How to Prepare for ACL Surgery

Four Methods:Preparing in the Weeks Before the SurgeryPerforming Exercises in the Weeks Before the SurgeryPreparing on the Day of Your SurgeryEating Foods That Will Help You Heal

An ACL (anterior cruciate ligament) injury is the over-stretching or tearing of the anterior cruciate ligament (ACL) in the knee. This can be an extremely painful injury, and most often happens during intense physical activities such as sports. It may become very difficult to walk on the hurt knee, and painful even to stand up. In some cases, surgery is necessary to recover fully from an ACL injury. However, by taking some steps to prepare for the surgery, you can make a relatively painless transition back to a fully functioning knee.

Method 1
Preparing in the Weeks Before the Surgery

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    Discuss the different aspects of ACL surgery with your physician. This will help you understand the true nature of your health status and assist you in making an informed decision.
    • Ask as many questions as possible. Let the physician know of any concern or anything that is unclear to you.
    • During the ACL surgery, a tendon from other place of your body will be taken and used to surgically reattach the two torn ligaments. This is needed because even surgery cannot simply sew back together the ligament without additional tissue.
    • The surgery is done with the use of a narrow, fiber-optic viewing scope. The surgeon will create a small incision on the knee. The scope will then guide the placement of the ACL graft.
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    Make sure that surgery is the only option. In most cases, surgery is the last option when it comes to ACL injuries. Therefore, you and your physician should have already explored other medical interventions before resorting to surgery.
    • Remember that not all ACL tears needs surgery. People who have only stretched or partially torn their ACL can recover easily with physical therapy and non-invasive treatments.
    • Usually, surgery to treat an ACL tear is needed for athletes who need stronger and more stable ligaments to support intense and sudden movements. Surgery of the ACL may also decrease the chance of its recurrence.
    • There are two cruciate ligaments, the anterior and posterior. Along with these ligaments are the collateral ligaments positioned at the side. When there is more than one ligament injured and other adjacent structures of the knee are affected, then surgery is probably the best option.
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    Set up your house so that you will be able to move around easily after your surgery. Take a moment to think about your living space. If you need to go up or down stairs to reach your bedroom, make sure that this is okay with your surgeon. Otherwise, you will need to come up with an alternate living arrangement.
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    Stop taking NSAIDs two weeks before your surgery. Discontinue your use of non-steroidal anti-inflammatory drugs (NSAIDS). These medicines thin your blood, which can result in complications due to bleeding after or during surgery. In order to reduce your chance of complications, avoid the following medicines:
    • Aleve (Naproxen)
    • Advil (Ibuprofen)
    • Motrin
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    Quit using tobacco products four weeks before your surgery. If you use tobacco products of any kind, discontinue your tobacco use at least 4 weeks before (and for 8 weeks after) your surgery. This is important because tobacco products negatively affect your body’s ability to heal itself, which could lead to infection.
    • There are many online resources to help you stop smoking.
    • Additionally, many commercially available products exist to help, such as patches, nicotine gum, and more.
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    Talk to your doctor one week before your surgery about discontinuing medication used to thin your blood. You will most likely need to stop taking prescription medicines that are used to thin your blood or prevent blood clots from forming 7-days prior to your surgery. These medicines can cause you to bleed excessively during surgery, and should be avoided.
    • Consult with your physician to determine if this applies to you.

