ACL Surgery Pain Management – 2 Week Update

Today I would like to share a story from one of our readers about ACL surgery pain management and how she was able to reduce pain from a 10 to a 1 very rapidly. Maybe it will help you reduce your pain after knee surgery.

After ACL Surgery I was in intense pain the first night (got home from surgery around 8:30 p.m..) from my big toe all the way up to my hip. I didn’t sleep at all and was taking my the max of my meds every 3 hours. I realized the next day that someone had wrapped the bandage too tight after my surgery and that’s why I was in excruciating pain! And I’d even decided post-surgery to get a block because the pain was so bad. I didn’t realize it was the bandage until after my bandage change the next day when my pain level from 1000 down to 1 or 2, as in normal post-op pain. And it wasn’t until later in the afternoon that it dawned on me what caused the tremendous drop in the pain level! And yes, I told my doctor about it. It was actually his assistant who wrapped me up after surgery so my doc was going to have a chat with him.

ACL Surgery Pain Management

ACL Surgery Pain Management

Anyway, I’m almost 2 weeks post-op and doing well! I’ve had full and hyper extension 2 days after my surgery and I can flex my knee to well past 120 degrees, as in my heel is maybe an 2″ from my butt when I’m sitting and doing passive flex exercises. The pain is only bad at night. It will wake me up. So that’s when I’m taking most of my meds now. I hardly have any swelling at all but ice has been my best friend. And I’m doing my rehab on my own since I don’t have insurance and I’ve rehabbed my hip, shoulder, and knee on my own previously. My doctor saw me yesterday when I got my stitches out and he was amazed! He said he’d like to use me for a case study of what can be accomplished without PT when a patient is motivated….but I also had PT for 3 shoulder surgeries before I did my 4th shoulder surgery, hip surgery, and knee surgery on my own.

As I said, the pain is the bad at night. I can get by during the day without taking meds. My doc said I don’t have to sleep in my knee brace but I’ve tried doing that, elevating my lower leg, and every other position to try and make it not hurt but nothing seems to work. The pain will actually wake me up in the middle of the night. I know it might hurt more than usual because I’ve been pushing the PT pretty hard and have been up and about much more than I probably should be, but as my doctor says, it’s not hurting the the knee itself; it’s just causing ME more pain.

My Advice For Dealing With Pain After ACL Surgery During The Night…

Well the best advice I can give is to try and stay ahead of the pain. If you know the pain is going to occur at night and wake you up then set an alarm and wake yourself up before the pain gets bad, when you wake up take some pain meds and ice your knee then go back to sleep. By getting up before the pain forces you to wake up you will have a much better chance to reduce the pain.

Hopefully this helps you sleep through the night.

The Top 5 At Home Exercises
I did that helped get me walking 4 days after surgery

Click Here to see the exercises


  1. i have the surgery next monday and am worried about the pain. i dont currenty have an acl in my left knee but i have a high tolerance of pain and i can walk and run straight (torn menicus too) without much pain. do you think i will have much pain the following week of my surgery?

  2. Hi guys I’m a 16year old male and I’m having surgery on the 25th of october. I will be having my acl reconstructed using my hamstring as well as a meniscus repair and they are aslo gooing to reconstruct the out ligament all on my right knee. Any advice would be great as well as how much pain I can expect. I had an arthoscopy in june where they removed my acl and pain wasn’t bad at all. Really hoping this surgery can be the same??

  3. I just had surgery on my left knee for completly torn acl and I too also had to tears on my menicus and I can tolerate pain and as long as you keep taking your meds and perscribed and keep iceing your knee you won’t have that much. Pain and when you do its more of a sore feeling than pain its self. Hope that helps.

  4. Just had my second ACL surgery my first was left knee, now my right knee. I had a femoral block get my pain at tolerable level for first 18 hours, which in my opinion is the worst. I have a very high pain tolerance and pain meds make me nauseous. I used antiemetics with motrin and ice for pain relief, rough but it helps.
    I had my graft utilized from same side patellar tendon. I am using alot of exercises from various site because I have to use my facilities rehab and they are not very good, it really is a waste of my money. Thanks for the tips on exercises

  5. Just had my right knee done yesterday. The knee feels fine but my right hip is killing me and won’t even subdue with 2 pain pills. Any ideas on why this might be.

