ACL Recovery – 15 Things I’d Do Differently

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Mountain path leading uphill

This post is part of a series. You may want to start here.

If your want the quick links, here’s the full series:

This might be another side-venture from my usual travel topic but ‘that post’ about my ACL surgery has fast become one of the most popular on this site. Not only have people told me it’s been a huge help, it’s offered a place for people to share their own stories and, in doing that, help each other.

Back to my recovery.

I’m writing this post because, over two and a half years on, I’m still not as recovered from my surgery as I want to be. But I’m still working very hard on it. In fact, I feel like I’ve progressed more in the last 3 months than I have in the last 3 years. Perhaps it’s because I’ve found an amazing new physiotherapist. Perhaps it’s all of the learnings of the last three years finally coalescing.

I’m deeply aware that many people screw up their knee, have surgery and get back to normal life. No drama. But my experience didn’t go like that. Why? Probably some of the mistakes below. Probably my perfectionist nature where anything under 100% recovery wasn’t going to cut it. Probably both.

Either way, I’m writing this in case you also haven’t had a ‘surgery-return-to-normal’ experience. Or, if you’re about to have surgery and want to take some tips for how to have a speedier recovery, what I’ve learned might help you. 

So, here’s my list of things I’d have done differently after my surgery to recover faster and better. It’s starting as a list of 15 but life has taught me that my knee is on a journey. So, there’s every chance I’ll be adding to this list as I continue to learn. Some of it will be very personal to me and you might think – duh, obvious but please be kind – sometimes we need to walk through the woods to see the trees. In my case, I needed to bang my head against a few tree a few times before I realised what I needed to do.

Also, if you have any of your own tips, please do share them in the comments below. 

1. Better pre-habilitation before surgery

Indiana Jo hiking up Machu Picchu in Peru
Ok, I probably wouldn’t have hiked the Inca Trail again – not with all those steps but I could have pushed myself more.

You’ve probably been told to work on your leg and knee strength before surgery and in my head I thought I was doing precisely that. In reality I wasn’t doing nearly enough. Why?

First, a practical issue – my knee was locked up and it took me months to get it bending again.

Second, fear – that locked knee was terrifying. In hindsight, I’d done the damage so pushing myself to get more mobile, more quickly would have been the smart thing to do. 

Third, and this is critical – ‘go do pre-hab’ wasn’t nearly prescriptive enough for me. Knowing my knee bone was no longer connected to my thigh bone (or something like that), I wasn’t sure what I could and couldn’t do. I’d already had a nasty fall after rupturing my ACL, so I didn’t want to add broken bones to the list. The few exercises the physio gave me were basic. Once I got range of motion going, I went out and did a bit of running and some work at the gym but I could have done a lot more had I known what the hell I was supposed to be doing.

How you can do it differently: There’s still very little useful info on the interwebs about ACL prehab. This is the most useful article I’ve found. But even this is off kilter – it confuses a sprain with a tear and predicts surgery might ‘sideline you for month’. Wouldn’t it be nice if it was only months? Personally, I wouldn’t do much of the jumping and landing exercises either (detached ACL and all that), but it’s a decent starting point if you’re looking for pre-hab exercises.

In addition, I’d:

  • get a specific set of pre-hab exercises from your physio;
  • get a specific list of what you can’t do (just to be safe);
  • hit the gym and, once you’ve got range of motion and basic strength back, hit the weights progressively harder – many of the strengthening exercises I’m doing now (hamstrings and quads) were possible even pre-surgery and would have saved me a heap of time and pain down the line;
  • get on the static bike and progressively turn that resistance dial up…up…up. 

2. I’d have pushed to have my surgery quicker

Yes, there’s only so much we can control when we’re on a public healthcare waiting list but I waited 9 months for my surgery. During that time, I didn’t chase them once to see what was going on. Having had my pre-surgery health checks in May and then not hearing anything further until September, I’m convinced I got missed or skipped. Coulda-shoulda-woulda isn’t a helpful way of thinking but if I’d followed up, maybe my surgery wouldn’t have been forgotten (if it was), or I’d have made myself known as a cancellation candidate. Of course, psychologically, I felt better putting it off but it only ended up delaying the inevitable and impacted on my overall recovery time. 

How you can do it differently: Find out who holds the surgery appointment list (someone in the admin team at the hospital) and get their number in your phone. Make a casual ‘just checking in’ call every few weeks. Make yourself known. Don’t get forgotten. If you can ‘drop everything’ for a cancellation, let the list-holder know. And if you can comfortably afford to have it done privately i.e. more quickly, I’d go for it.

3. I’d have got on (and stayed on) the static bike

Indiana Jo Hiking through mud in Nicaragua
I don’t always make the smartest decisions…like this hike up a volcano in Nicaragua with just a pair of Teva sandals on.

Go on the bike…use the bike…try the bike…are you doing the bike? Bike. Bike. Bike. So many times, my doctors, physio, friends and strangers all told me to use the static bike to help strengthen my leg muscles after surgery. Did I use the bike? Did I hell. And this is one of the most obviously silly decisions I made. Head. Banging. Trees. Woods. Repeatedly.

My reasoning was I hate the static bike. Boring with a capital BORING. I’m a runner. If I want to burn so few cardio calories, I’ll get on my yoga mat. It just wasn’t in my brain to do bike work. But, you know what, years – yes, years – after the masses advised me to get on the bike, I finally relented (after trying everything…anything else), and, what surprise, it worked. Yes, I still find it boring but as far as working all the correct leg muscles goes, you can’t find a better low-impact, strengthening exercise to help you recover. If only someone had told me that, eh :/

How you can do it differently: I use the bikes at my gym alternating between 10 minutes on the upright bike and 10 on the more lie-back (official name recumbent – had to Google that) bike. I tend to go for resistance (strengthening) over speed (cardio) training. 

