After the operation, recovery begins
Ligamentoplasty of the knee, most often to reconstruct the anterior cruciate ligament (ACL) is a well-codified surgery, frequently performed in sports or active patients. But a successful operation alone does not guarantee a good result: everything depends on rehabilitation.
Dr. Coulin reminds every patient: it is the efforts made after surgery that make all the difference. Rigorous rehabilitation is the key to finding a stable knee, mobile and efficient, on a daily basis as well as in sports.
A multi-phase recovery protocol
Rehabilitation after ACS reconstruction takes place in gradual stages, with clear objectives at each phase. It can last from 6 to 12 months, depending on age, activity, type of graft and any associated lesions.
Step 1 : Protect, relieve, initiate (day 1 to week 4)
The objective is twofold : to protect the graft and prevent post-operative complications.
- Management of pain and edema (ice, elevation, anti-inflammatories if needed).
- Work on the complete extension of the knee, essential to avoid stiffness.
- Partial support then progressive with crutches (according to the surgeon’s instructions).
- Gentle muscle awakening (quadriceps, hamstrings).
- No sport or exercise in torsion.
The patient is closely monitored in physiotherapy and surgical consultation.
Step 2 : Walk, strengthen, stabilize (week 4 to week 12)
When healing is well underway, the goal is to return to normal walking, strengthen muscles, and work on joint stability.
- Free support and walk without crutches.
- Progressive muscle strengthening (closed chain).
- Proprioceptive work (balance, coordination).
- Stationary bike, swimming, elliptical without impact.
Tracking the amplitude gain is fundamental to avoid bending or extension blockages.
Step 3 : Reathleticization (3 to 6 months)
The knee is stronger, but not yet ready to resume pivot-contact sports.
- Straight-line races (without changing the support).
- More intensive strengthening (gluteus, trunk, legs).
- Functional work (jumps, stairs, mini-accelerations).
- Control tests to evaluate symmetry and stability.
Dr. Coulin collaborates with physiotherapists specialized in sports and orthopaedics to guide this strategic phase.
Step 4 : Return to sport in safety (6 to 12 months)
The resumption of pivot sports (ski, football, rugby, handball, tennis) must not be done too early. The graft needs time to firmly integrate into the bone, and neuromuscular reflexes need to be rehabilitated.
- Isokinetic and proprioceptive tests.
- Simulations of sports gestures.
- Gradual resumption, supervised, with medical follow-up.
The complete return to sport is usually allowed between 9 and 12 months after the operation, sometimes earlier for online sports.
Why follow a rigorous rehabilitation ?
A well-conducted rehabilitation allows :
- To protect the graft in the critical early months.
- To avoid stiffness or residual pain.
- To restore muscle and joint symmetry.
- To reduce the risk of recurrence, particularly among athletes.
- To regain confidence in one’s knee before the recovery.
A motivated, well-accompanied and well-informed patient puts all the odds on their side.
Did you just have a cruciate ligament surgery ?
Dr Coulin provides personalized post-operative follow-up in Geneva, in close collaboration with rehabilitation professionals. The goal is simple : to help you recover completely, without haste or loss of performance.