Method 2
Performing Exercises in the Weeks Before the Surgery

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    Understand that exercising your ACL will help to speed up your recovery after surgery. Surgery is usually scheduled in advance to give you enough time to prepare and work on an exercise routine. Exercising prior to surgery will restore some of your knee function and will ensure that your knee will be strong enough for the surgery.
    • The main objectives of exercising the ACL are to strengthen the supporting muscles and to improve your range of motion as much as possible.
    • The intensity of the exercise should be gradually increased. Be alert of pain which may signal that you are pushing yourself too much.
    • When pain is felt, stop the exercise immediately and decrease the intensity of the exercise.
    • Your physician might refer you to a physical therapist who will develop an exercise program especially tailored to your current condition.
    • Talk to your doctor before starting any exercise regimens.
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    Perform the heel dig bridge exercise. This exercise will help strengthen your hamstring, gluteus (butt muscles), and hip muscles. Perform 3 sets of 12 repetitions of this exercise.
    • Lie on your back with your hands interlaced on your stomach. Your knees and ankles should be bent in such a way that only your heels are in contact with the floor.
    • Tighten your abdominal muscles and lift your buttocks and hips up off the floor until your knees, hips, and shoulders are all in line.
    • Hold this position for 6 seconds and then slowly go back to the starting position and rest for 10 seconds.
    • Repeat the whole exercise.
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    Try glute sets. This exercise will strengthen your gluteus muscles, which are important when extending and rotating your legs. Do 3 sets of 12 repetitions.
    • Lie on your back with your knees straightened and ankles at a 90 degree angle perpendicular to the floor.
    • Use your elbow to raise your upper body.
    • Squeeze your buttocks as strongly as possible and hold for 6 seconds. Relax for 10 seconds and repeat the whole procedure.
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    Perform hamstring curls. This exercise will develop the muscles at the back of your thigh. Do 3 sets of 12 repetitions.
    • Lie on your stomach with your hands folded to support your head.
      • You can place a washcloth above your knee if your kneecap feels painful or uncomfortable.
    • Bend the injured knee towards your hamstring.
    • Swing down your injured knee back to the starting position in a free-fall, but as the leg is about to hit the floor, “catch” it. Then continue bringing it down again.
    • Perform the same procedure until desired number of repetitions is achieved.
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    Give heel raises a try. This exercise will improve the strength of your calf muscles. Perform 3 sets of 12 repetitions.
    • Stand behind a backrest of a chair and hold it to gain support.
      • Your feet should be a 6 inches apart.
    • Slowly raise your heels off the floor. Keep the knees straight. Hold for 6 seconds and then slowly return to the starting position.
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    Try the straight leg raise exercise. Straight leg raises will strengthen your quadriceps muscles.
    • Sit on the floor/mat with your legs straight out in front of you.
    • Lift your shoulders, using your forearms to maintain this position.
    • Tighten the thigh muscle on the leg of your injured knee.
    • Keep your thigh tight and knee straight while you lift your leg 3 to 5 cm off the floor/mat.
    • Perform this exercise on each leg 5 to 10 times.
    • Hold each contraction for 5 seconds.
    • In time, you should be able to progress to 30 reps on each leg holding each contraction for 10 seconds.
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    Adduct your hip to gain strength. Performing hip adductions will strengthen your hip muscles and increase stability.
    • Lie down on the floor/mat with your legs bent.
    • Place a pillow between your knees.
    • Squeeze your knees together.
    • Hold this position for 5 seconds.
    • Rest for 5 seconds.
    • Repeat 5 to 10 times.
    • As you become stronger, increase your reps and your time progressing to 30 times and holding each rep for 10 to 15 seconds.
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    Strengthen your calves with calf raises. Calf raises will build the muscles in the lower part of your legs and enable you to support your legs properly.
    • Stand facing a wall.
    • Place your feet shoulder width apart.
    • Point your toes straight ahead.
    • Lift your heels so you are standing on your toes.
    • Begin with a set of 10, holding each lift for 5 seconds.
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    Ice and wrap your knee after exercising to manage swelling. Manage any swelling with elevation, ice packs and a wrap (ace bandage). If you notice that your knee swells more or your knee pain increases following exercise, bring the swelling down by wrapping your knee in an ace bandage, elevating it and using ice.
    • Ice packs can remain on your knee for 15 to 20 minutes.
    • Make sure you have a barrier between your skin and the ice; otherwise, you could damage your tissues.
    • You can use ice on your knee once every hour.
    • Bringing the swelling down will ultimately decrease your pain level.
    • Rest your knee and contact your physiotherapist or surgeon before resuming your exercise routine.
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    Use crutches or braces if required by your doctor. If your surgeon instructs you to do so, use your brace or crutches to get around. Avoid limping around and further aggravating your knee.