If you can hack it for longer without dying of boredom, do it. If you do suffer from boredom, I’ve been using Audible books to get me through (all the power music just makes me want to run).

Alternatively, you can buy a bike relatively cheaply for home. As a non-bike fan, I didn’t want to end up with an object that will become a clothes horse but if you think you’ll stick to it, buy an exercise bike for home. Better still, buy someone else’s unused clothes horse from eBay.

4. I’d have got the best professional physio I could afford immediately after surgery

I live alone, have no dependents, have a decent enough income and my main outgoings are biscuits and travel. That means I can afford private physiotherapy. So why I persisted with the free public health physiotherapist when I had serious doubts about his efficacy, I don’t know. After the initial free sessions (six in total), I did absolutely zero in terms of physio. I just tried to get back to my normal running and yoga activities, thinking it would just take time. Experiencing pain and issues doing both and convinced my knee was buckling inwards (my free physio had replied ‘it’s one of those things’), I should have booked myself straight in for more physio from someone better skilled/or with more time available to deal with my specific issues. But no, I persisted, stubborn (and cheap) as I am. 

What happened is I eventually injured myself (bursitis) two years after surgery and was laid up for months recovering. I at least credit myself with finding a private physio at that point when I could have put myself back on the free physio waiting list.

Although my ‘bursitis physio’ helped immensely, I still wasn’t making the progress I wanted. Cue: physio number 3. Dealing with elite athletes (yes, feel free to actually laugh out loud), I knew that if anyone could get my knee back to full strength, it was him. And, so far, I’ve come on in leaps and actual bounds from just three sessions with the new guy.

How you can do it differently: If your recovery is not where you want it to be, and post any initial stint with a physiotherapist, get more physio sessions booked. It can take time to find the right person so don’t be afraid to change therapists if one isn’t working out for you.You don’t need to spend a lot of money. Often my sessions are over a month apart and I have a programme to work on in-between so it’s reasonably cost efficient over the course of time. 

If you don’t have/want to spend the money on a private physio, get on any public health schemes you can.

Timing can be crucial – I wonder now if I’d have got full over-extension back (I have some hyper mobility) if I’d jumped into more physio straight away.

How to find a good physiotherapist:

The $64 million question. And I’m not sure I’m qualified to answer except here’s what has worked for me:

  • Use a sports physiotherapist rather than a generalist.
  • Find someone who has had proven results with with ACLs – my guy regularly rehabilitates footballers (yes, you may laugh again).
  • Make sure they understand what your sports goals are – getting your knee overall well versus having the strength to run will require a different recovery regime (I know from experience).
  • Assess how confident they are – assuming your PT isn’t full of bluster, find someone who is confident they can get you to where you need to be versus someone who accepts ‘we might not get there’. Of course, you need to be realistic but with my same knee, 4 physios had different views on whether I’ll be able to run properly again. Clearly, I want to work with the person who says ‘that’s possible’.
  • Make sure your physio is able to record progress – until my current PT, all measurements of my progress were done by look and feel. ‘It looks better. Does it feel stronger?’ With my new guy, he has a machine that tests my quad and hamstring strength. I get exercises. I do them. I’m re-tested. I like being able to see recorded progress. Or not. One of my muscles isn’t getting as strong as quickly as the others (hamstring on the injured leg, unsurprisingly). Solution: work harder on that muscle.
  • Tell your physio about your lifestyle. If you work 16 hours a day and travel 2 days a week, he or she needs to know so you can have realistic exercises. I have ‘travel compatible’ exercises for when I’m on the road and can’t hit the gym.
  • Check reviews – it ‘s pretty easy to do online these days.

5. Not ignored the running pain…for years

Injured knee before ACL surgeryin splint on the left and in kinetic tape 2 years later
Some days I don’t feel like I’ve made much progress at all. On the left, the brace they gave me in hospital in Puerto Rico after I bust my knee. On the right 2 years later – bursitis from running.

I developed what I call my ‘running-injury-recovery cycle’. I’d decide I want to get running again, go running, continue three times a week for 3 weeks. By week 4 I’d be injured (typically hip pain and then bursitis). I’d then rest for a few weeks before starting the cycle again. Upshot – I never progressed. In all that time, I barely managed a 5k before injury struck. Bursitis was the last straw that took me to a physiotherapist. In hindsight I should have gone sooner.

My current physio and all his wonderful metrics tells me my leg muscles are not only too weak and out of whack with each other (uneven muscle strength across the legs), my knee was buckling (as I knew), which collectively put me at high risk of injury. I’m lucky I didn’t hurt myself more. I now have a muscle strengthening plan in place and running is on the cards – first test run in a couple of weeks. 

How you can do it differently: If you feel pain, yes, RICE (rest, ice, compression, elevation) but don’t ignore it. Get it checked out. It may well be fixable. Or yelling ‘I’m about to break even more’.

6. Worked on a progressive physiotherapy programme

Let’s be honest, physio exercises are dull. We squat, bridge and lunge for the first few weeks but after that our efforts slacken off. A month ago I took my theraband to Miami and was motivated enough to lie on a hotel floor (that smelt of vomit from previous guests) and do my physio exercises. But I was motivated because they were new exercises with a new plan.

A few weeks later, I couldn’t be arsed to do the same exercises when I was so fiercely procrastinating against doing work that I was cleaning inside my fridge. Solution: Work with your physio to get new exercises at regular enough intervals that they don’t become boring. This has the added advantage of helping you progress – you’ll do more and improve your recovery.

How you can do it differently: Schedule your physio sessions around 4 weeks to 6 weeks apart – that’s the amount of time when my interest in a set of exercises starts to wane. 

