For a long time I’ve debated putting out an ACL resource. Because the rehab is so long, usually at least 6 months, I wrestled with attempting to make something covering that much time. So much can happen in 6+ months, everyone’s timeline is going to be different, goals are individual.
Over the last few years, after going through my own anterior cruciate ligament reconstruction, working with others, and talking to many others (a great deal from this website), I noticed a reappearing theme: People can’t get out of the first month.
They wake up from surgery and have absolutely no idea what to do from there.
“When can I walk?”
“How long should I be using crutches?”
“When can I bend my leg again?”
“Is there a risk of screwing up the graft?”
“How can I better deal with the pain?”
“When should I start physical therapy?”
The last question, when does one start physical therapy, was a primary impetus for me deciding to put something together.
After an ACL reconstruction, physical therapy does not start in one month, it does not start in two weeks; physical therapy, and your recovery from this significant injury, starts the minute you wake up from surgery.
I’ve encountered too many people starting their therapy 2-4 weeks post-op. Initially, my sympathy for those starting therapy this late, enduring the host of issues that come with such an approach, wasn’t much. People don’t research this operation thoroughly enough. However, over time I’ve noticed another theme: People aren’t taken care of physical therapy wise.
While everyone should do some perusing, not everyone can be expected to do extensive research on a topic as complicated as ACL surgery. This is why we have doctors and therapists. To do this for us, and take care of us. Yet, I’ve lost count of how many people have emailed me or left a comment saying,
“My doctor said I’ll start therapy at 4 weeks.”
“My insurance only covers once a week sessions.”
“My doctor said to do nothing for a couple of weeks.”
“I can’t get in to see my therapist.”
“My insurance only covers 10 sessions, total.”
The last quote, from a recent email, was the other impetus for me putting something together. Long story short -only having 10 session- is horseshit. You don’t put a power drill through someone’s body then say, “Alright, you’re on your own. Good luck!” That’s not fair. The rehab is just as, if not more, important than the surgery. If one aspect is taken care of, so should the other. Unfortunately, this isn’t true.
Hell, I had about as good of insurance as one could have when I had my surgery. The operation was fully covered, as many physical therapy sessions as I wanted to pay $10 copays for, you couldn’t ask for more coverage wise. I walked into my first appointment only for the therapist to go,
“Hey, I’m so and so, just wanted to let you know this will be my last day, but we can still do some work together.”
Me “I’m sorry, but is there any point to that?”
Next session,
Therapist “Hey, how’s it going? I’m so and so. I’ll be working with you today.”
Me “Are you the new hire?”
Therapist “Well, no. I’m a temp. I’ll only be here until they find a full replacement.”
Me “How long will that take?”
Therapist “Tough to say. A month maximum. But I could be gone tomorrow too.”
Next session,
Another new therapist “Hey, I’m so and so. I’m the new full time therapist.”
Me “Great. About time.”
Therapist “So, what procedure did you have done?”
Me “Uh, don’t you already have that information? Isn’t the doctor’s office across the hall?”
Therapist “I’m sorry, I don’t have it. But you can just tell me.”
I never went to that office again. In three sessions I had three different therapists. By the time they found a full time hire I was already four weeks post-op. There is no excuse for that. Luckily, I knew what to do that first month. Hopefully, this manual will give you the same ability.
Here are some of the things covered:
- Dealing with the pain
- When does pain peak after surgery? How you can align your pain killers with this timeline.
- Did you know just being more prepared for what the surgery entails, what the rehab process is like, having a plan, all this can help decrease the pain as well? (Here if interested.)
- When can you walk again? How do you progress into walking?
- The biggest mistake ACL patients make
- When can you bend your knee? How much can you bend it? When can you increase your range of motion? What type of bending can you do?
- What direction should you start your rehab with? Side to side motion? Forward? Backward? How do you progress this?
- Why it’s common to feel like your knee isn’t a part of you after surgery. Almost like your body is “here,” but your knee is “there.”
- Videos and pictures for just about everything. Most of which include a voiceover from me going over proper form.
- The mental aspect
- How do you deal with the emotional toll of things?
