ACL Surgery Recovery: A Physical Therapist's Guide to Latest Treatments & Best Practices

The ACL surgery recovery treatments are consistently evolving. With the many choices available today, it can be difficult for a patient to decide. To get the latest on ACL surgery and rehabilitation, we sat down with Dr. Ryan Miyamoto, an orthopedic surgeon considered among the best in Northern Virginia.

Watch the full interview here on our YouTube page.

Learn more about Dr. Miyamoto at www.ryanmiyamotomd.com

Overview of Current Options for ACL Surgery

Before we jump right into that rehab, we need to understand that ACL surgery has changed a lot ever since. When discussing one of the latest trends in A.C.L. reconstruction, Dr. Miyamoto says, “We are seeing a big comeback of quad autograft.” Other advancements, such as the BEAR implant, provide new reconstruction options in select cases.

The Evolution of ACL Rehabilitation

Blood Flow Restriction Training

Blood flow restriction (BFR) training has been one of the most critical advancements in ACL rehabilitation. Patients can lift lighter loads while still effectively recruiting their muscle fibers through this method. In our role as a physical therapist, when using BFR, we have seen really great results in:

• Strengthening in the early postoperative period

• Reducing quad atrophy

• Early Return to Function

• Managing Pain with Strengthening

The Comeback of Quad-Based Training

The most significant change in rehabilitation after an ACL injury is the increased focus on strengthening the quadriceps in isolation. “The long arc quad stuff that we used to avoid, I feel like that’s less a daunting exercise than it used to be,” Dr. Miyamoto says.

As physical therapists, we’ve seen that:

• Early quad activation is key

• There is nothing wrong with isolated exercises like leg extensions when executed correctly.

• Functional exercises in isolation may not be enough to target quad strength.

• The quad weakness seen in many failed ACL recoveries

Creating a Successful Recovery Timeline

The road to recovery is not a race but a race of milestones you should hit. Every patient presents differently, but our areas of focus are generally:

1. Early Phase (0-6 weeks):

2. Controlling swelling

3. Restoring range of motion

4. Initiating quad activation

5. Increased blood flow restriction training

6. Building Phase (6-12 weeks):

7. Progressive strengthening

8. Normalizing gait patterns

9. Functional activities progression

10. Continuing BFR training

11. Return to Function Phase (3-6 months):

12. Advanced strengthening

13. Sport-specific training

14. Movement pattern restoration

15. Balance and agility work

16. Return to Sport Phase (6-9+ months)

17. Sport-specific testing

18. Movement analysis

19. Strength testing

20. Gradual return to activity

The Truth About Return to Sport

One of the most common questions we receive is when can I get back to sports after my ACL surgery? Dr. Miyamoto emphasizes that rushing back too early can significantly increase re-injury risk. The current research shows:

• Return before 6 months increases re-injury risk

• 8-9 months is often optimal for safe return

• Individual readiness matters more than time

• Comprehensive testing is crucial before clearance

What Sets Apart Successful Recoveries

In our experience as physical therapists, the most successful ACL recoveries share several common elements:

1. Comprehensive Team Approach

2. Regular communication between PT and surgeon

3. Clear, shared goals

4. Consistent progress monitoring

5. Patient education and involvement

6. Focus on Quality Over Speed

7. Emphasis on proper movement patterns

8. Regular strength testing

9. Attention to compensations

10. Progressive loading based on individual response

11. Patient Engagement

12. Understanding of recovery timeline

13. Commitment to home exercise program

14. Regular attendance at PT sessions

15. Clear communication about goals and concerns

Taking Action for Your Recovery

If you're facing ACL surgery or currently in recovery, consider these key steps:

1. Choose your healthcare team carefully

2. Discuss surgical options thoroughly with your surgeon

3. Start physical therapy with a provider experienced in ACL rehabilitation

4. Set realistic goals and timelines

5. Stay committed to your rehabilitation program

If you are looking to start your ACL recovery or are not quite back to where you wanted to be months or even years later, we’d love to help! Contact our team to schedule an evaluation and learn how we can help you achieve your recovery goals.