If you and your physio are doing your work properly, your exercises should get gradually harder. Or, at least different. If something hasn’t produced results in a month, time to try a different exercise?

Get your physio to help you switch it up. Bored of lunges? Do squats. I currently have three different ways of strengthening my hamstrings (TRX at the gym, sliding discs at home and low tables in hotels – my three natural habitats covered).

7. Pushed myself more on the weights

Views over Verbier mountains with outdoor picnic table
This trip to Verbier around 2 years into my recovery was an eye opener – I opted for the relaxed version of the trip and skipped all the active activities. A real sign I’d stopped pushing myself.

I realised the other day that I’ve been leg pressing the same level of weights at the gym for decades. Yep, decades. Talk about a fixed gym mindset. It’s like I decided once I got to a certain weight level, that was enough effort, thank you very much. But it turns out that by gently pushing myself I can achieve more (who’d have thought it). And at a time when I can use all the leg strength I can get, it’s a good lesson to learn.

How you can do it differently: Keep an eye on what you’re achieving with your leg weights and gently, gently (I’m doing .25 of a kilo extra each time), see if you can push yourself a bit more. Just don’t go wild – this is designed to improve not ruin your recovery.

8. Kept up my cardio fitness (at the gym)

You probably have the sense by now that I like to run. Ideally outside. So, unless I’m doing that, cardio is off the menu. Which isn’t the smartest move during after ACL. I wish now I’d been more strict, making myself maintain some kind of cardio fitness even when I couldn’t run. Actually, especially when I couldn’t run. Because now, facing the idea of running in a couple of weeks time, I’m almost as terrified about how my stamina will hold up as I am about my knee. Needless to say, I’ve become a bit more focused at the gym, hitting the cross trainer in the past few weeks instead of just ambling along on the bike willing every minute to be over.

How you can do it differently: You may not be able to ski/run/play football but if you want to get back to it, you’ve got to keep your cardio up. I get it – gyms and cardio machines are duller than dishwater but they’re also the safest gateway back to your chosen sport. Commit to a regular cardio workout when you’re doing your strength and physio training. And no, a brisk walk or vinyasa flow on your yoga mat probably isn’t going to cut it. 

9. Invested in regular sports massage earlier on

One of the biggest barriers to me pushing myself after my surgery has actually been my leg muscles. Locked up would be an understatement. It wasn’t until, errrr, around year two that I really started to address this and wow did it hurt. Not knowing enough about anatomy and injury, it didn’t occur to me that my legs muscles could get themselves into such a state. Sure, I did some yoga and all that jazz but compared to a torturer…I mean sports masseuse…sticking the pointy finger of doom into the middle of your muscle to get it to release, the yoga was no more effective than a tickle with a feather.

How you can do it differently: Try a sports massage fairly early on in your recovery regimen. Just a few months after surgery I spent a month in Thailand and let the Thai ladies loose on my legs. I was nervous but they were careful and, though painful at the time, the regular massage worked. Keep it up (I didn’t). As we work to re-strengthen and regain proper function in our legs, our muscles can tighten to the point they’re hindering our recovery. 

Be aware, it needs to be a sports massage. Hot stones won’t be as effective, sorry.

At home, I also use these ‘miracle balls‘ – they help to release tight muscles while you sit on your backside watching TV. Bargain and effective for £15/$20. I use mine several times a week.

10. Worked towards recovering my ACL for all of my sports at the same time

Woman with surfboard at beach in Santa Teresa Costa Rica
I spend most of my surf time in the water not on the board but I’d still like to give it another go.

I’ve tried to get back to my sports on a ‘favourites first’ basis which has put running and yoga at the top of my list. So it was only recently I’ve started to enquire about other things I like to do or want to try – hiking (volcanoes are a particular favourite), surfing (I’m terrible but would like to improve), aerial yoga, K08 and getting back to Krav Maga. Some of those sports are going to be more achievable than others. And though I like that I’m specifically strengthening my legs for running, if I’d been a bit broader with my activity list, I could have gone on with some of the other sports in the meantime rather than being so single minded about my recovery and focus. Undoubtedly, this would have helped my overall strength and fitness.

How you can do it differently: Give your PT a list of all the sports you enjoy or want to try and see which they recommend tackling in the meantime while you work on full strength for your favourites.

11. Managed my weight (and pity picnics) better

“Fine, if I can’t run and still don’t have the flexibility to do the yoga I want, I may as well sit on the sofa and eat a packet of biscuits.” If you’ve suffered with weight increase generally or as a result of what I like to call pity picnics, I get it. Before I screwed up my knee, my emotional outlet was running. Take that away and I turned to biscuits and their salty cousin, crisps. Coupled with a reduced level of activity overall and it didn’t take long for me to gain weight. The problem is, it took me too long to lose it. And I’m still not 100% there.

I’ve had a challenging year emotionally (my mum died at Christmas) and the pity picnics have been an increasingly frequent occurrence. But it’s literally the last thing I need. So, over the past few months I made a dedicated effort and as a result I’ve said goodbye to over a stone in weight. I’ve stalled a little but I’m determined to push through and lose the last pounds I never used to carry when I was able to run. 

How you can do it differently: Mainly this was about mindset for me. First, I had to accept that that waiting until I could run to lose the weight wasn’t realistic. I had to lose the weight first. I identified my weaknesses (previously cited biscuits and crisps). I then had to apply some pretty serious willpower and stop putting the damn things in my mouth. It came down to: which do I want more – to be able to run without the extra weight on my knee, or the biscuit. Sure, sometimes the genuine answer meant throwing a chocolate digestive in my mouth but I started doing it as more of a treat than a 3 p.m. appointment with half a packet.