- Getting into the rehab immediately is a huge part of this, but I also cover an unconventional approach too
- How do you deal with the emotional toll of things?
As I mentioned, this manual is for the first month of ACL rehab. “Why only the first month?”
- This is the most important phase. It sets you up not only for having a continued, successful rehab, but to have a healthy knee for rest of your life.
- It is the phase I most often see people screw up. Whether it’s the individual, their doctor, their therapist, this phase is the most important, yet the most ignored.
- It’s the phase people are most often left to their own devices. They have no therapist yet, they don’t know what to do, and they’re full of questions. This manual helps bridge that gap. So, by the time you start a formal rehab program with a therapist, you’re a month ahead of most.
- After the first month individual differences start to matter more. What graft you have, whether you’re an athlete, how fast you can progress, etc. The first month though, there really aren’t going to be many differences.
Many things, like how much you can extend or bend your knee, ability to walk, handling the swelling, aren’t going to vary much, if at all. For example, while it doesn’t matter if you’re running by 3 or 4 months, it matters when you regain full knee extension. While it doesn’t matter if you’re playing basketball again at 9 or 10 months, it matters if you try to bend your knee too soon.
- Getting back to competitive sports, in the grand scheme of life, isn’t the biggest concern after such a major operation. This manual sets you up for a successful road to sports, but getting back to having a healthy, functional knee is the biggest concern. I want to make sure people get this right. I’m more concerned with you being able to walk well the rest of your life than I am you playing rec sports.
Here is the outline:
Table of Contents
- Setting the stage
- A primer
- Pain remediation
- Waking up
- Drugs
- “What should I take?”
- “Get ahead of the pain!”
- Compression
- ACE bandage technique
- Icing
- Walking
- Range of motion
- Immobilization
- Flexion versus extesion
- Extension (more specific)
- Quad inhibition
- Flexion (more specific)
- The Patella
- Extension (more specific)
- Other
- Sleeping
- Proprioception
- Strength
- Conditioning
- Nutrition
- Rehab program
- Day 1
- Days 2-10
- Days 11-14
- Week 3
- Week 4
- Appendix
- Some other questions
- “Can I do upper body exercises?”
- “The mental part of this is really tough. Do you have any other recommendations on how to deal with it?”
- “Where do I go from here?”
- “Should I be working my other leg?”
- Ibuprofen after activity
- NSAIDs and injury
- Icing and injury
- Some other questions
Lastly, going back to my own experience, I tried visiting a therapist the first month to get another pair of eyes. Having a pair of trained eyes at your disposal is invaluable. It’s impossible to be unbiased assessing yourself. Nor do you, or can you, always look for the right things.
So, in addition to the manual, if you buy the product and want me to check your form on something, such as one of the exercises, email me videos or pictures and I’ll be happy to take a look for you: b-reddy@hotmail.com
I don’t normally do this for my manuals, but I want to help out the best I can, as this is a topic deeply personal to me. I know how tough the ACL recovery process can be; having to worry about inadequate rehab shouldn’t be part of it. It’s a hard enough road already.
The manual comes in the form of a password protected link. After the purchase is complete you’ll be redirected to the link, and the password will be in your email.
You can get it for $20 here: 
–
Danny Smy
February 23, 2015
A breath if fresh air!! A true reflection of the whole process!!
Had my op on 22nd April 2014, rehab gone well an hopefully returning to football soon!
All the best, Dan.
reddyb
February 24, 2015
Best of luck. Hope it goes well.
Aveline
June 19, 2015
Hey, am on day 8 post ACL reconstruction with tendon graft. I had my cartilage fixed in nov 2024.
Your site has been super helpful. I was lucky enough that my therapist had a similar op so he advised me to get those quads ready. like you i awoke with a full brace with no knee flexion, followed the usual ex given and as you advise, concentrated on extension, I learnt that lesson after my previous op.
My only issue has been the difference between being able to do all my exercises pain free, I can even do a toe grab, but boy does it hurt when i stand!!! the pain of the blood rushing down around my calf like fighting to get through the veins!! I tend to take my med with the standing up in mind. Great resources!
reddyb
June 21, 2015
Hey Aveline,
Glad to hear some of the information resonated with you.
