ACL Rehab

By March 5, 2016 16 Comments

ACL Rehab

Background: Ski accident the 5 february, not to much pain, not to swollen, but the MRI showed a cruciate ligament full tear a little bone bruised and a minor tear in the lateral menisk (which they say will not affect the rehab as it was minor.).

Reconstruction of the ACl with semitendinosusgraft, operated 18 february.

Day 1-3

The first day after the operation the pain was insane, so insane that I needed to go back to the hospital so they could paralyze the leg witha femorlis blockad (not sure the name in english).

I could only do the easiest exercise when pointing my toes upwards and downwards, I did this a lot as it´s good for the circulation. I could also tighten the quad muscles a little. Every day it became easier. I could put weight in the leg and it feelt ok. I jumped on crutches.

4-5 Start to feel better, I could have the leg pretty straigt, not uncomfortable lying down.

I could start to do more exercises. Like dragging the knee from extension towards flexion. I could work more on the quad muscles, and I did the exercises for motion and extension.

I have 10 exercises from my fysio ( I guess all of you have almost the same, more or less, so I don´t write them here)I feelt very tired, I could not concentrate for long, my body and mind just want to rest. So I did that. I guess an operation is a pretty big impact on the body.

6-8 I could bend the knee to 90 degrees comfortable. My psoas is so tired from jumping to much on crutches!! So I took some easier days. Still tired. I noticed small progression, just like I could tighten the quads for a little longer in an extended position, I could press down the knee a tiny little more . Tiny tiny steps, and they made me so incredible happy! These days I also started with a few isometric exercises for the hamstrings. It was very difficult and it feelt very fragile. So I took it very slow and only did a few seconds in every position.

9-10 My energy was coming back slowly. This days I could do some upper body training! Great feeling! Focus still only on the rehab exercises. Tiny progresses.

11- I could walk without crutches, dragging the right foot on the floor when going from back to front. Controlled, balanced and very slow. I still used crutches as it goes faster, only (more or less) during training I walk without them try to find a normal walk. The knee is still a little swollen, from day 6 until now it hasn´t changed much.

12- Doing the rehab and adding the compex when I have the leg straight. Getting super tired from that. But it feels great to use the quads!!

Skärmavbild 2016-03-05 kl. 13.00.08

13 I tried to cycle, slow very slow it works and it makes the knee feel more flexible afterwards. I only cycled for some minutes, then rested, made extension excercises, some balance and then I cycleed for some more minutes.


It´s not super comfortable the angle on the cycle, but as long as it´s not pain it´s ok. Afterwards the knee is less swollen.


It´s not to swollen, just a little around the knee and on the backside of the knee. I think with more movement this will go away!

14-15 same routine with rehab exercises and cycling a few minutes. I do this 2-3 times a day. The hamstrings start to feel better, I can “connect” it a little more when I walk, and the isometric exercise start to feel better ( but it´s very small steps, it´s not good, just a tiny tiny little better!) The last few days I have putted more focus on the extension of the leg, I do those exercises a little bit more, and I think about having the leg straight and tightening the quads every now and then during the day.

To be continued..!

Please if you feel like you want to share your experience, please do this in a comment! I think it can be so interesting for everyone with this injury to read about rehab from different persons. This is not to be compared, we need to know everyone is diffierent, and have different background and preconditions.

So far I have had one black day, a day when I felt tired in the knee, I felt immobile, and so depended on Kilian to do all the things I couldn´t do (I can do them, it just takes so much longer, and it´s a good experience to trust someone to do all things for you, not because they need, because they want!) and I felt just miserable. I missed so much to be healthy and in the mountains. But this passes away, like the clouds on a blue sky.


Let´s do rehab together and share the road back to where we want to be!



Mountain athlete, trail runner and ski mountaineer. Writer,mum and Co- founder of Living on a small farm in the Norwegian fjordlands!

  • Elena

    Keep up the good work and focusing on what you can do! This is great to hear from. Cheers

  • marc abella

    Emelie, I don’t want that you considere my coment as a attack. I only want ( as a physical therapist) to remark the importance to not make comparations between two diferent patients! I know you wrote it in your post, but when people have healthy problems they always try to do comparations! As you said, everybody have diference backgrounds and preconditions, it’s important to remark it!

