ACL Surgery: What to Expect Before Surgery

Preparing for ACL Surgery: What to Expect Before Surgery

ACL reconstruction surgery can feel overwhelming, especially if it’s your first major knee injury. Preparing ahead of time can make the recovery process smoother and help you feel more confident going into surgery. 

At Catalyst Physiotherapy, we often meet with clients before their ACL surgery to help prepare both physically and mentally for what lies ahead.

Why Pre-Surgery Physiotherapy Matters

Rehabilitation often starts before surgery, a phase known as prehabilitation (pre-hab).

The goal is to prepare the knee so it enters surgery in the best possible condition. Patients who complete pre-operative physiotherapy often experience:

• Less swelling after surgery
• Better early knee movement
• Faster return of muscle activation
• Improved long-term outcomes

Before surgery, physiotherapy typically focuses on restoring knee range of motion, reducing swelling, and activating the quadriceps muscle.

Key Goals Before Surgery

Most surgeons and physiotherapists aim for several milestones before ACL surgery:

• Full or near-full ability to straighten the knee
• Improved knee bending
• Minimal swelling
• Good quadricep and glute activation
• Comfortable walking pattern

Entering surgery with a stiff or swollen knee can make early recovery more challenging.

Exercises Before ACL Surgery

Pre-operative exercises often include:

• Quad sets
• Straight leg raises
• Heel slides
• Stationary cycling
• Hip and hamstring strengthening

These exercises help maintain strength and mobility while protecting the injured area. Your physio can help customize your program prior to surgery.

Planning Ahead  - Read ACL Surgery Equipment Guide 

Preparing your home and schedule before surgery can make the first few weeks much easier.

Consider organizing:

• Ice therapy options

• Crutches

• Custom ACL Brace
• Loose clothing that fits over a knee brace
• Transportation to appointments 

• Work or School schedule

It is also helpful to schedule physiotherapy visits in advance so rehabilitation can begin 1 week after surgery

ACL recovery is a long process, but starting prepared can make the early stages much smoother.

**Recovery timelines after ACL surgery can vary depending on the surgical technique used, whether a meniscus repair was performed, and each individual’s healing response. This article provides general guidance, but your surgeon and physiotherapist will provide recommendations specific to your procedure. Meeting with a physiotherapist before surgery can help you better understand what to expect and prepare for the recovery process ahead.