leefregels na een voorste kruisband operatie

7 rules of life after anterior cruciate ligament surgery

Are you having anterior cruciate ligament surgery? Then it's good to know where you stand. For example, whether you can continue to work, ride a bike, or walk. Of course, at first you will be using crutches and relying on others. In this blog, we provide guidance on what to do and what not to do after ACL surgery. Here are 7 rules to live by after ACL surgery.

What you can and cannot do after ACL surgery

After ACL surgery, life changes dramatically (temporarily). The knee is swollen and the physiological response is to reduce the strength of the leg muscles. The ACL has to grow in and the wounds have to heal. The knee is fragile and different rules of life apply.

Rules for living after ACL surgery

A common question after ACL surgery is, "What can I do and what can I not do? Unfortunately, there is no one-size-fits-all answer to this question because recovery is an individual process. In order to give you some guidance in the first time after surgery, we have created 7 rules of life. Together with your physiotherapist you can adapt them to your personal situation.

The 7 rules for living after ACL surgery:

  1. Avoid public transportation.
  2. Driving a car is not allowed insurance-wise (read on for the exception).
  3. Cycling outside (different rules apply to the exercise bike).
  4. Customize work.
  5. Dose walking and standing (with crutches).
  6. Do regular knee exercises
  7. Eat healthy.
leefregels na voorste kruisband operatie knie oefeningen

When can you take public transportation after anterior cruciate ligament surgery?

The advice is to avoid public transportation (public transport) for the first six weeks. A bus, streetcar or train is unpredictable because of the abrupt braking and acceleration. After anterior cruciate ligament surgery, the muscles no longer respond quickly enough and strength is also reduced. Also, fellow travelers do not always take you into account, making public transport risky. In daily practice, it happens regularly that rehabilitants still choose public transport. It may go well 100 times, but the warning applies to the one time it doesn't. Coincidentally, this fate happened to one of my patients the day before I wrote this blog. She had boarded the streetcar and appeared to get stuck with the crutch, causing her to fall. This is an unfortunate example of why there are living rules for the first phase after anterior cruciate ligament surgery. Fortunately, the cruciate ligament was still intact and after hearing this, she swore off public transportation immediately.

When can you drive a car after anterior cruciate ligament surgery?

As a general rule, you should not drive for as long as you are on crutches. On average, this can take 4-6 weeks. If you do, you are probably not covered in the event of a car accident. Always get permission from your doctor or physical therapist before you start driving again. If you have an automatic transmission and have had surgery on your left knee, you can usually start driving sooner with the permission of your insurance company, physical therapist and/or doctor.

When can you ride your bike outside after anterior cruciate ligament surgery?

It depends on the anterior cruciate ligament surgery and the additional structures that have been treated, but usually starting at 2.5 weeks on a hometrainer be cycling. Cycling is medicine for the knee and it is recommended to do it 3 times a day for half an hour, if allowed and possible. A little resistance and a leisurely pace are recommended. For cycling you need at least 100 degrees of flexion. A Tacx (road bike stand) is relatively unstable and not comfortable to get on and off, so we recommend a normal bike stand. hometrainer to use. Once you can ride well on an exercise bike, you might think you can ride outside. However, it is important to wait because suddenly getting on and off is risky. When you are off crutches and have sufficient strength (squats, step and balance), you can start riding outside. Talk to your physiotherapist about what is possible.

Note: After meniscectomy or repair, do not ride a bike for 6 weeks to protect the suture.

When can you return to work after anterior cruciate ligament surgery?

After 2 weeks, you can resume an office job with confidence. Some may need a little more time. Working from home is ideal, especially since travel can be difficult. For physical work, it depends on the condition of the knee whether it is possible to return to work. On average, it takes 8 to 12 weeks to fully recover. In the meantime, modified work may be an option. The return-to-work process is managed by the company physician.

How much can I walk after ACL surgery?

The load capacity of a knee after anterior cruciate ligament surgery varies from person to person. Some people still experience a lot of pain and discomfort after several weeks, while for others the pain subsides rapidly within a few days. For many patients, pain is an indication of how well the recovery is going. Experiencing little to no pain is pleasant, of course, but this does not automatically mean that the knee is already fully load-bearing. It is important to resist the temptation to want to do too much again too soon.

The advice for the first few weeks is to stay home and get plenty of rest, such as lying on a couch or bed. At the same time, it is important to do regular knee exercises and walk around the house for a few minutes every thirty to sixty minutes. As the weeks go by, you will find that you can gradually increase your walking distance.

How does walking with crutches work after anterior cruciate ligament surgery?

On average, you walk with crutches for 4-6 weeks after anterior cruciate ligament surgery. One of the basic prerequisites to the crutches decrease is having a symmetrical gait pattern and sufficient strength to carry your body weight.

Het afbouwen van krukken gebeurt geleidelijk over de weken:

  1. Two stools are used indoors and outdoors.
  2. One stool is used inside and two stools outside.
  3. No more crutches are used indoors, one crutch is used on short distances and two crutches are used on longer distances (>5 minutes).
  4. No more crutches inside, one crutch is used based on the situation.

In addition to providing support while walking, crutches also signal to those around you that something is wrong. They provide a measure of protection.

After anterior cruciate ligament surgery, you may put 50 percent load on the operated leg. Standing upright on two legs is 50 percent load, while standing on one leg is 100 percent load. So while walking, you need to absorb about 50 percent of your weight through the crutches.

Note: Exceptions possible after meniscopexy/repair or cartilage treatment.

How much should I exercise after anterior cruciate ligament surgery?

Het doen van knieoefeningen staat centraal in de voorste kruisbandrevalidatie. Een of twee dagen na de kruisbandoperatie begin je al met knieoefeningen. Gedurende de dag doe je knieoefeningen met grote regelmaat (intervallen van één tot twee uur). In de blog "knee exercises after anterior cruciate ligament surgery" you will find exercises for the first weeks after surgery. Are you looking for knee exercises check out our YouTube kanaal, instagram of training programs.

What should you eat after anterior cruciate ligament surgery?

It is important to eat healthy food and get enough protein (protein). In the beginning you sit still a lot and for a long time so be careful with high-fat and high-carbohydrate foods. In the blog knee rehabilitation and protein you can read how much protein you need per day. 


An anterior cruciate ligament rehabilitation is an individual process and should be carefully coordinated with your physical therapist. What is allowed and what is not allowed depends on the course of rehabilitation and the status of the knee. If you have any questions about what is allowed and/or tips for others, please leave a message at the bottom of this blog.

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