12. Tracked my recovery better

Indiana Jo Hiking in Cocoa Valley in Colombia
I don’t always do the right planning – like turning up to hike the Cocora Valley in Colombia during rainy season.

Every heard the saying ‘what gets measured gets done’? Or, more specifically, if you write down your goals, they’re more likely to be achieved. It’s been proven. And I knew this, which is what makes it so frustrating that I didn’t think to apply this approach. Instead of having goals and targets, I let my recovery amble on. Which is probably why I’m writing this post nearly three years after my repair. 

And, d’you know what, even as I write this, I don’t have specific goals set. Not measurable ones. So, that’s my next task after I hit publish on this post. 

How you can do it differently: Make a list of your goals. Discuss it with your physio. Put that list somewhere you can see it. Check it often and revise it as necessary. We don’t always hit our targets 100% but you’re 100% more likely to hit something you’re aiming at (run 10ks without risk of injury) than some idea (I should run again) that floats vaguely around in your head. 

13. Set deadlines for my progress

What I like about my new PT is that I know where I’m heading and, most importantly, by what date. I know that for the next 4 weeks, I’m trying to make my hamstrings more solid than Mr Schwarzeneggers’. I know that if I manage to do that (or do the best I can – he’s got some very fierce hammies), I will try to run. I will try to do it across the space of 40 minutes with the view to being able to run outdoors on my own for 20 minutes the following week. 

Without tough but achievable deadlines, I’ve not made as much progress as I’d have liked.

How you can do it differently: Put some deadlines on your plan and make yourself accountable. Deadlines will also help you spot any flaws. While you might be working towards a goal in one month, are you realistically going to hit the gym every day if you’re on honeymoon for two of those weeks?

14. Invested in motivational gadgets and fitness kit

Hiking into the Grand Canyon
Kit aside, looking at old photos of some of my best hikes is pretty motivating. Like that time I hiked below the rim of the Grand Canyon – not a lot of people do that.

I love a gadget – nothing motivates me more than new kit. When I couldn’t sleep years ago, I went out and bought a Fitbit to track all the sleep I wasn’t getting. Not exactly motivating, confirming how little I slept each night, but it at least helped me understand why I was so goddam exhausted all the time. I now use my Fitbit to motivate me to get fitter (cardio) and lose weight during my journey. 

How you can do it differently: The best gadgets I’ve bought for my recovery are:

  • a set of smart scales. Not only do they track my weight loss, I can see my muscle mass increasing bit by bit as well as my bone density and water levels – all measures of a healthier, fitter me (not sure how scales can measure this? Answer: it’s science not magic). It’s often the prospect of stepping on those scales than makes me push harder at the gym or remove that 6th…ok, 7th biscuit from my mouth. 
  • Training gadgets – I’m not talking about anything expensive (all under $20) – sliding discs (to work on my hamstrings), miracle balls (to unlock my muscles), dumbbells (for some quick lunges during a work break) and a gym ball for all sorts of fitness fun including gentle flexion during the early days.

Yes, it’s my inner child demanding new toys to play with but if those toys are helping me get fit and strong, I’m happy to continue to indulge her.

15. Woken even morning to ‘You Better Work B*TCH’ by Britney

Tal Volcano in the Philipines
Though the memory of hiking Taal Volcano in the Philippines is good motivation too. Don’t know about Taal? It’s ‘an island within a lake, that is an island within a lake that is on an island.’ So, a lot of boats and a lot of islands.

Ok, I’m only partly serious (though Britney’s song is often enough to get me to the gym when I’m not in the mood). My main point is, I would have applied a bit more tough love. It can be hard getting fully recovered but I’m not a stranger to hard work. And this really is one of those times where effort and outcome are directly correlated. 

How you can do it differently: Persist. Persist. Persist.

So, that’s my list of things I would have done differently to help my recovery. Got any extra tips and suggestions? Let me know in the comments below. 

Interested in some of the photos you saw in this post? I wrote about a few of the destinations here:

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Mountain path with text overlay for pinterest
Author - Jo Fitzsimons

Hi, I'm Jo, the writer behind Indiana Jo. In 2010 I quit my job as a lawyer and booked an around the world ticket. As a solo female traveller, I hopped from South America to Central America, across Asia, the Middle East and Europe. It was supposed to be a one-year trip but over a decade later, it's yet to end. I've lived in a cave, climbed down a volcano barefoot, spent years as a digital nomad, worked as a freelance travel writer, and eaten deadly Fugu. Now I'm home, back in the UK, but still travelling far and wide. You can find out more About Me.

46 thoughts on “ACL Recovery – 15 Things I’d Do Differently”

  1. Hi Jo
    I’ve found this blog incredibly useful.
    My story is that I used to play football and then gave it up when I had my kids because it was taking up the time that I wanted to spend with them. I switched it up to running and gym early morning but as time went on, I had a niggle over whether I could still cut it and it’d be nice for the kids to see me play.
    So I went back in July of this year. 2nd game in. 15 minutes. Bit of a coming together and my leg is one way, my knee the other. That was August 20th.
    Incredible pain and I knew I had done something bad. After the X ray and MRI it was confirmed I’d ruptured my ACL.
    I do a manual job but luckily as well as work being supportive we have private health care cover.
    First when I did the injury I went into the NHS hospital and they put me in a knee brace and told me not to move it to protect the knee. As I found out when I changed my cover to private this was the worst thing I could have done as it just locked it out.
    I saw Mr Paul Sutton in Sheffield who is absolutely fantastic. He explained my options – physio could work and surgery might not be needed dependent on my lifestyle and how strong the knee would be, or physio to a point that there’s more movement in the knee and then reconstruction surgery.
    Up until yesterday I had been doing physio as well as straight lined, controlled movements at the gym – cross trainer, bike and foot plate as well as upper body. My worry was that when I had surgery I would go back to the start – not being able to bend, shower or put my sock on but knew it was for the greater good. I’ve missed running around with the kids more than anything and fear that my job would be at risk.
    Yesterday I had surgery and I’m in the hospital as I write this and read your tips. I have to say that when I first had the accident ‘ pity picnic ‘ was definitely me. I was grabbing everything I could possibly eat and snack on- even raiding the kids sweet drawer which was an all time low. I’m not going to do that now – all in moderation and going to look to try and keep to a high fibre, high protein diet to aid recovery. Its a long road ahead and I think as well as physically I’m struggling more with the mental side. I’m not one to sit still and have been told to be a ‘patient, patient’
    Anything else that you can recommend whether that be diet, exercise or any other useful literature would be really appreciated.
    Thanks for taking the time to read this and look forward to looking forward not back

