1 Year After ACL Surgery

Last week marked the 1 year anniversary of my ACL surgery and that means it’s time for my 1 year update and a little reflection. I hope to go over what I did right and what I did wrong so that I may be able to help those of you that are starting the recovery process now.

First off I want to say thanks to the many readers of this site. Many of you have sent me emails saying how much the information myself and others have shared on here has helped you. Those messages have kept me motivated to share as much useful information as I can.

Well my recovery started off really well with being able to walk without crutches 4 days after surgery but I bumped my knee in the second week carrying a laundry basket(stupid) and believe that has led a little “looseness” in my knee. The rest of my recovery went well especially the great physio I had who was getting me ready for returning to activities by doing a lot of jumping and balance exercises.

So what have I learned that can benefit other people about to go in for ACL surgery or are currently recovering from it…here is my top 12 lessons!…

The Top 11 Recovery Lessons I Learned In My First Year After ACL Surgery


Stay on top of the pain
Questions about pain in the first week after acl surgery is one of the most common here on aclsurgeryrecovery.net. My answer is always the same, the best way to minimize pain in the first week after acl surgery is to stay in top of it. What I mean by this is that once you are feeling a lot of pain it can be very hard to get rid if that pain. Therefore it’s best to proactively take your prescribed pain medication at the instructed time intervals. Many people will not take their pain meds since they think they aren’t in pain but then the pain will come and they will try to take the medication but it’s too late and the pain is already there. 7 Tips to manage pain in the first week after ACL surgery.

Use a cryo cuff
If you are getting acl surgery and are thinking regular ice packs will work let me tell you that’s it’s not worth it! Make sure you use a cryo cuff or air cast ice thermos. They are great and can stay cold for long periods of time.

I have used both the one with the electric pump and the themos jug style. I much prefer the thermos jug style since there are far fewer cords/plugs etc and it therefore encourages you to move around helping in the recovery.

Aircast Cryo Cuff

My Aircast Cryo Cuff

Inexpensive Aircast Cryo Cuff

Do your at home exercises
There are many exercises that you should do at home in the first weeks. If you only do your exercises when you are at physio you will not recover very quickly.

Here are some of the at home exercises I did to recover. ACL Surgery Recovery Exercises

Don’t overdue it
In the first few weeks/months you will start to feel better and when this happens it can be very tempting to push your knee too hard. One not very well known fact is that the acl graft is the weakest at week 16 right when you usually start to feel like you can be doing a lot of activities. Make sure you don’t do any activity that causes your knee “pain”, discomfort is ok but not pain. If your knee swells up significantly after an activity you can be sure that it was too much too soon.

“Secret” Icing tip

Here is how to get rid of swelling that wont go away, the swelling right inside your knee that no matter how much you ice it wont go away! One of my most popular posts on this website is the one how to get rid of swelling inside the knee. I go into the thermodynamics of why it works HERE, but the basic premise is to ice your ankle and knee(yes ankle) and then apply heat to your upper thigh. This tip really helps with the swelling that is inside the knee that is so hard to get rid of.

My “Secret” To Reducing Swelling Inside Your Knee

Go to physio
Some people, including myself, have a hard time taking the time out of there week to make it to physio, especially when your knee starts to feel better and you question whether its worth it. When I tore my ACL the first time I stopped going to Physio after a couple months and thought I was doing everything right on my own. However, I paid dearly since I did not do enough cutting and balance drills which resulted in me re-tearing my ACL when I played soccer.


Biking after ACL surgery is one of the best things you can do for your knee. It helps increase the range of motion and helps get the blood circulating. Not only that but it will be the first activity you will be able to do with any level of intensity and therefore is the fastest way to get back into shape.

Biking After ACL Surgery

Me Biking After ACL Surgery

In the first few months after my ACL surgery I really put a large emphasis on biking and as a result was able to go on a mountain bike trip 5 months after my ACL surgery.

Don’t return to sports too soon (like I did once)

If you return to sports to soon you can have the same result I did on my first ACL surgery. I re-torn ACL at 8months when I played soccer. The decision to play soccer was dumb on my part and I have paid for it with another knee surgery. After my second surgery I took my time, didnt return to skiing at the 4 month mark like I did on my first surgery and didn’t do any high intensity cutting sports until the 10 month mark.

