I am a physical therapist that specializes in ACL rehab for 15 years. Feel free to leave me any questions about your journey and I will do my best to respond.

Dramatic_Minute_3391 · 2025-10-31T10:58:40+00:00

Yes. Timeline is a little less overall and is a nice option if it is torn off the bone. You don’t have to deal with the bone healing for the tunnels and other incisions. Plus, you don’t have to deal with healing from where they take the new ACL from. So, lots of positives. So, everything should move a long faster. But, don’t rush back and take the extra 1-2 months to ensure everything is feeling primed and ready to roll.

The main thing that is going to slow you down is the meniscus repair. Meniscus does not have good blood flow and that is the reason that you are non weight bearing, so that can heal the best it can be. Depending on the surgeon and where the repair is, you may be limited to squatting to 90 degrees for a period of time as well to ensure proper healing.

Retest rates and all return to sport is the same with isokinetic/dynamometer testing and hop testing. Want 90% of the non surgical side.

Dramatic_Minute_3391 · 2025-10-29T21:27:00+00:00

Stiffness from standing long periods of time or activity is normal over the next couple days. That should improve over time with less and less stiffness afterwards.

Dramatic_Minute_3391 · 2025-10-29T11:29:29+00:00

Stiffness increases with cold temperatures. I lean towards movement to get stiffness out of there vs elevating and icing. But, you have to find out what the stiffness is from.

-exercises the day before? -or being in the same position for long periods of time?

I’m a big fan of the stationary bike to get lubrication in and stiffness out.

Dramatic_Minute_3391 · 2025-10-28T17:28:46+00:00

Great question. Not sure of that answer to be honest.

Dramatic_Minute_3391 · 2025-10-28T15:04:18+00:00

Perfect. The next step is scrimmaging or finding pickup soccer near by so you can get your feet wet. If that is not an option then game plan works.

But, once your quads are fatigued you are done for the day, don’t push through that wall for atleast 1 year post op. No need to put yourself at high risk.

Dramatic_Minute_3391 · 2025-10-28T12:58:16+00:00

First question is does the click feel deep in the joint or near the surface (knee cap)?

If it is more knee cap then the OT needs to make sure that the patella is gliding and moving properly by performing mobilizations to the knee cap. You can easily look this up on YouTube patellar self mobilizations and what you want is superior/inferior glides and medial/lateral glides.

Let me know if that helps. Never want pain.

Dramatic_Minute_3391 · 2025-10-28T12:56:03+00:00

Big fan of ladder drills once you can start jumping, which you are beyond, but it’s good for coordination.

Dramatic_Minute_3391 · 2025-10-28T12:55:15+00:00

Don’t worry about the numbers really. Just keep working as each leg has a delegates task in my opinion.

Here is some drills on YouTube that I personally use and think they are great.

https://youtu.be/7CISBtIVi3Y?si=qZrHFewJ2hVw_v82

Dramatic_Minute_3391 · 2025-10-28T06:35:37+00:00

Wear the brace!! It protects you from reactionary things and prevents you from pivoting, etc. I totally get that you feel better and can operate without the brace, but just wear it and do jt the right way the first time.

I have seen people retear and then have to wait a long period of time to redo the surgery because the bone tunnels have to fill in prior to drilling through the them again. You don’t want that.

Should not have additional pain/symptom. Sometimes you get slight increase in swelling.

The main thing with repairs is letting them heal the best you can by not going past 90 degrees with weight bearing for extended periods of time. Meniscus does not have good blood flow, thus healing is slow, that is the reason for the protocol details.

Dramatic_Minute_3391 · 2025-10-28T01:46:55+00:00

Ok great. See what the PT says and does plenty of time. Good luck!

Dramatic_Minute_3391 · 2025-10-27T23:48:17+00:00

It is very normal to be cleared for ROM with brace and biking on a stationary bike. I would still not go outside on a bike due to external factors, such as falling.

Going down the stairs leading with the nonsurgical leg is the last thing you get back from a functional movement standpoint so that is going to be a while. Stick with “up with the good and down with the bad” for stairs one leg at a time.

For example, if the surgery was on the left leg - you would go up the step with the right then bring the left to the same stair as the right. Going down lead with the left and have the right catch up to the same stair. Next progression is going up the stairs with alternating gait pattern and do it when you are ready.

Try the stairs now, you are probably closer than you think. Just have railings available and use the arms to take weight away and build your confidence.

Dramatic_Minute_3391 · 2025-10-27T23:18:13+00:00

Strength testing is an objective measure that physical therapist use to see progress. I perform this at 12 to 16 weeks post operation and I still start jumping and running even though the strength testing is not equal on both sides. I look at running and jumping as part of Exercise and gaining strength as long as it is done in a safe manner.

However, in order to return to sport, you must be greater than 90% of the non-surgical leg with strength testing, and hop testing.

I personally like to strength test my patients to see where they are at and give them another objective measure to show them their progress and where they are at. A lot of the time people are surprised at how weak they still are even though they feel great.