    • Hi Si, sorry you’re even having to search for ACL tips. And urgh, I wish the NHS would stop messing up those initial stages. High fibre, high protein worked for me after my pity picnics, and having a more structured eating routine with fewer snacks. And definitely steering away from the carbs for a while (more chilli, less rice, big salad kind of thing). Then mostly sticking at the physio. Even now, years later, I have a TRX slung over my kitchen door and every time I make a tea or coffee, I squeeze in a few squats or lunges. I loved Charles Duhig’s book on the power of habit. Knee strength is going to become a lifetime habit for you and his book was great for getting me into the mindset. Good luck with the recovery. Do come back and let us know how you get on.

  2. Stumbled upon your page as others did. I live alone and have scheduled surgery. I’m in the States so things are differently here as far as medical care. But I am glad to see that most of your suggestions I am already following so that makes me feel better. My injury was in April of 2021, Unhappy Triad. I was scheduled to hike Rim to Rim, Grand Canyon, two weeks after it happened. Still need to make up for that.

    I was always into fitness and had rehabbed a couple injuries previous and for this I started prehab the week following with my same sports PT. At that point I was in an immobilizer but surgery for six weeks for my meniscus to calm down before surgery could even be done, and my swelling was extremely bad. Hands on massage was part of every appointment, was for my first injuries as well. I was already a cyclist so actually couldn’t wait to get on the bike and had bought a spin bike at the beginning of Covid in addition to home gym equipment. I still feel like I am not doing enough strengthening as far as weights but on my road, mountain or spin bike 3-5 times a week. I actually got to the point two orthos deemed me surgery optional but said when I find I can’t do stuff I want to do then it’s time. So even though I’m over 40 I’m not ready to throw in the towel on bootcamps, sprint work, plyometrics, etc.

    But I do live alone so a little stressed about that. But I am prepared for the mental aspect this time. Post injury, much like you mentioned, fitness was my identity and it was a very depressing time for me. Now that I’ve gotten this far post injury I know post surgery there is light at the end of the tunnel and I’m excited to get back to 100 percent. Another reason I’m doing it in the winter is cold I hate the cold so my winter riding drops tremendously. I’m finding that it’s really hard to keep weight off when I can’t do all the activities I want to do. It gave me the cushion with my non perfect eating that I don’t have.

    Great pics in this article too!

    • Hi Sabrina, winter is a good time to do the surgery. I also lived alone and was worried about it and it turned out fine. Get yourself some over the shoulder light shopping bags for carrying things around so you have your hands free for stairs. I wouldn’t say I got back to 100% and every doctor and physio agreed that isn’t likely but I have gotten pretty close. Good luck with the surgery and recovery!

  3. Hello Joe. I found out all your tips and experience very useful, thank you for sharing your experience. I just got my ACL torn some weeks before but still can not bend my knee is look as similar as the problem you had. I learned that rehabilitation is important, but in this particular case were you can not basically bend your knee over 90 degrees would like to know how did you manage it? I read that you were scare of bending your knee because you thought you would damage something. Appreciate your comments on this! Thank you in advance!

    • Hi Paulo, I did it little by little – a little bit of walking, a little bit of time on the bike, a little bit of time at the gym, a little bit of yoga, and a little bit of crying. In hindsight, I would have got a physio to help me. Good luck.

  4. I’m 11 days post op and I am allowed to partial weight bear with crutches but it’s been really hard to overcome the mental block. I want to get back to my life, but as much as I tell myself that, it’s still hard to actually force myself to stand on my leg again. I did a fair amount of damage aside from the acl tear that had to mostly heal before surgery so I have been on crutches and fully non weight bearing since January 2nd. This article really helped tho, I’m gonna go write myself a plan to keep myself accountable right now!!!

    • Hi Amelia, taking those first steps – literally and mentally – all the hardest. I hope your plan works out. Good luck with the recovery.

  5. Hi Jo, thank you for this blog. I don’t often write but I felt compelled to share my experience out of gratitude. I’m so glad Dr Google found you. Those of us who are going through ACL recovery know how real the struggle is. I’m currently 9 months post op (ACLR hamstring graft, medial meniscus repair with sewing and minor meniscectomy), 11 months post injury. I only realised the full damage having no improvement for 2 months and went for an MRI. I’m far from recovered and have come to accept this can take years. If I may share my struggles:

    1. This is a mental battle as much as physical. I’ve been active all my life and I’ve felt my identity has been taken from me. It’s painful to look at old photos and not have my eyes laser target the once healthy knee! Clean out as many toxic people and obligations from your life. Be with people who care for you. You’ll have mood swings. It’s normal being depressed/a-hole because you were TRAUMATISED.