If this is your first ACL surgery you are recovering from and you are really wanting to return to a given activity make sure you take your time….its not worth it.

Stay Motivated

Whether its in the first week or 4th month there comes a time where your motivation to go to the gym, do your exercises or protect your knee starts to disappear. It will be important to find something that will keep you motivated, everyone is different and the same strategy wont work for everyone but here are a few of the tricks I used to keep me motivated.

  • Schedule a vacation a few months out that will take a lot of preparation for your knee (see my bike trip above)
  • Pay for physio in advance (this makes you go)
  • Set and track goals (range of motion etc) – see my acl surgery recovery timeline
  • Have friends, family keep you accountable – my wife and this website helped keep me accountable

Start any activity slow

Whenever you are returning to an activity whether its walking or rugby make sure to start slow. Don’t jump full speed into any new activity, make sure to take your time and make sure your knee gets its balance back. Most activities use sets of muscles in unique ways that cant be duplicated in the gym or physio and for that reason the only way to do the last 10% of your physio is by doing the activity at 1/2 speed and then full speed. For example when you return to skiing the right way to do it is to start on easy hills in smooth conditions at 1/2speed and slowly but surely over the course of a few days work your way up.

Continue exercising your leg

Once you have finished going to physio and have returned to a few activities it can be easy to forget about your knee and no longer make a concerted effort to exercise it. This is a big mistake, your knee/leg will now always require a level of exercise to ensure you don’t end up re-tearing it. Over the next year this will be my big focus when it comes to my knee, making sure I continue to go to the gym reasonably regularly and do the required ongoing exercises for my knee.

What’s next for aclsurgeryrecovery.net
I plan on continuing to provide useful information on how to manage your knee after acl surgery but I hope to get feedback on some of the questions below to see how much value different ideas will have for you the readers…

Take The 5 Question Survey – HERE – Help Me Help Others With Their ACL Surgery Recovery

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

Click Here to see the exercises


  1. James Maher says:


    I am also about a year out from my ACL surgery and I was wondering if there is a specific program that you are using to get you back close to normal?

  2. Avi Ratica says:

    I just hit the one year mark myself. I broke my tibia and severed my ACl and tore the maniscus as well. I had to wait for my fracture to heal first and after surgery I was very weak in that leg for months. As a former bodybuilder I knew the mechanics of my body and ended up doing my own rehab after a week of going to Phisio. I have slowly getting better and there are a few tips from my own for you folks. If you lift any kind of wts, have each repetition last at least 5 seconds as this will eliminate momentum which is not a friend of any joint that you have and Plyometrics add too much G- Force to your joints as well. The Leg press is your friend and the Company MedX has the finest one ever made. Take a bit of Creatine to help strengthen your Muscles and Omega 3’s as well. I have also been losing about 1 LB a week and my Osteopath Cousin tells me I am doing everything right. Don’t give up and fight the good fight!

  3. I’m having my ACL reconstruction in two days. I’m very excited to get the show on the road. I’m a bit nervous because I’m the type of person who pushes my self and I understand you don’t want to do to much to fast. I hope I can follow the rules.

  4. I am 6 months out and just returned to hockey. My speed is way down but I know that will come in time. My question is at what stage did you stop having any knee pain and/or stiffness at all. My doctor cleared me to play but I still have stiffness if I am not moving the knee.

  5. Make sure you have 80% strength and conditioning
    on weak leg compared to strong leg. Do single leg hop test and test and measure distance with weak and strong leg. If this feels good that means your close to 100%

  6. Have just finished my 4 th week post op acl repair- bone tendon bone Graft-patellar. Am attending physical therapy and doing well with regard to Range of motion and strengthening however still need OTC ANTI INFLAMMATORY MEDS!! Although I seem to have a high pain tolerance
    This surgery had been very painful. Any thoughts on when the pain and stiffness start to go away?? I cm 43, very active, a therapist myself and do my home program between sessions, light statoionary bicycle eyc..Trying not to overdo it and using ice! Getting frustrated …

  7. I had the same graft option. The pain went away fairly quickly (week 1-2) but the patellar tendon area remained stiff until week 3-4 when it started to feel better.

