The Infamous ACL Tear: Part 2, The Road to Recovery

15 min readJan 30, 2022

You can do it!

Preface

I will talk about what my journey was like, the ups and downs, and the things I learned along the way. As I mentioned in my first article, one of the most important things in this journey is developing a good relationship with your PT and your doctor. It is crucial that you set realistic expectations and goals early on so that you are all on the same page and so that you have something tangible to work towards.

Intro + PT

It has been 6 months since I had surgery, and I am officially done with (weekly in office) PT. It went on a little longer than expected, but this was by choice — I wanted to get back to top sports shape so I could return to soccer, or at least that was the plan. Due to the rigorous prehab I did that I mentioned in my first article, I didn’t need to spend more than 4–4.5 months in PT. The last 1.5–2 months were all dedicated to advanced movements, sprinting, cutting, soccer-related movements, increased flexibility, etc.

Weeks 1–2: A whole lot of nothing

These were probably the most challenging. Immediately following the surgery, the nurse helped me out of the hospital bed, and I had no idea what it would feel like to stand, so in trying I almost collapsed because I had no feeling in my right leg… I instantly had a hunch what the next few weeks would be like. I left in a wheelchair — the first time I had ever been in one, so that was another weird feeling.

My father greeted me outside the hospital, and we went right home where I immediately hobbled to the kitchen on my crutches to feast. You must fast from the night before so naturally I was starving. I ate standing, leaning on my unaffected left side, because I wanted to stand whenever I could, assuming I would be spending much of my time in the near future seated… and I was right.

For the first few days I laid on a couch with my leg in a “CPM” Machine, which stands for continuous passive motion and looks like the below image.

It does exactly what you would expect — it moves your leg for you up and down, for 8 hours a day. I drank lots of water to stay hydrated, which is super important post-surgery. It also helps you to come up with an excuse to get up occasionally and use the restroom and get out of the machine once in a while to avoid cramping.

I took a few days off from work, but there wasn’t any noticeable pain in the beginning — most of my leg was numb thankfully, but as you can see from the picture below, the overall scarring and sets on incisions were quite minor; this is due to great craftmanship and expertise from my surgeon as well the fact that he performed arthroscopic surgery (minimally invasive).

I recommend doing the surgery later in the week so you can additionally take the weekend to recover and fewer days off from work. The following Monday I returned to work and (eventually) built myself a wooden snack tray to mount my laptop on — this isn’t critical and you can use many different stands and apparatuses, but you need something to mount a laptop on whilst sitting in the CPM which is a kind of large and cumbersome machine to maneuver around, especially with a laptop.

I didn’t leave the house for a week and a half — there wasn’t anywhere really worth going with the effort of getting in and out of my brace, dealing with the car and riding with the crutches, etc. A few days later, two weekends after the surgery, was my childhood best friend’s birthday. Months before the surgery I had planned around this date intentionally, something that was quite difficult, which I discussed in my previous article. My plan worked, with a little bit of liquid courage, I was able to return to the dance floor hopping around on one leg with a brace on the other, getting sympathy of other athletes who knew and drunkenly remarked, “ACL BRO!” or “Good for you man!” It was definitely encouraging at the time, but not at all the way I expected to bond and make new friends that night; looking back I guess it is something that is a bigger part of my life than just an injury or operation. Anyway, at the end of the night the muscles in my left leg were throbbing and engorged with blood from all the time spent with all my weight on it. As fun and as worth as this was, I knew I couldn’t keep this up because it would lead to imbalances, which was the exact opposite of my goals of returning to normal, which would start the following week.

Weeks 3–4: Laying the groundwork

Monday of week 3 was the real beginning of my efforts towards recovery. I started PT back up with the same physical therapist I had for prehab and I was no longer on crutches. This was very different than just a few weeks earlier; the last time I was in PT I was doing heavy lifting, deep squatting, full stretches, etc.; this time I was just trying to make my leg move and put a little weight behind it. The first sessions definitely were discouraging as there wasn’t a lot to do other than sit and shake my leg, but every day I could more comfortably put more weight on the leg.

After just a few days of PT and walking, 15 days after surgery — I made my return to the gym, braced up and all.

As I discussed in my previous article, I set the goal of going into the surgery in the best possible shape, and after not working out for 2 weeks, I was determined to pick up where I left off and then some. This was among the most important for my recovery, for it not only strengthened the muscles around the surgical area, it helped instill in me a routine and work ethic to focus on daily strengthening and healing. I would go PT as a warmup, then go to the gym, then go home and stretch, and end the night with PT at home again in the evening.

Consistency became the most important thing. I set a reminder in my phone everyday to do PT when I didn’t have a scheduled session and every night to do the same. Whenever I missed a session I would feel extra tightness and stiffness, that was very apparent due to the lack of training. I set daily reminders to stand, go for very short walks, massage my leg, and just keep generally active.