    2. (Having decided on ACLR) Get the best sports physiotherapist you can get your hands on. I totally agree with you Jo. We all have the right to lead a lifestyle of our choosing. The sports physios are not reserved only for professional elite athletes. No one should put you down and compromise your body and lifestyle because of your age or occupation. If you aim for the stars and miss, you may land on the moon? Also Sports PTs have experience with athlete mental traumas. I was not afraid to tell my Sport PT my mental issues. He respected me. If the entire session was just one experienced word of advice or encouragement to unlock your mental block then it’s worth more than endless sets which you have no faith in. I would keep my appointments so that I have an experienced professional that would lead the way from uncertainty and self-doubt.

    3. Stop counting the days, make the days count. Don’t put a timeline in terms of a comeback date. Unless you’re a professional with a club paying you, I’ve learned each of us will be different. I’ve stopped counting the days, making sure I progress forward all the time.

    4. Get your leg as straight as possible, as early as advised. It took me months before I attempted to get TKE as my surgeon was ultra conservative. My PT saw otherwise and we forced the knee straight eventually. It was tearfully painful but I had to break down months of scarring developed post op.

    5. Static bike. I don’t know how different my knee would’ve been but I rode a static bike religiously for the first months once cleared. My PT says the skin is much looser around the operated scars. Fill your mobile phone with motivating songs to past the time. If you’re in a gym then you’re not alone. Everyone is fighting their own battle with you.

    I hope this blog stays up (for all the right reasons! Get well soon Jo and all) so I may share a happy update. From a philosophical perspective, this injury was not what I wanted, but maybe want I needed? I am much more focused, determined and grateful for all that life has been provided to me. I hope one day I will put this injury firmly behind me with a full recovery and reach a better place in life. As of now, life has got real. There’s work to be done!

    • Hi Jaso, thanks so much for taking time to share your experience. You’re right about it being a mental struggle! Thanks so much for your other tips and thoughts. I wish I’d worked harder to get my leg straight sooner. Good luck with the recovery!

  6. Hi Jo, thank you so much for sharing your journey. I ruptured my ACL and tore my meniscus 4 weeks ago and as you know with the NHS, I still don’t have an update regarding when I may start pre-op physio. So I’ve decided to go private and would really appreciate it if you could share details on how I could get in touch with your physio and where he/she may be based? It’s really difficult trying to find someone and I would appreciate the help! 🙂

    • Hi Jadon, my physio was based in Liverpool, City Rehab. Not sure if they will be able to treat you by video but worth asking? Good luck!

  7. Great article! Helpful and remotivating to stick to a plan to avoid future injuries. I had surgery 3 weeks ago and I’m so lucky my dr and therapist are wonderful and communicate well. I’m in Colorado and thankfully have great insurance that’s covering pt 2x a week, 1hr sessions. They know my goals and I let them know if I don’t feel challenged. Just today I did stool slides for the first time…literally just pulling myself around on a wheeled stool with my repaired leg and wow that humbled me bc it was damn hard! I still do all the boring things at home, I’m sure that will get old but appreciate your reminder of get on and use the darn bike all the time! It will help me in the long run! Thanks again for the post.

    • Hi Samantha, glad the surgery and PT went well. It’s crazy how much we regress in our leg strength – humbling is a great word for it. Good luck with the ongoing recovery.

  8. This is EXACTLY what I needed to read! I’m 15 months post ACL surgery and am totally in the cycle of run, injure, rest, repeat. My physio is brilliant but I get so bored so quickly of one-leg squats and glute bridges and just want to be out on my bike or running around… really thought I’d ‘finished’ with physio when I was smashing out three runs a week but apparently your knee doesn’t just magically heal cause you want it to. I’d better work, b*tch. 🙁

    • Hi Lily, urgh. I know that cycle only too well. And I definitely can relate to the boredom of the squats and bridges. I plan to update the post but my latest approach is a TRX – I’ve thrown it over my kitchen door and every time I make a cup of tea of coffee (happens multiple times daily), I do my lunges and squats using the TRX while I wait for the kettle to boil. It’s no less boring but it’s a habit that seems easier to stick to – little and often – compared to the constant stop start. Might be worth a try? Good luck!

  9. Help please. I am 10 days post op ACL surgery and am having very frequent episodes of spasms in the repaired leg. They are so intense when I’m standing it lurches me forward. I am doing everything my doctor recommended. I am not sure how worried I should be. Has anyone experienced this???

    • Hi Colleen, so sorry to hear about this. It’s not something I experienced and I’m not a doctor but if it’s not painful, might be your muscles are locked up. Speak to your doctor but perhaps a physio could help with sports massage?

  10. Hi Jo, this is the best article I found online for ACL recovery and advice so thank you. I’m 30 and did my ACL and cartilage playing football. I agree try and push to get the operation as soon as possible it took me 10 months before I got mine, by this time my leg felt better and then you have to go through the recovery process all over again. Couple of things I found useful:
    Do the little excersises they give you straight away after surgery eg quad activation, they may seem insignificant but make a big difference.
    Also constantly work on straightening the leg, it feels more comfortable not to but your muscle will shrink and will be a lot harder to straighten.
    When getting showers I used a waterproof cover called ‘LimbO’, never leaked once.
    Hope this helps a few people, thanks again ?

