- A normal walking pattern
After hitting those four basic goals, there is some advantage to performing a basic strength training program (if you have a delayed surgery) to build up your overall lower body strength and better prepare for ACL surgery.
Prepare for After Your ACL Surgery
Make accommodations at school or work for your schedule after surgery.
Depending on your exact post-operative guidelines from your doctor, you will be on crutches for a little while after surgery. Even after getting off the crutches, walking will take longer and be slightly more difficult than normal. Try to find ways to decrease walking distances or use stairs at work and school to make your first few post-op weeks easier.
Make your initial physical therapy appointments.
Ask your doctor how long after surgery you can start physical therapy, as each surgeon is slightly different. From our perspective, we like seeing ACL patients within the first 3-7 days post-op. This allows us to get working on your range of motion and quadriceps activation as quickly as possible. We encourage patients to schedule out their first month of visits so you can stay on top of your recovery and not have any delays in your rehab. Remember, you want to be seeing an ACL expert, and experts tend to have full schedules! You don’t want your progress delayed simply because you couldn’t get an appointment in time.
Take Care of Your Lifestyle Habits
Healthy lifestyle habits are the low hanging fruit in every rehab process. These things aren’t exciting, but they are key to creating an environment where your body can heal.
- Sleep 8 hours each night
- Eat an adequate amount of protein, carbohydrates, fats and fruits/vegetables
- Drink at least a ½ oz of water/ pound of body weight each day
- Minimize the amount of alcohol and caffeine you take in
Taking care of these basic things while you prepare for ACL surgery will create an environment within your body that is set up to heal and regenerate healthy cells. You will have adequate building blocks, energy to heal, recover and come back stronger.
Start building these habits before your ACL surgery so that you can stick with them after surgery as you are recovering. If you take care of these four steps, you will be prepared for your ACL surgery and ready to nail the ACL rehab process.
Tools for You:
If you found this information helpful, check out our free online mini-course on preparing for ACL surgery: everything you need to know from time of injury to surgery.
This course is completely online and is broken up into three ~20 minute sections that go into more detail on everything we covered in this blog, as well as:
- An example prehab program
- Answers to the most common preoperative questions
- A detailed look at graft selection
- Tips on finding an expert physical therapist
- Questions you should ask your surgeon.