    I think you’r idea of write and share your progresse is really good one, and I’ll use it with my patients, I’ll tell they should write a notebook with everyday progress to make they consience that they are making a little but continuoius progress!

    You should know that your progress is good and fast, but it is common in elite athlets!

    So, try to enjoy your rehab progress and for sure you’ll be back to the mountais as fast as you can imagine!

    Thanks for your idea, and sorry for my bad english level!!

  • Pavel Škabraha

    Hi Emelie,

    I wish you a speedy recovery. Now I am doing anyway, so I know what you are talking. Also on my blog, but only in Czech, titles Fuck of comfort zone.

    Good luck!

  • Anja TF

    Det är glädjande att läsa din progression, jag tror att du snart är tillbaka!! Lycka till med all rehab! Och med odlingen i vår! Jag ser fram emot att få läsa vad ni odlar och hur det går. Jag har precis satt igång min hemmaodling, tyvärr bor jag i en liten lägenhet så det blir “bara” tomater och chili hemma!

  • Alessio Rungatscher

    Swim swim and swim! I started the rehab in swimming pool while I had the suture stitches on my knee! It helps a lot. Do cycling and stretching movement into the water! Good look!

  • Elizabeth VanArsdel

    My experience with a torn ACL and surgery was years ago – 15 or more. And it’s fine now – I ski hard, so know that you will be OK. It will take a while. For the pain and swelling after the surgery, the best for me was acupuncture, once a week for several months. Also know that your knee will get better for a really long time. After 6 months they said – you are good – go do everything, wear a knee brace when you ski. It didn’t feel that good, I wondered if this was as good as my knee was going to feel. No – it took longer than that. Hard workouts in the weight room and hiking were fine, but skiing was really hard on it. But 1 year was better than 6 months, 2 years was better than 1 year and 3 years even better. My knee kept getting better for years after the injury. So when they tell you – you are fine, go play and if it doesn’t feel that good, just know it will be much better than that later on. Good luck, be patient with yourself and your recovery.

  • sarah

    day 17 – cycle on turbo
    day 44 – 1000 step ups
    day 69 start on the ski machine
    day 89 – 10 min run
    day 112 30 min run on good trails

  • Jasmin Paris

    Really sorry to hear about your injury Emelie. I did the same thing when I was 17 (complete ACL tear and meniscus tear) falling off a horse, and I know how frustrated you must be. But you will heal quick, and will be back in the mountains soon, loving it more than ever. Wishing you a very speedy recovery.

  • Sarah Burns-Morwood

    Keep going Emelie! My injury is slightly different, a patella fracture and then 4 weeks later re-fracture and I’m non-weight bearing with leg fixed to a maximum of 40 degrees extension in a brace for 10 weeks total, but it’s amazing the workouts you can do with just your upper body. I’ve started seated sparring with my husband and that gives a really intense 30 minute workout, plus cycling with one leg on the static cycle and I have a table-top arm cycle which gives a pretty good workout as well. A Swiss ball makes core work much more comfortable and possible. Good luck!

  • Good luck Emelie! You are doing your best, and I’m sure you’ll be back at running.
    I have tendinitis in my right knee, nothing to compare to you, but I’m in the same position with fisio, excercises and now short walkings. I miss my runs, but if we take care of ourselves, we will be back on running as fatstest and strongest than ever! 😉

  • sarah

    Day 125 for me and a smiley day, a 50 minute run with muddy legs at the end
    Stay strong Emelie

  • Dominique

    Bonsoir Emelie,

    I am happy to read the progress of your business. I’m in a similar situation to yours and read gives me a reassuring feeling. I hope you find pleasure in rebuilding your knees and your physical conditions, we’ll all be a bike this year.

    looking forward to reading you

  • Asier Uria

    Hi Emelie,
    no hurries, step by step and you will recover even sooner that you get realize, always follow the advices from your physio, make a good eating and let to Kilian all the stuffs of the day to day.
    I’m into triathlon and I recommend you the cycling as the best way to start feeling some strength in your knee, isometric exercises and similar and then get into the pool to start doing some exercises,
    get well soon.