  11. Thanks for the article as feeling a bit low today lets me . I am in my mid 50s previously very fit & now 16 months post ACL rupture & 8 months post reconstruction. Still walking with a crutch & can’t get my knee fully extended. I have done everything asked & attending gym 3-4 times a week doing exercises & bike 2-3 times every day but appear to be making very limited progress. I really wanted to get back to walking holidays but truthfully would settle for being able to walk properly. Now waiting for another scan to determine whether further surgery or not but as is the way with the NHS it is another wait for the scan & probably another wait for surgery if needed. I will try increasing resistance on the bike & whacking up the weights. I hope 2020 is a better year for you & you continue to progress

    • Hi Carol, I’m sorry you’re having a tough time with it. I know how you feel. I was told my precious yoga would be pretty restricted post op and I’ve persisted for years and got back to where I was. My knee still hurts. I know that’s inconsequential compared to getting extension but my advice is persist, persist. Yes, 8 months of persisting wears you down but please keep on. We ACL people understand. Work on your extension exercises several times a day and try to get some private physio if you can. It made a huge difference to me. Good luck!

  12. Thank goodness I found this blog. Two weeks ago at the gym some broad/long jumps went wrong and I ruptured BOTH ACLs, torn BOTH MCLs and a lateral meniscus tear. I’m 45 years old, a special education teacher. I enjoy HIIT fitness and do 10-12 mile obstacle races. I’m by no means lean and mean, but I’m in shape and fighting old age as best as I can. I’ve never had any knee injuries, so this was a complete fluke accident. I’m about to under go my first ACL reconstruction surgery and MCL repair on the right knee next week. The left knee will undergo the ACL reconstruction, MCL repair, and lateral meniscus repair approximately 2-3 months down the road. I’m very uneasy about my recovery since I won’t have a stable leg to stand on, literally, for any of my rehabilitation. In addition, I also concerned with things like: what can I wear after surgery, how can I shower, how long can I expect to be immobile.

    • Oh wow – ouch!!!! I’m so sorry that happened to you. On the huge plus side, you’re currently fit and active, which will help with your recovery. Long dresses were my friend post-surgery, as were leggings. Showering was a challenge but was possible. I was up on my feet very quickly (within a day or two) but normal mobility is likely to take longer. Good luck with the surgeries and recovery.

    • Hey Meredith and Jo, great to read the blog, some really useful advice so thank you. I also ruptured both ACLs in February 2019 (skiing) and it’s been a long old journey (still waiting on that second surgery ?) sorry to hear you’ve also had such a bad injury Meredith, you are the first other person I’ve heard about who has injured both knees! Even my physio/surgeon didn’t know what to do with me! It’s been 5 months since the op on my left knee and the second had been delayed by Coronavirus and I have been feeling a bit rubbish today about the slow progress so it’s good to hear I’m not alone. I had 10 months of pre-hab whilst on NHS waiting lists, so got to a great level of strength before the op, which I’m sure has helped me post -op but doesn’t do much for my frustration levels!! Fantastic to hear about your return to adventuring Jo, I was due to start a round the world cycle trip last October so you are giving me hope that it won’t be too long until I can finally get going! I am intrigued to hear how you are getting on with your knees Meredith? Would be great to hear from someone else with ‘the double’ on their progress!! Good luck both x

      • Hi Lauren – both ACLs – ouch and so unlucky 🙁 It’s definitely a frustrating time having to wait for the second op and having it delayed by the stupid virus is even harder. I hope you can keep at it with the pre-hab. It might take time but you can definitely get there. Wishing you luck and hope you get your op soon!

  13. I broke my femur five years ago. I was never sporty but always busy. I found the static bike was amazing in getting my knee working again. And it wasn’t boring at all because I used my tv time to cycle . Films – shows were not allowed to be watched unless I was on my bike .
    I’ve just broken my patella and waiting to find out when I can start bending my leg that has been in a brace for over a month now. As soon as I’m able I will be back on my bike.
    Thanks for your fabulous article x

    • Hi April, ouch! My mum broke her patella so I know (as an observer) how challenging that can be. Brilliant tips for the bike! I should have done that. Funnily enough, I have adopted a not too dissimilar approach with my physio exercises – I put a good audio book on listen to that as I run through the routine of 3x weekly lunges and bridges and balance poses. It definitely makes a difference to my motivation. I might give the bike another go with some TV. Thanks for sharing your tip and good luck with the recovery.

  14. Hi Jo! Thank you so much for sharing your experience! I am 9 weeks post ACL reconstruction (with stitching for small meniscal tear too) and had my surgery 3 months after injury. I am Canadian and living and working in the US, and thankfully have good insurance. I did a quad graft which there is very little info on online, but I am happy to say I am healing well and doing everything I can to stay on track. I do physio 3 times a week (covered by insurance) and was just given clearance to bike as much as I want. Because of all the specialized exercises I’ve been doing, I’m able to tolerate much higher tension on the bike which was surprising. My doctor said it’s common. As soon as I was able to crutch over to the gym (I was on crutches for 4 weeks, one crutch for another two and in leg brace outdoors only for 7.5 weeks) I started doing upper body stuff. Mainly to fight off boredom and isolation. I saw a lot online about leg lifts and some people being able to do them right away. I could not lift my log/leg for 3 weeks! And it’s much easier but still challenging as I rebuild the muscle. Maybe because of quad graft. I started physio after 8 days and did ALL my exercises. I happened to have a yoga strap that helped with heel slides so would recommend that. I ate well, drank a ton of water and planned for the recovery – lots of books, visits from friends, stocked the fridge and freezer – to fight off the pity party. I also benefited from a shower stool – very helpful! I have also been massaging the scar tissue as recommended by therapist (also doctor endorsed) and also got a cane for when the weather gets a little slick because I live in New York City and the subway is very inaccessible. Stairs down are still very hard! My goals so far have just been to be mobile and as strong as possible. Also when I’m at home, I try to bend my knee just a little more and so far it’s getting easier. Throughout recovery, my goal was to get outside every day (in the early stages I just sat on a bench in front of my building to get fresh air). For those getting the surgery, you will absolutely need full time help. And quite frankly, it was nice to have company for a couple weeks since I live alone and couldn’t get around the city. I read a lot online about other people’s progress, but ultimately realized everyon’e recovery is different and with the different grafts, there’s no right way to heal. Patience is definitely essential, and celebrating all the little gains. Thank you again Jo and all the best to everyone else!