  6. Hi
    i had a ACL surgery done 7 weeks back and still my knee gives me pain when i walk also i have started going to gym and i do cycling and some leg extensions , is cycling good after acl surgery , pls. advive coz i have to join back work next month.

  7. Chad Hampton says:

    Let me start by noting that this is my second ACL surgery (left knee in 2000). Had my surgery this morning. After getting home, I did not sit still enough and started to pay for it by around 8:00 P.M. I moved from the couch to the bed, got the cooler pumping and took my happy pills. I am feeling much better by 9:00 P.M. It is amazing how much you forget after 11 years. By the way Jon, did you have a pain pump for any of your surgeries? It is leaking a lot. Has anyone had experience with these pumps? I did not have one back in 2000.

  8. John Paul Chulliyil says:

    Hey all,

    I tore my ACL in my left knee in 1999 and had surgery and then blew it again in 2000. I have been having reoccurring injuries to my left knee and decided to have a the surgery for the 2nd time. the first time I had my ACL surgery done there was a ton of pain, since then i have been traumatized to do it until now, since i have no choice. I realize that the surgery will be arthroscopic, have any of you had that type of surgery or did they cut you open? I am planning on having it the middle of January, any pointers on what I should do before surgery? The stories that I am reading eases my mind going forward with the surgery, so thanks everyone for sharing.

  9. My son is having surgery Nov 21st. He completely tore his ACL in football. I know nothing about the surgery and pretty nervous about the whole thing. Hes only 17 and hes feeling nervous also. Any advice?

  10. First of all…everyone reading this column needs to understand, that the pain will be different depending on which surgery you have.

    The most painful, but arguably the besprocedurere due to its bone to bone healing is thPatellaer graft. Pain will come from the graft site (middle third of the patella tendon), bone as a result of the bone taken from both the knee cap and tibia, and the general reconstruction procedure.

    The middle painful procedure is the hamstring graft. Two tendons are taken from the hamstring and are bundled together and inserted into the bone tunnels for the ACL acl. It takes longer for this type of graft to become rigid in the knee (bone is non existent on the grafts and thus bone to bone healing can’t occur). The pain that will be experienced is from the graft site (incision is smaller than a patella graft and no bone is taken), and the general reconstruction procedure.

    The lest painful procedure is the allograft or cadaver graft. It is the weakest graft used, but the least invasive on the knee. The cadaver graft is at its strongest immediately following surgery, followed by a weakening of the graft over the next several weeks. The graft is at its weakest a month or two after surgery and will once again reach peak strength some months post procedure. The pain experienced in this procedure is limited to the procedure itself.

    As far as pain management is concerned…

    I recommend for the patella and hamstring grafts taking
    10-20mg Oxycontin bid (2x a day or every 12 hours) or you may find that you need to take it tid (every 8 hours) *this is because it’s questionable if Oxycontin lasts a trSupplements

    Suppliment this with 5-10mg of Oxycodone taken only on an as needed basis. Usually as needed will be for issues like rehab or other extended activities that will cause higher than normal pain for short periods of time.

    This regimen of medication gives you a “long acting” medication that provides consistent control of pain, and thus avoids the roller coaster peak and trough effect that comes from ONLY taking short acting medications that are dosed every 4-6 hours. The peak and trough effect of only taking short acting meintensifiesonly intesifies your pain…Think of walking on the hot sand at a beach…the first few steps don’t hurt, but the longer you go…the hotter the sand feels and the more intense the pain gets. The fact is, the sand actually isn’t any hotter, BUT your body tells you it is to get you off of the sand because you obviously aren’t listening to what your feet are telling you! It’s called a “ramp-up effect”.

    For Cadaver or Allograft procedures, I recommend taking a short acting medication. The trauma from the procedure isn’t nearly as severe as the Patella or Hamstring graft and can adequately be controlled with short acting medications.

