Children's Hospital Colorado
A teenage girl talks about her experience with an ACL injury.

ACL Recovery and Rehabilitation

Surgery recovery and rehab

After surgery, most athletes have one goal in mind: getting back to their sport. Though the recovery journey varies from athlete to athlete, our team is focused on helping them get back to their sport as safely as possible to avoid any additional injuries. Watch to learn what helped Caroline thrive along the way.



Timeline for ACL rehabilitation

ACL injury recovery is different for every athlete. You should follow your care team's recommendations for your rehabilitation. Here's a sample timeline and recovery process from our physical therapists (PTs).

  • Change your dressing within 48 hours after your surgery. Make sure that your steri-strips remain intact.
  • Re-apply your ace bandage; this will help with swelling and will act as a barrier between the ice and your skin.
  • Schedule your first physical therapy visit (usually 5 to 7 days after your surgery).
  • Meet with your PT to summarize what to expect. Your PT will remove the compression sleeve and wrap around your knee; it's normal to have a swollen and bruised knee at this time.
  • Focus on reducing pain and inflammation, moving your knee and working on strengthening your quadriceps.
  • Slowly start to wean off the dependence on crutches and begin weight bearing as your PT directs.
  • Wear your brace at all times until you can perform 75 straight leg raises; this will ensure safety when you walk without your brace.
  • Continue to improve your range of motion between 0 to 90 degrees in the first two weeks, then up to 110 degrees by the third and fourth week.
  • You'll likely start core and hip training. Hip strength plays a crucial role in controlling your knee.
  • Ride the stationary bike to help your blood circulate around your knee; this will help the recovery process and increase your range of motion.
  • Start balance, stability and strength exercises as guided by your PT.
  • Biking should feel normal; increase resistance as your strength improves.
  • Continue to work on reducing swelling, regaining (and maintaining) range of motion and building strength in your legs, hips and core.
  • Remember to be aware of your body's pain and swelling and use this as a guide to how far you can push your limits.
  • Focus on improving your single leg so that it's similar to your other leg before you start running and jumping.
  • You should have your full range of motion returned by 10-12 weeks; this means getting your heel to your buttock just like your other side.
  • Your PT will determine when you're ready to run based on your strength and how well you can control your knee during specific exercises.
  • Typically at 3 to 4 months, you are fitted with your return-to-sport brace that should be worn whenever you run or jump outside of therapy.
  • During 4 to 9 months, focus on building strength in your quadriceps, hamstrings and hip stabilizers.
  • After sufficient strength is achieved, you will progress slowly to impact activities.
  • At Children's Colorado, you will progress through a jumping program in your home exercise program.
  • Work on regaining cardiovascular and muscular endurance to prepare for the physical demands of your sport.
  • At Children's Colorado, you must be cleared by your surgeon and PT before you can start playing sports again. This will usually require a test conducted by your PT to assess your strength, speed and how well you control your knee. The test typically covers demands that will be expected for your sport.
  • The return-to-sport test varies for each young athlete. You could take it anywhere between month 9 and 11 depending on your recovery process.
  • Once you're cleared to return to sports, it is important to return progressively. This means practicing for several weeks or months before you are ready to play in a game. Your PT will help you plan a safe return-to-sport progression depending on your sport, level and time of season.
  • Typically, we require that you wear your return-to-sport brace for at least one year with physical activity, and then gradually progress out of the brace pending your strength and comfort. Most patients will continue to wear their brace for two years after their surgery.
  • Remember to continue strength training at least 2-3 times per week, in addition to any practices or other sporting events you might have. This keeps your legs strong and helps reduce the risk of future injuries.
  • Continue working on is mental training and trusting your body and all the work you've put in throughout your rehabilitation process.
A Sports Medicine Center physical therapist stands in a gym, helping a teenage athlete recover from her sports injury.

Sports psychology and recovery

Sports injuries affect more than muscles and bones, so it's important to heal both mind and body. Children's Colorado's Sports Medicine Center offers a full range of athlete injury-recovery services, from orthopedic surgery to evidence-based mental health treatment for overcoming symptoms of anxiety and depression.

Learn how psychology impacts recovery

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"I want you back on the field as quickly as we can get you there, but a safe return is just as important as a fast one."

Dr. Albright, pediatric orthopedic surgeon
Children's Hospital Colorado's Dr. Albright gives an overview of ACL tears.

Partnership with the University of Colorado School of Medicine

Children's Hospital Colorado partners with the University of Colorado School of Medicine, where many of our physicians and care providers serve as faculty.

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