The pain of blood rushing into the area after standing is a common one. Not everyone gets it, as some seem to be more of a “sweller” than others. But boy, did I sure get that myself with certain injuries! It’s not fun. Feels like your skin is going to explode.
Best of luck with things!
Gary
June 22, 2015
This is a great source of information about ACL surgery. I have had all the after affects and I am still feeling the lows/pains even after 3 months, but reading this has made me feel a lot better about having the surgery done as I now know the feelings aren’t abnormal. Thanks
reddyb
June 22, 2015
Thank you Gary. I’m glad you’ve found it helpful.
Three months is still quite early. Keep at it. It’s a process that while seems forever, does tend to get better month by month. Best of luck!
Avisek Sarkar
June 28, 2015
My name is Avisek .I am from India
I have my acl surgery one year ago bmy surgeon says my acl is ok now but i can’t play soccer till now
reddyb
June 30, 2015
It’s common for the surgeon to say the ACL is ok, but at the same time one not feel ready to play, or be able to play, a dynamic sport like soccer. The surgeon is looking at one thing, the structural integrity of the ACL. The ACL can be solid, but that doesn’t mean ROM, strength, proprioception, psychology, and all the other factors associated with this, are also good to go.
B
July 26, 2015
I had my surgery 3 days ago and I wish I found this before my surgery so I could’ve been more informed! I have to wear a brace and its a struggle to sit down! I was advised that I can unlock it when I’m walking and lock it when I’m laying down. I don’t really understand the numbers on it though like it’s on 0 and 90 I don’t know if it’s good like that. Also is it normal to have my knee slightly bent? I’m a bit worried about it not being fully straight.
reddyb
July 28, 2015
0 and 90 means you can extend your knee to 0 degrees, and bend it to 90 degrees. It’s common to not allow a person to bend past 90 in the beginning. There is a fear of stretching the graft if knee flexion is too much, too soon.
By having the knee slightly bent, if you mean is it normal to not be able to completely extend the knee, yes, it’s normal, as in it’s very common, but it’s not good. Regaining full knee extension is the #1 priority rehab wise, and something that is ideally accomplished within *hours* after surgery. I hit on this hard in the manual.
Helen Powderham
September 11, 2015
Hi , i have just been reading through your article, i have to have this op soon. is there anything i can do to strengthen my knee before the operation? , I have completely torn my acl in my right knee.
reddyb
September 13, 2015
I would check out the manual and use it as a prehab for the operation.
sappy
September 17, 2015
Hi Brian ..
You have no idea what a noble job you have done writing this article. I had ACL reconstructed exactly 6 weeks ago, till yesterday I was on cloud nine as follow up with doc ended with positive note and I was feeling no pain or stiffness at all n then by evening my knee swell up n pain around incision was bad specially while walking. I can’t see any reason as if why all of a sudden this started. This hampered my progress n for two days I haven’t done any exercise as pain swelling n stiffness sont allow me to do any .. Wondering if anyone else or you might have such experience .. To tell u the truth I was pain free n progressing so good that Physio n Doc was keep saying tht my progress is beyond their imagination feels like fuckers Jinxed me man 🙁
Any advise help would be really appreciated mate..
Thnx!!
reddyb
September 20, 2015
Hey Sappy,
Thank you for the nice words. I’m glad you’ve found things helpful.
Having some ups and downs is a normal part of the process. Typically, when pain or swelling occurs like this, it’s often from the person doing too much one day. Where it’s good to back off for a few days, then start progressing again.
This is more theoretical on my part: I think there is also something with the healing process that can cause these sudden flare ups. I’ve seen a few people have this type of thing right around the incision area(s) as well. Where I think as the tendon that’s been cut gets to certain stages of healing, it may have a concurrent pain signal attached.
Regardless, I’m not sure I’ve ever seen someone just linearly improve. This is rare in most things involving training the body (strength, endurance, pain, etc.) Ups and downs seem to be inevitable.