  11. I am a 45 year old female. Just had my second ACL surgery (rigt leg in 2009 and left leg 11/15/2011) 3 days ago. The first night was the most painful. I took my pain med by it upsets my stomach. The best way I have found to deal with the pain is to stay in the CPM
    Machine and take ibuprofen and use the cryo-cuff with supplemental cold pack at the site of the incision. I also take an anxiety pill at night to relax me so I can sleep through the CPM motion. I’m at -5 hyper-extension, and 120 degrees extension, able to walk slowly forwards, do assisted heal raises, walk backwards and stand on one foot. I will use my crutches and immobilizer for safety. Can’t wait to get rid of the IMobilizer

  12. Hello I had a ACL reconstruction this Monday on the 20th 2012 and my knee feels fine with pain at night I used a allograft and the pain is not as bad as you would think.The best way to keep the pain to a minimal is to ice and make sure you clean your incisions from getting infection but as of right now I’m trying to keep swelling down.If anybody having ACL surgery good luck just follow the doc orders and you will be fine……

  13. Just had my acl reconstruction surgery three days ago. Pain is almost all gone. I have a high tolerance though. I have been bearing weight since an hour after surgery. However, the most painful part is the incision. The doc cut me open pretty big. I have one poke over my thighbone, a small incision where the camera went in and about an 8 inch incision that starts at the top of my kneecap and goes all the way down. I call it my zipper. He put me back together with staples! I’m a bit ticked. I had meniscus surgery years ago and had stitches not staples. This sucks.

  14. hi..i also had an acl tear early this year..amid my rehab now..though there was a slight delay in my physio..but neverdless, i’ve got a 90 degree flexion in my leg in a very short span of tym soon aftr my surgery…even i’d like to help ppl by sharing some exercising tips, rehab myths..n more..those interested can follow my facebook page”Com-batting ACL tear”..i think together we can learn a lot more n discuss pain -mngmt strategies.thx..cheers!!!sanjula

  15. Hi, im Natalie, I recently tore my ACL while playing soccer and on April 20th im having recontruction. They are useing my hamstring graft from my other knee.Im really nervous. Any tips, im scared of the pain, and if im going to need a brace or not, the swelling. Im only 16 and i really want to beable to play soccer in the fall.

  16. Richard says:

    I had left knee acl surgery in the first week of Jan 12. The pain is quite strong in the first 7 days but can be reduced with painkillers. You have to keep up with the medicine in order to keep exercising your knee. Icing and cooling are the key to quick recovery. Buy 6-8 jel ice bags. Put some in freezer and use others in rotation. Sleep is very important. I put a small pillow between my knees at night with made things more comfortable with the support. I never used a knee brace and walked with crutches from the hospital.Throughout the whole process your brain will be telling you to rest but you have to keep you knee flexible by doing exercises to stop the scar tissue forming. If you do the right thing in the first 4 weeks, the long term recovery will be much quicker. I am a cyclist and managed regularly 17 miles on the flat on week 7 and 35 miles after week 12 ( no standing in the saddle or steep hills) Cycling is one of the best exercises you can do with my leg still a little swollen. Follow the intructions of your physio to a tee. Rehab to compete in football etc takes up to 9 months. You need to be patient and make time. Really there nothing to worry about and even the progress can be slow, the pain goes very quickly.

  17. Hi, its me again thanks for the advice, I had my surgery done yesterday. i like the fact that i have a nerve blockagde in my knee for a couple of hours, but then it wore off and ive had extreme pain all day long. Im on percocet and take them every 4 hours. Im iceing and resting but im scared for monday. I have phyiscal therapy monday morning and he has to change my dressing and stuff. I was supposed to start bearing weight today but im in to much pain to even try. When he went into my knee yesterday not only was my ACL torn and my meniscus was ripped so he had to shave that to, by the way it was my left knee i had surgery on. Its also extra pain because he took my hamstring graft out of the same knee so im having lots of pain. Anyone else have opions on what else i can do, im only 16 and it would be great for you advice.

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