    At week 9, once I get moving, I don’t notice it unless I’m performing a squatting or leg press exercise but after a set or two, I don’t feel it anymore until a couple hours after my workout at which point I’ll ice it for 20-30 minutes.

    My suggestion to you would be to ice as much as possible, take an Advil or two and stretch it out many times during the day.

    By the way, I’m also 43 and I did stay in a Holiday Inn Express last night.

  8. Michelle Collins says:

    Thanks as always :)

  9. Thank you for the website it’s been very helpful with our daughter. She had surgery just over a week ago. Used your tips and she is doing good. The one tip I would add is her doctor wanted her to do leg raises and she was unable then the doctor showed her: lay on your good side, raise your bad leg and slow roll over to your back with your bad leg still in the air. As you are doing this bend your good leg for support then you can do your leg raises. She has been doing 3 set of 10, 3x a day. by the next day she was able to lift her leg without having to start on her side.

  10. Hi Jon,
    As always, your tips on ACL recovery has been very helpful. I am in week 7 with hamstring graft. Still, have restrictions with ROM. Moving from passive extensions to active exrecises like biking, swimming etc. on advise of the surgeon.

  11. Jen Koper says:

    Thanks for the tips! I found your site after I tore my ACL in January 2012, and I came back before I went in for surgery in Feb 2013. I had tried to rehab with physical therapy, hoping I didn’t *need* surgery, but alas, I did. Your posts were very helpful in my preparations – I really appreciate you sharing!
    The best tips, some from you and some mine or modified:
    1. Set up your nest before the surgery. I did so, and it was very helpful and practical, since I couldn’t do much when I got home, and my partner was busy.
    2. Start working fiber mixes (e.g. Citrucel, Muralax, Metamucil) into your diet a few days before your surgery. And have some every day for the first week or so when you’re on heavy meds. I didn’t have any problems with constipation.
    3. Keep on top of pain — use the medication schedule if they give you one, or make a grid for yourself. You don’t want to wait until you feel the pain to take your meds.
    4. Don’t rush recovery — I’m fiercely not rushing. :) Going to PT, doing as much as I can of PT at home, but not rushing. I schedule as many PT appointments as I can (if you’re at your insurance out-of-pocket-max, which I bet most people are after surgery, they may not cost anything). Get a referral for someone who is a specialist for sport injury/recovery.
    5. Don’t plan for your time off to be productive. Depending on your meds, you may be sleeping 18 hours a day, and hardly coherent for 4 of the remaining 6. :) (Lots of TV when I was awake – took me 3 days to finish the last 20 pages of a very easy book)
    6. Also, make sure you get details about time off – ask questions more than one way. I had planned to be back at work 5 days after surgery, though hoping to work from home for the first two days back at work (surgery Wednesday, working Monday). However, because of the meds, and particularly because they gave me a nerve blocker with pump and catheter I had to wear for 3 days, I was not able to stay awake more than a couple hours at a time until about a week after surgery. I ended up staying home for a week and a half. I probably was able to stay awake for 8 consecutive hours by 9 days after surgery. Surgeon had told me 5-7 days to return to work, but then they did the nerve blocker the morning of the surgery and it pushed everything back about 3 days. (I kept dropping my phone trying to talk and send texts, and my hand kept falling off my keyboard when I was trying to type or I’d nod off — quite funny, but not productive!)
    7. Consider how you’ll be getting in and out of vehicles, and going to the bathroom. I had a graft from my own hamstring, so putting weight on it, like the pressure of a chair or toilet seat, was very painful. With my small bathroom, I had to have a towel folded over the bathtub door tracks so I could swing my leg up as I sat down, nearly sideways, to rest it level. :)
    8. If you are on other medications, check in with your doctor to make sure you don’t need to stop any 2 weeks before. Unless it’s an emergency, you’ll probably have a pre-op physical within 10 days prior. However, some meds need to be stopped 2 weeks before, so ask someone so you don’t get rescheduled by the anesthesiologist!

  12. just did 15k run less then one year after surgery,faster time. Thanks for the infor, and Thanks Mayo clinic jax fla

  13. WOW just what I was looking for. Came here by searching for 1
    year after acl surgery

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