These 2 weeks weren’t super pivotal, but they helped me develop an understanding of what was needed with regard to time commitment, effort, etc.

Weeks 5–8: Raising the Bar

I got into a rhythm and it was time to start picking up the pace. Given that I was going to the gym every day, this meant I just had to tailor a portion of my routine towards now building strength in the problem areas. Sticking with constant PT, my flexibility was increasing along with my overall ability to utilize my quad, which a few weeks earlier I had little activation and brain-muscle connection. In the gym, I switched to a sport brace instead of the full hospital brace.

Week over week my PT would push me to stretch further, push harder, and try new things. Every weeks we would take ROM (range of motion) measurements to track progress, as this along with general strength and activation are the key indicators of success.

I started wearing my knee brace a little less, especially not around the house. I relied less on the CPM machine and started to spend more time standing during the workday and taking short walks. Staying active was really important to minimize stiffness and continue to make progress.

This is when mentally things to start get better, as the idea of returning to normal becomes more conceivable, again, if you stick with it. I felt more confident and in control going to more places, restaurants, malls, longer walks, etc. I still always moved slowly and carefully and made sure to the wear brace at all times as this is when the knee is the most fragile right after the surgery while the ligaments are reconnecting.

I checked in with my doctor once a month, and it was reassuring to see him and my PT be in agreement about my progress. This is another critical relationship you have to maintain, for your doctor is the one who recommends and determines when you’re ready to try new things at PT and in the gym. At the end of this phase, he allowed me to return to light-weight open-chain exercises, like leg extension and leg press, for example. Being a soccer player and weight-lifter, this was a very good sign because these are critical muscle-building exercises. I had to be sure to do extra on my right leg because it was so far behind that of my left leg.

Weeks 9–12: Pretending to be Normal

At this point I was able to pretend that even though I had an injury and a huge daily time commitment dedicated towards recovery, for all intents and purposes I tried to live life normally again. I had a few good friends in NYC I went to visit often, went on some dates, went dancing more, all still with the brace unfortunately, but more confidently and less restricted overall.

At this point I was able to now add an entire leg day to my gym regiment. I did this after PT intentionally so I would have a good warm up and be loosened before lifting. The routine mirrored my old routine, save squatting — this I held on for because having that heavy a load pushing down via gravity was not comfortable. As for the rest of the routine I started light and slow, but was able to quickly make progress, especially on single-leg exercises, given that I had residual muscle from prehab that I simply needed to learn to use.

At PT we focused on increasingly difficult balancing exercises, some of which you’d see in the NFL training, sprint training, etc. We also worked on reaction time and acute strength in all the different parts of the leg. The measurements were heading in the right direction and the doctor cleared me for heavier lifting, including squatting. My outdoor walks turned into slow jogs and I wore the brace less and less.

Weeks 13–18: Putting it all Together

At this point I was mostly functional and back to normal with great ROM, flexibility, and reduced tension and adhesion in all the original problematic areas. My leg day became a legitimate leg with the goal of rebuilding the muscle and strength I had prior to the surgery. Through progressive overload, week over week I inched closer and closer to these previous numbers.

With regard to PT, we did things I couldn’t at a gym or needed a partner for. We continued to make measurements but the last few degrees of ROM were always the slowest and showed the smallest progress, which was as expected. We also did more competitive exercises, hard cutting and sprints, HIIT workouts, etc.

Weeks 18–24: Setting good long-term habits

The last few weeks I needed PT less and less and went from 3 days to 2 and eventually only 1 day a week. We switched back to deeper, slower stretches to really mimic that 100%, unaffected sense of normalcy. This helped instill in me the reminder of stretching and warming up before and after all activities, soccer, lifting, etc. Since then I have continued to increase my flexibility in strength in stabilizer and auxiliary muscles throughout my whole body.

As you see in the video below, I hit my 6-month goal of hitting a squat at the same depth and personal record weight of 315 pounds, which is what I did before the surgery. This was a huge accomplishment and atypical post ACL surgery, and I am proud of myself for staying on track. Having this goal was super helpful for this because it was just another metric I had to track progress for, and it also marked my official last day of PT down to the day; ready or not, I was determined to hit my goal.

https://www.instagram.com/reel/CYIIUA8NzK_/?utm_source=ig_web_copy_link

Family and Friends

This is a huge part of the entire process that you can’t take for granted and you need to set some expectations and understanding early on. I was very fortunate and blessed to be with a loving family that I was able to stay with during the surgery and the whole recovery period.