Have you read the comments on the “Biggest mistakes” page? You can see some others with a similar experience.
http://b-reddy.org/2013/10/23/the-biggest-mistakes-acl-patients-make/
Dev
October 24, 2015
Hello Brian,
Glad I came across your article, I am in the border of stepping into surgery in a couple of days.
Really thinking if I have to undergo a surgery and if it is worth the pain and helplessness.
I tore my ACL while playing field hockey, and am on crutches since the past week.
I wanted to hurry up with the process and surgeon said its better to get the surgery as the knee might cause damage to meniscus in the long run (10-15 years) without support. So I agreed initially and he has a date for surgery next week.
This is when I started exploring about non surgical recovery options, I am just looking to have a normal lifestyle with little bit of running and biking if it permits.
After a week am trying to come out from crutches and trying to walk with without support.
Do you have any information on how long it might take to walk normally after Complete ACL tear?
With excercise and PT without surgery?
I shall take a call if I have to proceed with surgery or not to take that path.
Cheers,
Dev.
reddyb
October 27, 2015
Hey Dev,
Sorry to hear about your injury.
After the initial injury, many are walking well within a week. My personal experience was I was on my legs for 10 hours (personal training), two days after the injury. I didn’t feel great that day, but it was doable. By 5 or 6 days, I was fine walking. (I was running again after 7 days.)
That said, while a person may have a normal gait, they may suffer from the leg giving way at various times, once the ACL is torn. This is very individual. Some may tear their ACL, then after a week never think about the knee again. (They may never know they even torn their ACL.) Others may have the leg regularly give way on them. Maybe once a day, or every other day. And yet others may have the leg give way every week or so, then as they get some therapy going, and their body adapts, the giving way may progressively lessen. (This can be over many months though.)
My experience has been most people fit into the last group. After the injury, they know something is up. But get them with proper rehabilitation, and they do very well. This is one reason I just about always recommend people hold off on surgery, and see how things go.
There do seem to be some people that really need an ACL, where once it’s torn, they have a tough time ambulating without at least a weekly giving way sensation. I haven’t personally worked with any of these people, so I’m not sure if this is due to a lack of proper exercise, or something about their anatomy i.e. they really rely on an ACL.
Hope this is helpful.
Jim
November 12, 2015
Hey Brian!
Really a great site and I’ll be buying your manual.
It’s been 7 weeks since I had allograft ACLR. I’ve been doing excellent up until about the 5th week where the swelling and pain was increasing every other day. I hadn’t taken any NSAID’s until that point. At the 7th week, the knee was so swollen I couldn’t really walk well and it was really tough to go up the stairs. The entire time was going to PT (twice a week) and I had a few therapists but only the one felt it important to measure the knee and compare with the next time I came in. The day after seeing this PT I couldn’t stand the pain any longer (unable to sleep etc) so I went in to see the Dr. He was quite surprised to see me with the knee so swollen since I’ve been doing extremely well. He immediately did an evaluation and decided to aspirate the knee, taking about 120cc out. It immediately felt better and he recommended that I rest and ice it and no PT for 6 days until he saw me again.
What could have caused this?
I’m thinking that I may have just been over using it but the only thing I did outside of PT was walk from the car to/from the airport starting at the 4th week for one day then in the 5th week for one day.
Still waiting for the lab results and feeling quite depressed!
reddyb
November 12, 2015
Hey Jim,
Thanks for the nice words.
At a month post-op, there are maybe 3 typical scenarios going on with something like this:
-Certainly could have pushed things too much.
-A complication from the surgery.
-Range of motion was never properly restored, but you started to walk on the leg anyways.
-> To a lesser degree, people lose the ability to push off with their ankle. Because of this, the knee has to pick up the slack, and it doesn’t like that. A knee which just had surgery especially doesn’t like that. Restoring this should be part of restoring gait post surgery, but not everyone properly does this. Some just try to walk as much as they can, regardless of how they’re walking. (Sorry, I don’t have any posts written on this yet. One coming soon though.)