Method 3
Preparing on the Day of Your Surgery

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    Stop eating and drinking by 12 am the night before your surgery. Typically, you will be instructed to fast for at least 12 hours prior to your appointed hour of surgery. Fasting will reduce the chances of nausea or throwing up during surgery, which can be triggered by some types of anesthesia.
    • Fasting includes gum, mints, and other small items.
    • You can brush your teeth; just do not swallow any of the water or toothpaste.
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    Arrange for someone to drive you home after your surgery. You will be discouraged from driving home after the surgery, due to residual effects of the anesthesia. Arrange a driver so you can get home after you are discharged without any delay.
    • Your driver can also help you get your medications from the pharmacy on the way home.
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    Wear your glasses and leave unnecessary items at home. Try to avoid placing anything on your body that could inadvertently interfere with the surgical procedure. This includes jewelry, makeup, perfume, cologne, lotions, etc. Also, wear glasses instead of contacts, as your eyes may be dried out during the surgery.
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    Bring the necessary paperwork to the hospital. To expedite the process of registration and make sure you are ready for surgery on time, make sure to bring the required items. Bringing these items and having them on hand will save you time digging through your bags or returning home to get them. Bring:
    • A photo ID (driver’s license or state identification card).
    • Your health insurance card.
    • A form of payment if another arrangement has not already been made.
    • A list of the medications you are taking, the dosage and time of the day that you take them.
    • You should also bring a list of the medications you are allergic or have had a reaction to.
    • Walker or crutches, if necessary.
    • Bring a case for your glasses, dentures and hearing aid, if applicable. All of these items will be removed prior to surgery.

Method 4
Eating Foods That Will Help You Heal

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    Understand that nutrient-rich food can help to speed up your recovery process. It should be noted that in some instances, the healing process after a surgery is slowed and can even fail. Therefore, you need to eat the right amount and types of food before the surgery to give yourself the best chance at a healthy recovery.
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    Concentrate on eating protein-rich foods. Amino-acids are the building block of protein and without protein, the body cannot heal itself. Getting a sufficient amount of protein in your diet will allow your muscles to rebuild properly and swiftly.
    • With this in mind, eat lean meat, legumes, and fish such as tuna, salmon, sardines, and trout.
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    Eat more kiwis to aid in your recovery. Though kiwis may seem tiny, they are densely packed with nutrients that can help you recover from surgery. Kiwis have an amazing amount of Vitamin C (twice as much as found in oranges). They also contains large amounts of fiber, potassium, phytonutrients, minerals, vitamins and more.
    • Vitamins, minerals, and potassium are known to help in collagen formation, essential for the healing of the graft.
    • Aim to eat at least two kiwifruits a day.
    • Kiwi has higher antioxidant content when it is very ripe.
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    Snack on some cherries to reduce swelling. Cherries are high in anti-inflammatory substances which will decrease the swelling of your current knee injury. In addition, after the surgery, the anti-inflammatory properties of the cherries will decrease pain and swelling you experience.
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    Eat guavas to quicken the healing process. Guavas are rich in antioxidants, lycopene, and vitamin C. These substances aid in healing by supporting collagen formation, decreasing free radicals in the body, and suppressing inflammation.
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    Make sure to stay hydrated. Your body will not function well without proper hydration. Water keeps your cells healthy and therefore contributes to proper healing.
    • This means drinking at least 8 glasses of water.


  • ACL reconstruction injury is a minor procedure, meaning that you can go home after the surgery.
  • When going to the hospital or clinic of the surgery, wear loose pants or shorts. This will make sure that the knee bandage will not be disturbed.
  • Relax before and during the procedure. When you have high blood pressure, the surgeon might postpone the surgery because hypertension can increase risk of bleeding. Watch TV, read magazines or do anything that may help you relax.
  • Practice how to use crutches. There is a high probability that you’ll be using them after the surgery.


  • Avoid unhealthy activities, including vices, lack of sleep, and engaging in high-risk behaviours.
  • Smoking decreases the oxygen level in your body. Your cells need oxygen to better heal itself.

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