You’ve torn your ACL. You decided to have surgery. The next step is the operating room, right?

As we mentioned in our last post, an ACL reconstruction surgery doesn’t need to happen immediately after the injury occurs, and it oftentimes isn’t scheduled until several weeks later. This time between injury and surgery presents a great opportunity for patients to set the groundwork for a full, long-term recovery.

Preoperative Therapy for an ACL Tear

It may seem strange to start therapy before you have surgery, but it in fact can be very important to the long-term success of the surgery and recovery.

Preoperative therapy for an ACL tear helps:

• Reduce swelling and pain
• Restore pre-injury range of motion
• Maintain strength of quadriceps and glute muscles

All of these together will work in your favor as you come out of surgery and start the post-operative recovery phase.

For Sandy, preoperative therapy lasted for about a month. It included regular icing and elevation to reduce swelling as well as low-impact strength exercises for the quad and glute muscles.

“The better the knee functions before surgery, the better it will function after surgery,” says Joel Hein, MD and orthopedic surgeon at OSMS. “Preoperative therapy helps ensure effective range of motion during the procedure, helping us properly place the ACL graft. It also builds a strong foundation on which to start post-surgical rehab.

From Pre to Post

Sandy’s ACL surgery was on a Thursday. The next day, she had her first post-op therapy session.

“It was horrible! I could barely move my knee, and it felt like I had absolutely no quadriceps muscle,” Sandy says. “The ACL surgery wipes out your quadriceps strength, which is why building it up before is so important. I can’t even imagine what it would have felt like if I hadn’t done the pre-op therapy.”

Day 2 wasn’t much better. But, as week one ended, Sandy was able to see movements in her quad muscle; she was able to do heel slides and ankle pumps; and her knee extension and flexion improved.

Ankle pumps. SOURCE: Original art redrawn

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Despite a difficult start, Sandy’s hard work paid off. Check back for the final part of Sandy’s story to see how her real-life progress aligned with her rehab plan goals.