ACL Rehab: The Journey.

The ACL rehab is a journey. There are physical, mental and emotional aspects of it that all deserve their own articles.  This is an overview of common experiences.

The physical aspect

Once you had your surgery, your leg will be wrapped, and you will be using crutches. Under your bandage, you will find three portal sites and sometimes a scar right below your knee cap. The time spent on crutches can vary greatly, ranging from 3-5 days to as long as 3-4 weeks. You will begin physical therapy within 2-7 days after surgery.

Therapy typically lasts 9-12 months, at which point you should be strong enough to return to sports. ACL rehab is long, at times it is boring, you can experience pain around the knee and your lifestyle will have to be adjusted drastically. It is very difficult for very active people to follow rules and timelines that hold them back from doing what they love. Yet, patience is absolutely necessary in order to allow your ACL graft to appropriately heal. That brings me to my next point.

The mental aspect

You will be tested. “Patience is a virtue” will have never sounded so annoying. You will have days of highs and lows. In other words, you will feel elated like a baby learning a new skill for the first time and you will feel frustration that will make you cry. Be ready for the roller coaster of emotions that is ACL rehab.

It will be nerve-racking as there is always the little voice in your head, replaying the ACL injury, asking, “Will it happen again?” So, every twist, crackle sound, and weird sensation in your knee will have you paranoid and scared. You will have to dig down, find your grit, and get through the boring parts and the hard days to focus on the achieved milestones.

The emotional aspect

You may feel as though you were left behind. You’re watching your friends and family from the sidelines, doing the things that you used to love doing. It is very hard. Because of this struggle, you will become stronger and grow as an individual, gaining a view of life from this whole different perspective.

In working with high-school athletes, I witness the emotional effect the ACL injury has on the other family members, particularly the patient’s parents. For an account of a parent’s experience, I encourage you to read the chapter “A Tango For Gabriel” from the memoir Traveling Heavy by the cultural anthropologist Ruth Behar (available on Amazon and possibly at your local library). In this chapter, Ruth Behar recalls her experience as a mother when her 12-year-old son tore his ACL. It is an incredibly accurate portrayal of what it’s like to watch your child injure their ACL and then going through the medical system in ACL rehab.

I quote an excerpt below for educational purposes, as the author gives voice to the emotional turmoil of ACL recovery:

Excerpt (pg. 47) from Traveling Heavy by Ruth Behar:

“Before surgery, the doctor saw his patients in a private examining room, but after surgery, after he’d used his knife, they were all seen publicly in the clinic. Patient after patient, dozens of people, waited at the exam tables. There was the day the boy to our left, just before Gabriel’s turn, received bad news. The doctor said something that made it clear that sports were over for the boy. He wept. His mother stood next to him like a ghost. Then the doctor came to Gabriel’s side. Gabriel was doing well. He was still one of the model patients. The doctor patted him on the back. He checked Gabriel’s knee, checked his gait. Everything was fine. He could go forward, play sports. We were the lucky ones.”

– Ruth Behar, Traveling Heavy

In conclusion, treat the ACL rehab process with well-deserved respect and you will get through it. I have seen many high school kids turn into young men and women and mature in front of my own eyes during ACL rehab, because it is either sink or swim. This event will shape greatly who you are and what you do for the rest of your life.