Yet, even with all the above, it is still very burdensome. In the beginning when I wasn’t leaving the house at all, things like groceries and physically being helped around the house, up the stairs, asking for a glass of water, really add up over time. I also had the help of some friends to take me around to lessen the burden on my family. Eventually with both groups I was able to create routines to optimize everyone’s time.

Fitness and Nutrition

I already covered sufficient fitness throughout the article, but if you have any specific questions I didn’t address feel free to reach out!

With regards to nutrition there’s 2 things to consider:

- 1. Your inability to perform most cardio and lower-body exercises

- 2. There are additional things you can take to help speed up recovery

Disclosure: I am not a licensed nutritionist and offering suggestions and simply what worked for me. If you have any questions feel free to reach out!

On the first point, it’s very common that people gain weight after the surgery for that reason specifically. This isn’t inevitable if you plan accordingly with your diet and try to maximize the exercises that you actually can perform. Overall, there will be a few changes to be made. For example, you will need to go in a greater caloric deficit than normal given you are far more sedentary. Additionally, you will want to minimize higher-glycemic carbs because you won’t need equitable energy. I recommend doing more research to get a full list of changes.

In addition to what you eat, there are a few things that are recommended to aid in the overall health and recovery from the surgery. Generally speaking, you want to add supplements that will help to reduce inflammation. The first few weeks you’ll be on painkillers and ibuprofen, but this definitely isn’t a good long-term solution. I drank lots of green tea with turmeric and ginger; you can add honey if its overbearing. Another big one is collagen, which is the main protein that ligaments and tendons are made of. By taking this safe supplement, again — safe because you’re made up of it, you are giving your body more to pull from to help rebuilding and re-attaching your newly surgically added or repaired ligament. Collagen comes in many options for intake — I personally take it as an unflavored powder thrown into my protein shakes.

Mental + Psychological + Emotional Wellbeing — the Rollercoaster

This is probably among the most important of all aspects of the recovery process. There are many difficulties along the way, but none are more difficult than this. Physical progress has a general upward trend, with only small potential drops or deviations week over week that you can push through more easily. The non-physical sentiments though, could drastically swing depending on the situation and how you handle it, which is exactly why I am writing this article — to help prepare you as much as possible.

There are many different ways to cope, so I’ll share some that worked with me. For starters, I became much closer to my family; we had more meals more frequently and talked more — I continued to become more grateful and always cooked when I could to try and reciprocate for all the extra help they provided for me. Likewise, I spent more time with my friends, watching plenty of live sports at home, at bars, etc. We went out a lot more, “squaded” up together, met new people wherever we went, and always tried to stay social and active — these all provided great distractions for me, which is sometimes all I needed.

On my own, I decided to journal and read as often as possible, especially since I had so much time sitting. I would journal about whatever came to mind, and often followed a pattern of talking about goals and learnings I had that day. I also spent time more reading and powered through a few books, which I struggled to find time before this. I even tried my hand at wood-working and built a few cool projects I am (now months later) proud of. Everybody’s journey will be different and non-linear, and everyone will find his or her way to get through it, which is why it is important you take the time to get to know yourself better. Try to think about all those things you wish you had time for, because now may be the best time and opportunity, and it will most likely also help you mentally more than you could imagine.

Hobbies and goals

As I stated in the last section hobbies are pretty straightforward, but they are often smaller in scope with regards to time commitment have a clear and abrupt ending in sight. Finishing a book, completing a wooden table, the end of the sport season, etc. All the little hobbies I had were ephemeral “quick wins,” because that’s what I needed at the beginning. I wanted a way to stay positive, and what better way to do that than to accomplish small feats often. But after a while, the desire for something bigger and something more permanent grew inside me.

I decided I need something that would take months of effort, that would coincide along with my overall recovery. The squat goal I shared above was one big one, as it truly took me 6 months to confidently get there. But that was still too finite, and I needed to look beyond my PT journey, because it doesn’t really end there. I am nearing 7 months post-surgery, and still spend time stretching and taking care of it every day.

I eventually found bodybuilding and decided to pursue it for a few different reasons:

It would help me stay in shape overall
It would help keep me accountable for my stretching and at-home PT
It would help me eat healthy
It would give me a daily routine
I could have little wins
I could set long-term goals
I would have to give up certain things like soccer and skiing, which are 2 high-ACL injury-prone sports, so this would keep me out of trouble as well

And finally, because it was something I always wanted to and finally found the time to do it. Over the last few months, focusing one major goal, I have been able to be busier, more positive, and overall happier with something to look forward to. Of course, I didn’t want or plan to tear my ACL in order to learn and experience what I have had in the last few months, but it is helped me grow in many ways and for that I am grateful.

Here’s a few photos of me about 3 months in overall independent training and as you see — no brace and my legs are nearly equitable in strength!: