The short answer is yes.
Physical therapy prior to ACL surgery, also known as prehab, is an important step in the recovery process. When one injures his or her ACL, there is often a significant effusion (swollen knee with blood), inflammation, decreased motion of the knee, along with muscle inhibition and atrophy. In general, going directly into surgery with poor motion and an inflamed knee may make the immediate postop recovery much more difficult. It can also lead to arthrofibrosis, significant stiffness of the knee which sometimes requires surgical lysis of adhesions and manipulation under anesthesia. Thus, we generally recommend prehab to obtain a "quiet knee."" This means that the effusion is minimal, the patient can obtain full extension to past 120 degrees flexion, and the quadriceps muscle is active. This period of prehab is generally 1-4 weeks. Giantss' Malik Nabers underwent surgery approximately 1 month after tearing his ACL as reported by Yahoo Sports.
A study published out of the Delaware-Oslo ACL Cohort demonstrated significant benefits of extended preoperative rehabilitation on outcomes after ACL reconstruction at 2 years. Those who had the addition of pre-operative rehabilitation had greater functional outcomes and return to sport rates 2 years after ACL reconstruction.
There are some exceptions to the rule when surgery may be warranted quicker. For those who have a bucket handle meniscal tear, tibial spine avulsion, or other concomitant injuries, we may skip any prehab process and proceed with surgery sooner.
If your doctor is trying to rush you into ACL surgery the same week you tore the ACL, have an open discussion with them about the pros and cons of prehab for the ACL tear. Also, discuss with them their volume of how many ACL reconstructions they perform a year, how they handle complications, and if they do ACL revision surgery.
Please consult with a board certified orthopedic surgeon if you feel that you have sustained an ACL injury. This blog post is for educational purposes only.
