ACL Surgery Recovery Time: How Long Does It Take to Heal?

The Anterior Cruciate Ligament (ACL) is one of four major ligaments in the knee. ACL injuries are common among athletes, especially those who participate in sports involving sudden stops and direction changes, such as soccer, basketball, and football. However, ACL injuries can also occur in non-athletes due to accidents or falls.

When the ACL is torn, it usually cannot heal independently and requires surgery to repair it. This blog post discusses how ACL surgery works, how long it typically takes to recover, and what you can expect while you’re recovering from surgery.

Common Symptoms and What Happens During an ACL Tear

What Happens When an ACL Tears?

An ACL tear occurs when the anterior cruciate ligament is overstretched or stressed beyond its capacity. The ligament may wholly or partially tear, leading to instability in the knee joint. Common injuries arise from sudden stops, pivoting motions, or direct impact to the knee, often experienced during sports or accidental falls.

Immediate symptoms of an ACL tear include:

• A sudden “pop” sound or sensation in the knee
• Severe knee pain that prevents movement
• Rapid swelling within a few hours of the injury
• Joint instability or the feeling of the knee “giving out”
• Difficulty bearing weight on the affected leg

Symptoms over time include:

• Limited range of motion
• Persistent swelling
• Painful stiffness in the knee joint

It’s essential to get a prompt medical evaluation including a physical examination, an X-ray, and possibly an MRI to determine the severity of the tear and the appropriate course of action. Left untreated, a torn ligament can increase the risk of further knee damage, such as meniscus tears or cartilage degeneration.

What Is ACL Surgery?

ACL reconstruction surgery replaces the torn ACL with a graft, a piece of tendon taken either from another part of the body (called an autograft) or from a donor (called an allograft). The procedure is usually performed arthroscopically, which means that small incisions are made in the knee and a tiny camera is used to guide the surgeon. After surgery, patients typically undergo rehabilitation to regain strength and range of motion.

When Is ACL Surgery Needed?

The vast majority of ACL tears that we see (around 95%) require surgical reconstruction. ACL surgery is typically necessary when:

• The ACL tear is complete, particularly in younger, more active individuals
• The patient wants to return to sports that involve cutting and/or pivoting
• The ACL tear is accompanied by additional ligament injuries or meniscus damage

How Painful Is ACL Surgery?

The pain associated with ACL surgery can come from and depend on various factors. It’s generally a combination of post-surgical pain, normal post-operative swelling, and pain related to the source of the harvested graft. Doctors treat this pain through a multimodal approach combining:

• Preoperative and intraoperative nerve blocks
• Pain medications
• Postoperative therapies, including ice and compression

Does Age Impact ACL Surgery and Recovery?

While the majority of ACL tears occur in patients under the age of 50, age isn’t a limitation in having ACL surgery. However, it’s sometimes possible to treat ACL injuries without surgery for older adults who aren’t involved in sports or intense recreational activity. Orthopedic doctors can individualize treatment plans based on a patient’s age, existing knee health, and desire to return to sports and other activities.

What Is the Typical ACL Surgery Recovery Time?

ACL surgery recovery time varies depending on several factors, including:

• The patient’s age
• Their pre-surgical mobility and range of motion
• Concomitant injuries
• Commitment to physical therapy
• Surgical techniques

While most patients will return to basic functions (such as walking, climbing stairs, etc.) within 4 to 6 weeks, an athlete involved in active physical competition in sports such as soccer, football, or basketball may take 9 to 12 months for a full recovery.

How Long Are You Bedridden After ACL Surgery?

Patients typically aren’t bedridden after ACL surgery. While rest and elevation are essential for the initial healing process, patients are encouraged to walk the day after the procedure is completed, usually with crutches. In a routine ACL reconstruction, most patients will start physical therapy within a few days after reconstruction.

How Long Does It Take to Walk After ACL Surgery?

Recovery time varies, but generally speaking, patients can expect to start walking with crutches and a leg brace immediately after surgery and continue to do so until quadricep control improves. Barring concomitant surgery to the meniscus or other ligaments, many patients can walk unassisted within 1 to 2 weeks after surgery.

When Can I Return to Work After ACL Surgery?

Patients who work from home or at a desk at an office job may return to work within 4-7 days after surgery. Those with more strenuous jobs that require regular walking, standing, and other physical activities may take 6 weeks or more to return to work, depending on the strenuousness of the job and factors related to their particular surgery. Your orthopedic surgeon and physical therapists are the best people to advise you on when you can return to work.