My first move with anyone having post-op issues is to check knee extension range of motion (and quadricep contractility), then plantarflexion -ankle push off- ability. If those things are going well, a person has good range of motion and normalized gait, then a week off can be in order. If pain is still going on after all that, a serious look needs to be taken by the surgeon, with the probability they’re going back in becoming increasingly higher.
David
December 29, 2015
Hey Brian,
Only stumbled across your posts now, I’m 11 wks post op today. Had my patellar tendon graft used. Seems to be worse than it was last week with pain when bending more than 90 degrees. Also the knee still feels very weak and as if there is a lot of “pressure” inside the knee, especially when bending the joint. Is this normal?! Becoming increasingly worried now about it! I’ve been going to PT once a week pretty much since the operation and I’ve progressively been given exercises.
Any feedback would be most greatly appreciated!
reddyb
December 29, 2015
Hey David,
That sounds common. The pressure is typically from extra fluid within the joint. That can take many months to work its way out, even if the knee doesn’t look noticeably swollen anymore. The time this is most noticed is with knee flexion past 90 degrees.
Ups and downs are common throughout the process. Sometimes that’s from trying to do too much, sometimes that’s just because biology is finicky that way. As time goes on, it’s best to try and start looking at things on a month by month process. “Am I doing better than I was last month?” Monthly, there should be consistent improvement. Weekly, that might not always happen.
David
December 30, 2015
Brian,
Thanks for your quick reply – really appreciate it.
I must start looking at it on a month by month basis and in that situation it’s not even 3 months post op yet – had the surgery Oct 13th. Is it common for the knee to still feel so weak though?
My main worries at the moment were the pain when bending (although you’ve allayed my fears with this slightly – Hopefully that pain goes in the next few months when the fluid leaves the joint) and also the weakness at this point. I just thought i would be stronger at this stage.
I was also worried that maybe there is some sort of complication but the surgeon said everything was a success ( I had a miniscus tear fixed also)
Then I start thinking maybe I’ve done something to damage the graft etc but I can’t see how I could have as I’ve been very careful.
My PT thinks I am on schedule but I just have some niggling doubts as my knee feels extremely weak and as i said earlier a feeling of pressure in it at times.
I guess i will judge it in a few more weaks at the 3 month post op stage and then again after 4 months.
Not being able to run or play football (soccer) is driving me crazy!
Cheers,
David.
reddyb
January 1, 2016
Hey David,
Perhaps thinking of it this way will help: It’s overall a minimum of a 9 month recovery to get back to all out sports, even for pro athletes. So at 3 months, you can imagine it’s normal for things to feel quite weak still. The experience of many is things don’t feel pretty normal until the 12 month mark, even if you’re playing sports. And even still, you don’t *really* feel normal until around 18 months. (This is why most pro athletes have a better second season after their recovery than first.) It’s an excruciatingly long recovery when most have only dealt with a few week ankle sprain before.
I wouldn’t worry so much about any timeline though. Everyone is different on this, and the last thing you want to do is rush things. It’s hard to go too slow on this process, but it’s very easy to go too fast. With timelines it’s more you wait until you try certain things, but it’s not as if you’re *supposed* to be doing certain things at certain times.
As long as things are steadily improving, whatever the pace, then typically things are alright. It’s when something stops improving that a complication may have happened / it’s probably time to worry some.
The mind gets worked as much as the body in this process!
David
January 4, 2016
Thanks Brian,
12 wks post op now. I’m meant to be starting jumping/skipping exercises this week but as soon as i skip on the bad knee on its own I have a shooting pain right in the middle of the knee – starting to think there is something else wrong!
David.
