How much time off work should you take after ACL surgery?

Posted on October 8, 2018

(Last Updated On: October 8, 2018)

I’ve been surprised how many times I’ve been emailed this question, so let’s add it to the ACL reconstruction writing of the site.


What you do for work probably doesn’t matter

Most initial responses to this question are “it depends what your job is.”

Eh. Kind of.

I mean, of course, if you’re a bouncer at the busiest nightclub in New York, yeah, you’re not going to be working for a while.

But in the context of modern life, for most getting this surgery, very few need to worry their job is too physical.

I’m a personal trainer. Before the surgery I spent 8-12 hours a day on my legs, regularly showing people how to perform all kinds of exercises.

I had surgery on a Friday; I went back to work Tuesday.

Was I perfectly able to work the same exact way as before the surgery? Of course not. Did I loathe being on crutches so much? 100%. But I gave all my clients a month heads up I was having surgery. I told them I would probably sit down more during our sessions. Nobody cared.

Then, instead of demonstrating everything as I had been doing, I got better at talking people through exercises; using my voice rather than my body. Nobody noticed enough to mention it to me.

It wasn’t a problem, at all.

And, while I had very little pain (which I largely attribute to my preparation before surgery), I was not some abnormally quick healer. It took me nearly a full month to feel comfortable walking completely without crutches. That’s actually kind of slow.

So when people who work at a desk all day tell me they’re taking a month or more off, I’m dumbfounded. There is no need for that.

I’m not blaming the person either. I know the surgeons have bizarre recommendations on this front. One I consulted with told me I wouldn’t be able to work for at least three months! Making me think he thought I was teaching P90X all day or something.



This is another caveat.

If you’re high as a kite 24/7, you probably won’t be, or shouldn’t be, working.

However, you shouldn’t be high like that. I know this can be controversial but I’m 100% of the belief doctors and patients prescribe and use wayyyyy more pain killers than necessary.

The most straightforward way to view this is: in ten years you are extraordinarily unlikely to regret not using more opiates after your surgery. You are much more likely to have using too many be one of the biggest regrets of your life. Going that route is akin to playing Russian roulette. It doesn’t matter what the odds are. If there’s a bullet in the chamber, you don’t play.

Unlike a lot of crises, the opioid one is real. The amount of drug overdoses has climbed something like 5x in the last two decades, with the pace increasing. It’s been enough to be a primary cause for the two year DECLINE in the average life expectancy in America. That’s insane. Many people’s first exposure is through a prescription; not some drug dealer on the street. Many don’t know they’re prone to the addiction until they’re addicted.

ACL surgery pain can be terrible. For many, it will be the worst physical pain they’ve gone through. Too bad. Take some Advil or have a couple beers and deal with it.

-> I’ve seen research suggesting two beers is as effective as opiates for pain.

Maybe pop an opiate at night to help you sleep for the first week. But this is not meant to be a pain free process. You can’t, or shouldn’t be, popping pills for months on end, which is how long many people’s pain will last. (It won’t be as bad as in the beginning, but periods of pain can come back in the fold from doing too much in therapy.) You shouldn’t be high all day either, as you want to know whether any rehab exercises are causing pain. You need to actually be able to feel what’s going on, rather than trying to numb everything.

Not to mention longterm opiate use can make pain worse.


Even if you can, you shouldn’t take much time off

We humans are weird. Many of us participating in the daily grind have daily day dreams of doing nothing. “I just want to sit around all day.”

Then we do that for a day or two and start losing our minds.

The pain of ACL surgery routinely peaks the day after surgery. Call it the 36 hour mark. It’s kind of like doing a gnarly gym session. You often don’t feel the soreness until at least the next day.

After that point it should start calming down. Once it’s not so intense as to be the only thing you’re thinking about, your mind is going to start wandering, and watching Maury tell you who is or isn’t the father gets old rrrrrrreal quick.

The rebuttal I sometimes get when I tell people they’re unlikely to need too much time off work is “Work is ok with it.” That’s fine; you are unlikely to be ok with it.

What are you going to do all day? At most, rehab is going to take up an hour of your day in the beginning. You might not be able to drive yourself around for 2-4 weeks. Everybody you know is probably going to be busy during the day, you know, working. What’s a great way to feel worse? Add loneliness into the mix.

Some people are content to read all day. Some of us wonder if never seeing another human would make us happier. But most aren’t that way, even if we have times of thinking it. Human interaction is, while often the source of much of our angst, a prerequisite for mental wellbeing. And at some point, getting it solely through a television won’t be sufficient.

The irony is for many work is the perfect activity post-ACL surgery. They can sit down all day, they can use their mind, they can be distracted from how little they can do physically, it’s great.

Sitting at home crying, popping pills, dealing with the shittiness of using all your vacation days to go nowhere, watching television portraying some of the worst aspects of human nature (just watching the news all day isn’t healthy, never mind all the other daytime shows), isn’t going to make you feel better. Getting off your ass, feeling like a member of society, realizing you’re not the only person who has ever had a rough surgery, is a much better route.

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