How Long Does It Take to Regain Full Range of Motion After ACL Surgery?

A patient’s preoperative range of motion is the best predictor of how quickly their full range of motion will be restored after an ACL reconstruction. Most patients regain a full range of motion within 6 to 8 weeks after surgery. Regaining full strength and stability can take longer for people engaged in competitive athletics or strenuous physical activity.

How Long Will My Knee Hurt After ACL Surgery?

Postoperative pain will vary based on surgical technique and other factors. Acute pain typically improves within 4–7 days after the initial surgery and will continue to diminish thereafter. Many patients experience residual soreness and stiffness from surgery for several weeks.

What Are the Stages of Recovery After ACL Surgery?

Recovery from ACL surgery follows a structured timeline divided into stages. Each stage builds upon the last to ensure proper healing and restoration of function.

Stage 1 (Weeks 1-2): Initial Healing

• Focus on managing swelling and pain with ice and compression.
• Begin gentle exercises to restore range of motion (e.g., heel slides, quad sets).
• Use crutches and a knee brace to provide stability while learning to bear some weight.

Stage 2 (Weeks 3-6): Early Rehabilitation

• Begin physical therapy to improve range of motion and strengthen the muscles surrounding the knee.
• Gradually increase weight-bearing activities while using assistive devices like crutches.
• Work on achieving full knee extension and improving quadriceps activation.

Stage 3 (Weeks 7-12): Strength Training

• Perform activities focused on muscle strength and balance (e.g., mini squats, step-ups, and lunges).
• Transition to more dynamic exercises, including light jogging and stationary cycling, as approved by your physical therapist.

Stage 4 (Months 3-6): Advanced Training

• Reintroduce sport-specific drills and agility exercises under professional supervision.
• Gradually increase endurance and strength with advanced rehabilitation exercises.
• Continue focusing on proper mechanics to reduce the risk of reinjury.

Stage 5 (Months 6-12): Return to Normal Activity

• Athletes may begin conditioning for a return to playing sports upon achieving full strength and normalized knee mechanics.
• Continue post-operative check-ins to track progress and reduce the risk of reinjury.

The exact timeline can vary, so consistent follow-ups with your orthopedic surgeon and physical therapist are crucial to ensure optimal recovery.

What Can Affect ACL Recovery Time?

Recovering from ACL surgery requires both time and personalized care, but several factors influence the length and effectiveness of the recovery period.

1. Severity of the Injury

Whether the tear is partial or complete, as well as other injuries like a torn meniscus, can directly impact recovery. Combined injuries often prolong the rehabilitation timeline.

2. Age and Overall Health

Older patients or those with preexisting health conditions may experience slower healing. Younger individuals with robust physical health often recover faster.

3. Surgical Technique Used

Patients undergoing minimally invasive arthroscopy may benefit from a faster recovery compared to traditional open surgery. The quality and source of the graft (autograft vs. allograft) can also influence the recovery timeline.

4. Rehabilitation and Physical Therapy Compliance

A structured rehabilitation program designed by a skilled physical therapist significantly improves recovery outcomes. Commitment to prescribed exercises and avoiding reinjury are key factors in regaining strength.

5. Activity Level and Goals

Athletes aiming to return to competitive sports may require longer recovery (9-12 months) than individuals focusing on everyday activities. Gradual progression is necessary for regaining proper knee function and strength for high-impact movements.

Understanding these factors and working closely with healthcare providers ensures a smoother recovery process tailored to your needs.

What Restrictions Are There After ACL Surgery?

The greatest risk after an ACL surgery is reinjury. That’s why following your surgeon’s and physical therapist’s instructions is critical. Patients must avoid running, cutting, jumping, and agility exercises until their quadricep/hamstring function normalizes (generally taking four months or more).

The risk of reinjury is most prominent in the first 9 months after surgery, but some athletes and patients may return more quickly to sport once they normalize their lower extremity strength and mechanics. Many factors play a role in a return to sports activities, so discussing any advancement in activity after an ACL surgery with your orthopedic surgeon is important.

How Can You Minimize the Risk of a Reinjury?

The risk of reinjury after ACL surgery is highest in the first nine months, especially for athletes ready to return to play. Here are strategies to minimize this risk and protect your recovery progress.