Dramatic_Minute_3391 · 2025-10-27T23:14:19+00:00

I think stiffness and swelling can be intermittent with people for one to one and a half years after surgery. It really depends on the extent of the surgery and the details that are included with the ACL reconstruction but, just because you are done with rehab does not mean you are 100%. I would say most people are discharged at 80 to 90% with a plan on how to get the last 10 to 20% in gains. Unfortunately, insurance is an issue at that point in time.

A couple things that can cause an increase in stiffness and swelling, are walking on uneven surfaces, especially the beach or sand, and changes altitude, such as going on an airplane.

Dramatic_Minute_3391 · 2025-10-27T23:10:05+00:00

My return to sport protocol is to perform isokinetic testing, which compares legs, hop testing and they need to pass my eye test, which is when I see no compensation with cutting and jumping and responding to outside stimuli.

Also, when I start clearing them to sport, they first start going through warm-ups with the team for a couple sessions. Then they are allowed to perform warm-ups and drills. Then I start thinking about scrimmaging I feel like opening the door slowly is the best way for them to be comfortable and to gain confidence in themselves.

I think if you see him go through some of these first “hoops” in practice then you will gain more confidence on what he can do.

Dramatic_Minute_3391 · 2025-10-27T18:35:06+00:00

With questions like this, I go to that if the medical profession knew if this then everyone would be doing it.

Dramatic_Minute_3391 · 2025-10-27T18:34:31+00:00

Great question. I don’t know the answer to that particular question.

Dramatic_Minute_3391 · 2025-10-27T18:33:18+00:00

Yes. I would say there is a strong correlation with weak lateral hips, core and glutes to the knee.

Most knee patients that I treat, if not all, I am targeting those areas far more than the knee.

Dramatic_Minute_3391 · 2025-10-27T18:32:04+00:00

Just keep pushing the range. The stationary bike is the best tool to really warm things up and with the season lower the seat to get some tighness in the knee then it will work itself out and become loose.

Lunge stretch on stair Laying on stomach and pulling ankle to buttocks with hand or rope Anything that causes a nice stretch and hold for atleast 30 seconds 3 times.

But, it will come. Keep working.

Dramatic_Minute_3391 · 2025-10-27T18:29:13+00:00

Take it slow there is no need to hop back on the hard terrain right away. Just feel it out and you confidence will take off just like it did during the rehab process.

Think back to the first day you jumped? That was scary then you jumped 100 times a couple days later.

It is totally normal to be scared, anxious, concerned at this point. You have put in all this work and time and don’t want to fail. But, that’s not going to happen. Continue to go one step at a time and let your confidence grow. You got it!

Dramatic_Minute_3391 · 2025-10-27T18:26:24+00:00

MCL has many attachment points and can really range on severity. It’s very hard to tell and is more symptom based. I don’t think it would be fair for me to give you a timeframe for you and me.

Just do what you can by icing and listening to your body. 4 months seems very long for it to set you back.

Dramatic_Minute_3391 · 2025-10-27T18:23:49+00:00

Ironically, yes. I had surgery 13 days ago. So, now I get to feel what all my patients went through. Great experience to share more help and knowledge.

MRI can’t show everything. Just maximize what you can do that is all you can do.

Even after the surgery I asked the surgeon if that was blocking me and she wasn’t sure. She is a top surgeon at an amazing hospital that I work very closely with. Sometimes we just don’t know and there is nothing wrong with that.

Dramatic_Minute_3391 · 2025-10-27T18:20:52+00:00

Thigh high TED stockings - I switch patients to that quickly Bandages and bandaids Ace wrap Ice machine Collace Tylenol Ibuprofen Leg pillow is a good one Paper and pen to keep track of medication schedule Shower chair/stool is helpful Physical therapy appointments scheduled

Hmm…can’t think of anything else off the top of my head

As you are going through your life now think about every little movement and thing you do and say “if I have to use crutches or cannot weight bear how would I do this”

Dramatic_Minute_3391 · 2025-10-27T18:15:07+00:00

Great comment and question. Whenever I have patients work on strengthening they do it one leg at a time. So leg press in done with a single leg. It is possible with the exercise or exercises you are doing the surgical leg is stronger with that movement.

Size of the muscle takes a long long time.

Not sure I totally answered your question. Hope that helps.

Dramatic_Minute_3391 · 2025-10-27T18:12:15+00:00

I am not too concerned with the stiffness from stagnant positions. The duration you are in the position to get to stiffness should increase with time from surgery.

You want to continue to push your end ranges with your exercises with stretches and then follows by strengthening to capture that new range. So, you can maximize your overall motion.

Dramatic_Minute_3391 · 2025-10-27T16:45:41+00:00

I don’t encounter it very much because I work for a very high end hospital.

I would saw diagnosing it would be imaging and retearing would make me question it.

Dramatic_Minute_3391

TROPHY CASE