You need to be guided by a physiotherapist at this time
At 4 weeks: usually ready for driving and return to work.
Continue to progress according to your abilities.
- Progress with closed kinetic chain exercises.
- Progress unilateral exercises: sitting to standing, dips, exercise bike and step machines.
- Progress with resisted hamstrings exercises.
- Progress with dynamic proprioceptive exercises.
- Carefully resume gym work at week 4 -6
- Swimming: straight leg kick only, and pool exercises.
If you have patella problems (clicking, grinding, pain) try taping patella medially. Pain at the front of the knee at this stage is very common and is due to your thigh muscles catching up with your level of activity. It will settle with time.
You should have a full range of movement (symmetrical full extension to full flexion) by the end of this period.
Seated toe drags
Biking with toe clips
Very little information exists in current literature about the ability of ACL injured or reconstructed knees to respond to situation-specific stimuli, such as braking quickly while driving a car. It is difficult to determine when it is safe to return to driving following surgery. A recent study from Australia seems to indicate that following a right ACL reconstruction patients should wait at least six weeks before driving again. However, this could take place at two weeks for patients with left ACL reconstruction (or when they are able to operate the clutch if they are driving a manual car). If in any doubt check with your insurance company before recommencing driving.
There is no universal agreement as to when it is safe to travel by plane after an ACL reconstruction. It seems that most Orthopaedic Surgeons advise their patients not to fly for 4 to 6 weeks following the ACL reconstruction. Short flights do not seem to be a problem. However, long intercontinental flights are a potential problem as there is an increased incidence of spontaneous DVT (deep venous thrombosis), even in the young and healthy passengers. It is possible that sitting for long period of time, in a confined space could predispose to the development of deep venous blood clots, especially in people following recent knee surgery. If you have to travel by plane, between 2 and 4 weeks after your ACL reconstruction, it would be wise to contact your airline’s Medical Department and ask them for advice. Also, please discuss this issue with your GP, as you may have to take prophylactic Aspirin (as anticoagulant) for several weeks.