1. Follow Post-Operative Guidelines

Adhere strictly to the restrictions shared by your surgeon and physical therapist. Avoid activities like running, agility exercises, and jumping until cleared.

2. Build Muscle Strength Gradually

Focus on strengthening the quadriceps, hamstring tendons, and hip stabilizers to create a balanced support system for the knee joint.

3. Wear a Knee Brace During High-Risk Activities

If recommended, use a knee brace for added stability during sports that involve intense pivoting or cutting movements.

4. Use Proper Biomechanics

Training sessions should emphasize landing mechanics, running posture, and avoiding improper knee alignment during pivots or jumps.

5. Commit to Long-Term Physical Therapy

Even after returning to physical activity, periodic rehabilitation sessions ensure sustained recovery and reduce reinjury risk.

6. Warm Up Effectively

Neuromuscular warm-up programs that include dynamic stretches can prepare your body and reduce strain on the knee.

Preventive care through consistent strength-building and careful activity progression will protect your knee’s functionality and maintain your active lifestyle post-surgery.

What Is the Fastest Way to Recover from ACL Surgery?

There’s no single “fastest” way to recover from ACL surgery because healing always takes time and proper care. However, there are a few steps that can optimize your recovery:

• Recovery starts before surgery with prehabilitation. Often called “prehab,” prehabilitation is a physical therapy program designed to prepare your body for surgery.
• Follow your doctor and physical therapists’ instructions meticulously after surgery.
• Maintain a healthy diet with a focus on nutrient-rich foods.
• Manage swelling with ice and gentle compression.
• Maintain a positive attitude. Recovery is long, but the reward is worth it!

Medicines and Pain Relief

A multimodal pain management regimen is utilized after ACL surgery. This involves a combination of medications (both prescription and over-the-counter), perioperative nerve blocks, ice, compression, and other therapies (such as electrical stimulation).

Recommended Diet

With any surgery, you should maintain a well-balanced, nutrient-dense diet. Avoid fried foods, red meat, refined carbohydrates, and sugar-sweetened beverages, and seek foods rich in vitamins and anti-inflammatory antioxidants.

Exercises and Activities

Initially, after ACL surgery, crutches may be necessary. Patients are encouraged to maintain basic daily activities with their crutches after surgery. Once you can walk without crutches, light, regular walking is encouraged for exercise. More strenuous exercise should be avoided until you’re guided to do so by your orthopedic surgeon and physical therapist. Still, many people can return to stationary biking at around 6 weeks and light jogging at about 12 weeks.

Incision and Wound Care

Based on your surgeon’s specific technique, surgical incisions generally should stay covered and dry for 3 to 5 days after surgery, after which daily dressings are advised until the first follow-up appointment.

Non-Surgical Treatment Options for ACL Tear

Can an ACL Tear Heal Without Surgery?

While a torn ACL typically requires surgical reconstruction, non-surgical treatment can be a viable option for some patients. This depends on factors like the severity of the tear, the patient’s activity level, and their commitment to physical therapy. For minor or partial ACL tears, conservative management such as rest, braces, and rehabilitation exercises can help stabilize the knee and restore functionality. However, complete tears often require surgical intervention to regain full knee stability.

Some approaches include:

• Physical Therapy: Tailored programs improve muscle strength, knee function, and range of motion
• Knee Braces: Provide external support to protect the knee during recovery
• R.I.C.E Method (Rest, Ice, Compression, and Elevation): Controls inflammation and reduces pain
• Lifestyle Adjustments: Avoiding high-risk activities to prevent reinjury

If you’re unsure whether surgery is necessary, consulting an experienced orthopedic surgeon is critical for proper diagnosis and treatment advice.

Who Are Good Candidates for Non-Surgical Treatment?

Non-surgical treatment is most effective for individuals who:

• Have a partial ACL tear or sprain
• Are older adults not engaged in high-impact activities
• Have strong surrounding muscles (hamstrings and quadriceps) to support joint stability
• Can maintain reduced activity levels to avoid further injury

Trust Alexander Orthopaedics to Help with Your ACL Knee Pain

If you’re experiencing symptoms of an ACL tear, don’t wait to seek professional care from orthopaedic surgeons. The experienced team at Alexander Orthopaedics specializes in diagnosing and treating knee injuries, offering personalized care and advanced treatment options to help you recover and return to the activities you love. Contact us today to schedule a consultation.