    Hi Emelie,
    I tore my ACL, MCL and LCL 5 years ago and had the same surgery. Recovery was rough and took longer than I had anticipated- however I didn’t focus on rehab as much as I probably should have early on. I went back to work as a nurse and had long days on my feet several weeks post op. It took about 1.5 years for running/jogging to really feel good, however I was out of shape and not logging many miles pre surgery, so I was definitely starting over. For the last 2 years I have really focused on running, mostly trail races, and my knee has not had many issues. I think focusing on my core and hips through pilates and yoga has helped enormously. Last year I ran my first 25k, then the Moab Trail Marathon, and I’m signed up for RONR 50k in June. I ski a lot also, and my knee is fine with that. Basically, keep up the rehab, listen to your body and in time you will be fine. It is hard to be patient, but know that you’re not alone in the bum knee club!

  • tnta

    I am 13 months out from ACL and meniscus surgery–cadaver grafted ACL, both menisci trimmed. I have been able to run comfortably again just in the last few months, but continue to feel a small imbalance in the strength leg to leg. The neuromuscular connection has been the hardest to overcome physically. The body heals in its own good time and will heal, the brain/body connection is a bit trickier! I spent a lot of time deepening my meditation practice while I was unable to get out into the mountains. Being gracious and grateful for the small achievements like one more degree of flexion, a ray of sun through the window, or a visit from a friend will fill your heart until you can get back. You have been such an inspiration to so many while you ran, but isn’t because you ran. It’s because of your lovely warm spirit, which you share with others even when you cannot run.

  • Secret Orange

    I had ACL reconstruction surgery on 22 March 2016. I’ll share my experience so far, but like Emelie and PT Marc (in the comments) have said, you really can’t and shouldn’t compare recovery timelines with your own situation– everyone is different, treatment protocols are different, and you don’t want to risk complications by doing something that your medical team doesn’t think you should do. Honor the healing process– physically and mentally.

    I had a ski injury on 22 December 2015 that resulted in a complete tear of my ACL with some minor fraying to my meniscus and some minor issues with my lateral condyle (which might have been the result of daily life). Originally I was supposed to have surgery on 11 February, but I became sick and had to postpone my surgery. In the time period between 22 December and 22 March, I did *a lot* of gym work to keep my legs strong before surgery. I had to work hard to regain my full range of motion (both extension and flexion), and I spent at least 2 hours in the gym every single day for 3 months riding the bike, weight lifting, stretching, and massage. Around 6 weeks after my injury I was riding my bike outside again for a couple of hours at a time, including the day before my surgery.

    For my surgery, I had a hamstring semitendinosus autograft combined with peroneus longus donor tissue, and my anesthesiologist recommended an ultrasound guided adductor canal block (saphenous nerve block) that allowed me to start moving my quads (minus the vastus medialis) immediately after surgery. Fortunately I had no pain at all post-op, even after the nerve block wore off. Less than 48 hours after surgery I was off of pain medications and just took prescription anti-inflammatory drugs for 10 days. Since that time I haven’t needed any drugs at all.

    I spent the day after surgery doing many small exercises to keep blood moving through my legs and to start the muscles working again. On day 3 after surgery I had my first physical therapy (PT) session, and I was at full hyperextension and I could flex my leg past 90 degrees. By the end of the first week I was at 110 degrees flexion and walking with one crutch. At PT session #2 one week after surgery I was riding the bike very gently with no resistance– just for range of motion. During the first 2 weeks I was using an ice machine on my knee almost the entire day and night.

    And here’s why you shouldn’t compare to other people: despite my early, seemingly super fast healing, I started experiencing acute swelling and edema (fluid retention) around the end of week 2 after it seemed I had passed the early acute swelling phase. We now think that I started weight bearing exercise too quickly and/or I was icing my leg too much. Once I stopped icing so much and being more conservative with my activity level, my leg stopped swelling. I’m now at 3 weeks after surgery and doing well– up to 130 degrees flexion, doing light exercises several times per day, and continuing to ride the bike gently for 15-20 minutes at a time.

    For anyone going through ACL surgery recovery– or about to– understand that you’re running a marathon, not a sprint. It will take the graft months to heal properly (and donor/allograft tissue can take longer), even after you’ve started to feel better. And the single best advice I can give is to take your pre-surgery fitness level very, very seriously as that will improve your post-operative recovery and pain management.