    • Hi Christine, huge apologies – I somehow missed this comment :/ Well done on your dedication to the physio and the getting out/walking. Sounds like it’s paying off. I remember those first weeks of leg/log lifts, staring at my leg thinking ‘move!’ and nothing happening. It’s bizarre (and a bit scary) feeling so disconnected from your body but it didn’t take too long before I got enough strength back to at least be able to do a few lifts. The shower seat and yoga strap are great tips. I moved home (alone) after a couple of nights at my mum’s house and I was actually fine – and I live in an old apartment that has 2 flights of stairs to get into and then a further two flights within my triplex/apartment. It was definitely scary and I had family near to help with things like shopping, but I managed ok. I’m not saying that to disagree with your helpful comment to get help but just to give another view in case people are stuck doing this alone. It’s manageable. You just have to plan a bit and go really, really slowly. Good luck with the rest of your recovery and I hope the New York winter is kind to you.

  15. Bonjour from Chelsea Québec Canada
    I am now on day 5 recovering from ACL reconstruction ligament ARTHROSCOPIE surgery
    Should I start moving my knee?

    • Hi Christiane, so soon after surgery, I’d stick very closely to what your surgeon/doctor/physiotherapist has advised. It seems like everyone gets different advice so best to do what has been advised for you! Good luck.

    • Because I’m difficult, I had part allograft (my own hamstring) but because my hammie was a bit skinny, they supplemented it with a bit of something artificial. Hope that helps.

  16. This is very helpful. I am 39 and I tore mine in Feb of this year and put off surgery (it is scheduled for next week) . I have thought about putting off until spring. I am very active but haven’t had many issues and have been able to do a lot. I still have that concern that it can go out at any time though. So I am struggling if can do without it or should just do it.

    • Hi Carrie, I had not choice but to wait from December to September and mine was already torn. I’d just say be careful. I’d personally get it done asap so you can get on with your recovery/not waste your muscles further through being careful. Hope that helps.

  17. Hi Jo! I have just had my surgery and been researching some recovery tips. And here I am reading your articles in my sickbed, just want to say thank you so much! Really appreciate your efforts to summarize your experience. To be honest this injury hits me way harder mentally than physically, I totally can relate to your feelings (Static bike is BORING and yes I am a sports addict too!), so it feels so great to know I’m not alone. I definitely will take your tips into my recovery program! I hope you can put a full closure to your recovery journey soon and enjoy all the sports as you used too!

    Big love from Hong Kong xx

    • Thanks Janie. It is frustrating and I have to say my physio is ongoing but I’m making progress so there is hope for all of us! Good luck with your recovery!

  18. Super helpful! Currently laid up, 12 hrs post op and looking to recovery quick. My two kids both 2&4 don’t get why I can’t pick them up. Excited to start a plan to recovery ASAP.

    • 🙁 sorry about your kids – it’s hard to explain to them at that age. Don’t try and recover too quickly, it will only slow you in the long run. They can come and have cuddles and then get on your lap as you recover. Maybe save the ‘dead lifts’ for when your knee is a bit stronger. Have a good recovery!

  19. Hi Jo

    Firstly, so sorry to read your mum passed. May she RIP.

    Secondly, thanks for writing in such detail about your ACL journey (project / mission / adventure??). There’s loads for me to deliberate over before I go under the knife! Some fantastic tips and I’ll be dashing over to Bezos World to buy some miracle balls pdq.

    I’ve been doing a fair bit of prehab and have developed quite an affinity for the dreaded static bike. I pass the time by watching Netflix docs…. just finished Making a Murderer… pretty decent.

    Unfortunately I switched to a different physio for one session and that put back my prehab by a few weeks thanks to the Nordic hamstring extensions he had me doing!

    Thanks again


    PS. You have a brilliant way of writing…. I reckon you could make a career of it 😉

    • Hi Isaac, the pre-hab is so important. I was so slack at it, looking back. All it takes is one bad physio tip and – grrrr! Glad you’re back on track. Get stocked up and I hope the recover goes well. I’m part way through Making a Murderer – no spoilers, please! Also, thanks for the kind words about my mum, and my writing ;p

      • Thank you Jo for sharing your experience. It’s so helpful as there really isn’t much out there from a point of view of understanding the process. I’m 3 weeks post op today and I’m constantly worrying about my knee and if pain/discomfort is normal. Trying to get on with my physio & recovery without becoming a couch potato! Thank you for being so open and also so sorry to hear about your mum. Im wishing you all the best for the future and full recovery.

        • Thanks Raquel, I also worried a lot. Keep at it and keep following your physio’s advice. Thanks for your kind words. I wish you all the best also 🙂

  20. Thank you Jo. I read your posts before my surgery and enjoyed reading this after-the fact analysis. I am 2 months post-op on my ACL (allograft) & meniscus repair… 4 months from the date of my original injury. I am also a runner though and though I am chomping at the bit to try it, have so far resisted upon recommendation of my Physical Therapist. Oh and I am also almost 60 years old. Had some difficulty even finding a doc to do surgery because of my age but am so glad I persisted. I agree 100% with everything in your post. Best of luck to you as you continue the recovery journey; it is hard work!

    • Hi Linda, I’m glad you found a doc to do the op and that it went well. The thing I’ve learned with the running is that you have to take it really slowly. At the moment I’m on an increase of 2 minutes every month! THAT slowly. Your PT will be able to devise a plan for you but I was shocked at how slowly I have to take the running. Good luck with the recovery.


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