ACL Recovery Diary: Weeks 1-6
As you all know, I recently underwent ACL reconstruction surgery, and I wanted to share my journey in the form of a recovery diary.
Starting with weeks 1-6, I'll be talking about everything from the pain to rehab exercises to my state of mind. Additionally, my super physio, Amy Christie of Six Physio, is adding her two cents for each portion of my journey. I worked with Amy in the lead up to the operation and now during my rehab.
Caveat! Everyone is different. This is my experience, it is not advice. Always seek out your medical professional.
If you have'n’t read it already, also check out the explainer article for exactly the ACL is, why it’s prone to injury and what the surgery entails, by my physio, Amy Christie.
The Diary
Week 1-2
Surgery done! It felt like a long road to surgery. Now the next challenge starts. There was pain and swelling. It was uncomfortable. The main priority was to manage the pain and swelling with rest, ice, compression, and elevation (RICE!).
Stairs were not my friend. Without being able to bend your knee, and with crutches to synchronise, stairs are hard. I was also encouraged not to do too much walking during this time. All hikes and runs cancelled for the time being.
I was given some gentle post-op exercises by the hospital, such as ankle pumps, lying knee flexions, static quads lying, knee hangs (still not able to do this one at 6 weeks) and isometric hamstring exercises.
The instructions said to aim for 90 degrees bend in the knee - I was nowhere near that! I am only getting to 90 degrees by the 6 week mark. I've been assured that this is quite normal, so don't worry if you aren't there yet.
I was called in between 7 and 14 days for the first physio appointment at the hospital and to have the stitches out.
State of mind:
The first week was a real struggle. Inactivity, a lot more pain than I was expecting. I knew it was going to be tough but it was much more than I thought. I was cramping in my hips and back, my body was just not used to not moving.
A thing that helped me was to have some nice and gentle things planned so that I didn't feel stuck. I went for coffees with friends, for example. I also found it helpful not to be on my own during that time. I went back home and was lucky enough to have my mum and dad around to chat with and to help me with basic and annoying things that were just hard during that time.
By week 2, the biggest change was more confidence with the crutches. I got to the point where I would sometimes just use one getting around indoors. The swelling was more manageable by the end of week 2 but not a huge amount.
Week 1-2 Milestone Progress
Bending: 50-75 degrees
Straightening: 20 degrees from the floor
Walking: Ever so slightly weight-bearing, with the crutches
Amy, The Physio:
You've had a big op, chill out. This is the time for Netflix and mum's cooking (Grace had about 6 roast dinners in the space of 2 weeks...). Swelling management is important, so stick with the classic RICE to help acutely manage things. Look at maintaining mobility with crutches and weight bear as much as is comfortable, but key lesson: Listen to your body! Ideally, you're starting to work through that knee bend as pain allows, and extension likewise.
Weeks 3-4
By week 3, I was back with my super physio, Amy. We got into some more challenging exercises, under her supervision and with the help of equipment. We continued to focus on building extension (straightening) and flexion (bending).
I also had a post-surgery consult with the surgeon, who was super pleased the healing, scarring and my progress in terms of bending, but I had more work to do. I shared the surgery notes with Amy.
Even though it's a constant battle with stiffness and swelling, by week 3, my range was improving, and I was walking more unaided - particularly when there was no risk of being jostled. I never thought I'd be so grateful for a seat on the tube and I thank everyone who gave their seat up for me.
State of Mind
At this point, I compared my journey with others who had gone through it and found that my progression seemed to be very good, but I was getting quite frustrated and demotivated with the little exercise I was allowed to do. I basically couldn't be arsed. It was a tough time. There were a few meltdowns - I felt rundown, emotionally sensitive, had headaches.
Amy was great and helped me put my progress into perspective.
While the visible swelling had gone, there was still swelling and stiffness within the joint, which I expect to be there for the next few months.
I was back at work in small capacity, taking a few sessions in the gym. I found I got tired very quickly.
Weeks 3-4 Milestones:
Bending: 90-100 degrees
Straightening: pretty much full extension
Walking: Unaided except in public places where you could be bumped.
Amy, The physio:
At this point, the knee bend is coming along nicely, working through range is challenging, and Grace struggled with knowing where her limit was. The golden rule is: into slight discomfort, no pain. Look to reach the 90 degree mark into flexion and weaning off crutches as confidence/comfort allows (consultant guided also!). For Grace, the crutches were more for confidence than anything else (plus who doesn't like a seat on the tube, eh?)
Weeks 5-6
By week 5, I was progressing really well and was a little more motivated to do the exercises. I had a full week at work and was on my feet a lot. Unfortunately, I then had an episode of bad swelling and was completely panicked that I had done some damage. There is a risk of rupture, so this was heavily on my mind. I had to take it a bit easier. I really tried to hold back, rest more, icing the swelling. I was freaking out.
I spoke to Amy, and she reassured me. By the time I got in to see her again, the swelling had gone down. It was scary but, turns out, I didn't need to panic. This happens sometimes and doesn't have to be a disaster.
I've got to remember that it will be an up and down process. Your recovery is not a straight line - you will go backwards sometimes. It may feel very slow when you're in it.
I had loaded it up more that week and worked longer hours, so it's not really a surprise. The important thing to remember is to speak to your medical team if you have any concerns. No point freaking out on your own.
Weeks 5-6 Milestones:
Bending: 90-100 degrees
Straightening: full extension
Walking: Walking pretty normally but still have to be careful. Managing to go up stairs more comfortably. Down is still trickiest.
Amy, The Physio:
Minor blip! This happens, (all the time) and it's important to remember this is normal and part of the bigger picture, golden rule: trust the process. Range will hopefully be in and around the 100 degree mark and full extension. Gait practice is in full swing, and we're looking to normalise this as much as possible. Exercise wise, strength and stability is priority - for Grace she has great awareness of what her body should be doing/feeling, but it can be frustrating when it refuses to play ball - activation work to get stuff kicking in is key!
