ACL recovery timeline:
week by week, from surgery to sport
A recovery counted in months
The knee is swollen, the thigh no longer quite responds, and the pitch feels a long way off. After an anterior cruciate ligament reconstruction, recovery is counted in months, and each stage prepares the next.
Published guidelines split rehabilitation into phases. Moving from one to the next depends on criteria, as the date alone is not enough1,2. The weeks below are therefore landmarks: it is the state of the knee that decides when the next stage begins.
In most studies, running resumes around 12 weeks after an ACL reconstruction, and guidelines place the return to sport from 9 months, once strength and hop tests are passed. The Game Ready is used from the day you get home and through the first weeks, in sessions of 90 minutes; most rentals last two to three weeks. The Compex starts in the first week, to limit the loss of thigh strength.
Week by week
Week 1: swelling and pain
The knee is at its most swollen and most painful. Studies of cold after ACL surgery mostly cover these first days: it reduces pain and the need for painkillers, and compression adds to the effect1. The Game Ready® is used from the day you get home, in sessions of 90 minutes, as often as possible, at 4 °C with low compression. This is also the week to start the Compex®, as the strength gain in the thigh is markedly greater when sessions begin within the first seven days3.
Weeks 2 to 4: waking the thigh up
Swelling recedes and exercises take up more room. Game Ready compression moves to medium from the second week. Added to rehabilitation, electrical stimulation improves the recovery of quadriceps strength1.
Months 1 to 2: range of motion and strength
Two goals fill these weeks, a knee that bends and straightens fully, and a thigh that regains strength. Exercises are the core of rehabilitation, and strengthening is combined with balance and movement control work1.
Around 3 months: back to running
In most studies, running resumes around 12 weeks after surgery, sometimes from 8, sometimes after 161,4. The criteria cited most often are a pain-free knee, full range of motion and a thigh that has regained a good share of its strength compared with the other leg4.
Months 4 to 9: jumps, footwork, changes of direction
Rehabilitation moves closer to the pitch, with jumps, landings, accelerations and changes of direction. Strength and hop tests compare both legs and guide the return2.
From 9 months: back to sport
Among the athletes followed in the Delaware-Oslo study, each extra month of waiting cut the risk of a new injury by 51%, up to the ninth month5. Those who passed the tests before returning were reinjured in 5.6% of cases, against 38.2% for the others5. The Dutch guidelines plan 9 to 12 months of rehabilitation2.
What most often derails a return to sport is covered in our article ACL: the three things that derail a return to sport.
The Game Ready and the Compex in this timeline
Both devices are used at the start, when everything hinges on the swelling and the thigh. The Game Ready® works on pain and swelling. The Compex® SP 8.0, a wireless muscle stimulator, works the quadriceps during the weeks when it responds poorly. They can be rented separately or together, in the Recovery Bundle.
The device reaches your home within 24 hours, in Dubai as in the six other emirates. A member of the KOLDE team fits the knee wrap and starts the first session with you. The KOLDE knee protocol then sets out the sessions phase by phase, and a dedicated customer service team stays reachable throughout your rental.
Common questions
When do I start the Game Ready after ACL surgery?
As soon as you get home. Swelling and pain are at their highest in the first days, which is when sessions count most.
How long does the rental last?
Two to three weeks for most knees. You choose your dates, and the rental can be extended.
Does the Compex replace the exercises?
No. It works the thigh during the weeks when it responds poorly. Exercises remain the basis of rehabilitation.
Do I need a prescription?
No, you can order directly.
Sources
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Aspetar clinical practice guideline on rehabilitation after anterior cruciate ligament reconstruction. British Journal of Sports Medicine. 2023.
Kotsifaki R, Korakakis V, King E, Barbosa O, Maree D, Pantouveris M, Bjerregaard A, Luomajoki J, Wilhelmsen J, Whiteley R.
DOI 10.1136/bjsports-2022-106158 · PMID 36731908 -
Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus. British Journal of Sports Medicine. 2016.
van Melick N, van Cingel REH, Brooijmans F, Neeter C, van Tienen T, Hullegie W, Nijhuis-van der Sanden MWG.
DOI 10.1136/bjsports-2015-095898 · PMID 27539507 -
Effects of neuromuscular electrical stimulation on quadriceps femoris muscle strength and knee joint function in patients after ACL surgery: a systematic review and meta-analysis of randomized controlled trials. Orthopaedic Journal of Sports Medicine. 2025.
Li Z, Jin L, Chen Z, Shang Z, Geng Y, Tian S, Dong J.
DOI 10.1177/23259671241275071 · PMID 39811154 -
Criteria for return to running after anterior cruciate ligament reconstruction: a scoping review. British Journal of Sports Medicine. 2018.
Rambaud AJM, Ardern CL, Thoreux P, Regnaux JP, Edouard P.
DOI 10.1136/bjsports-2017-098602 · PMID 29720478 -
Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study. British Journal of Sports Medicine. 2016.
Grindem H, Snyder-Mackler L, Moksnes H, Engebretsen L, Risberg MA.
DOI 10.1136/bjsports-2016-096031 · PMID 27162233
This article is for information only. It does not replace the advice of your surgeon, doctor or physiotherapist. Always follow the recommendations of your medical team.