Jim Thompson
January 4, 2016
Brian, I think one of the key points that has been made in this forum is to NOT do anything if it hurts. There’s a reason that your body is feeding back this information. It could be that it’s just too soon for you to be doing that activity, or that there is actually something wrong, but let’s not jump to conclusions. I’m at 3.5 months and I was a picture perfect patient with no pain at all until the 5th week where I had to have my knee drained. After that point I did not do any real ambitious rehab, just ice, and stretching until the knee finally calmed down, which took at least two weeks, then I slowly started to get back into the rehab, but I’ve never been able to “catch up” to where I thought that I should be until maybe just a days ago. I know I might not be typical, but I think we all want to get back it quickly and rigidly follow the rehab protoclol but I’m not sure that we all can. I’m a very active guy an in shape for my age and my body just didn’t want to heal as fast as I thought it should. We all need to be honest with ourselves and listen to our bodies, regardless of what the PT or the protocol dictates.
reddyb
January 5, 2016
Hey Jim,
Very good comment.
This is one reason I never felt comfortable putting together an ACL resource that was 6+ months in length. It’s tough to build in enough flexibility in that time period. Because as you say, flexibility will be needed.
After the first month, I like to say there are still timelines, but they are indicators of when it may be ok to try something. Not when you *need* to be doing something. The first month there are timelines where it’s important to be doing certain things by certain time periods, but after that it’s a matter of steadily improving while being aware of those moments the knee needs some time to calm down.
Thanks for the comment Jim. Well said. Hope rehab continues to go well!
reddyb
January 5, 2016
Also wanted to let you know I reposted this comment on the “Biggest mistakes” post.
reddyb
January 5, 2016
Jim had a good comment regarding pain.
Sounds like the knee might not be ready yet. Plantarflexion strength is commonly lacking in knee injury people. If it’s not adequate right now, trying to do jumping / skipping is going to be tough. Single footed jumping at 3 months is going to be *hard* for a lot of people regardless.
More on plantarflexion and the knee here: http://b-reddy.org/2015/11/16/how-weak-calves-can-cause-knee-issues/
Of course, never hurts to check in with the surgeon. One reason they (should) have consistent follow up for ~9 months.
Britta
January 29, 2016
Great website!
I’m scheduled to have acl surgery on Wednesday. I feel like I’m mentally and physically ready but I’m still scared shitless.
It’s been over a year since I tore it and it really doesn’t bother me and I’m extremely active. I still continue to lift weights, circuit train, mountain bike and I even went skiing a couple weeks ago and that’s how I tore it, but it felt fine.
With my knee feeling so good it makes it that much harder to want to go through with the surgery. But, my surgeon said if I want to continue an active lifestyle I should get it fixed but if I wasn’t active he wouldn’t recommend it. I’m not a fan of doctors so whether that’s a line of bs who knows. I feel like all they want is your money. I’m more into the naturopathic medicine but I don’t have many options for that with a torn acl. So here I am going thru with it in a few days and not knowing 110% percent if it’s the right thing to do. Is that a normal feeling before going into the procedure?
I’m looking forward to your manual and exploring more of your website.
Thanks for all the info!
reddyb
January 31, 2016
Hey Britta,
That’s a very common feeling to go in with given your situation. I had a lot of the same thoughts, and you sound more active than I was! You’re very much someone who could potentially get away with not needing the procedure. In a large sense, you already are!
Unfortunately, as you allude to, surgeons get paid to cut. It’s not so much they’re bad people as the incentives they’re given dictate this. Their opinion on these types of things always need to be taken with this bias of theirs in mind.
I more thoroughly discuss surgery vs non surgery in these posts:
http://b-reddy.org/2011/11/29/reconstructive-acl-surgery-is-it-beneficial/
http://b-reddy.org/2011/12/05/reconstructive-acl-surgery-is-it-worth-it/
You may also be interested in this post:
http://b-reddy.org/2013/10/23/the-biggest-mistakes-acl-patients-make/
Britta
January 31, 2016
Brian,
The last couple days I have been putting some major research hours in.. I don’t know why I put this off until a couple days before my surgery.
Anyways, I have been finding some very interesting stuff on your page as well as many other websites. All of this information is making it very difficult to decide what I as an individually really need. How do you know?? I feel like I can get away with it, but then I’m scared to go out and play volleyball again or participate in a tough mudder. But, I think that’s a risk I’m willing to take over being laid up for almost a year. If I have a blow out at least I’ll know this time I really do need surgery. I’m not sure if that’s a good or bad way to look at it. I think regardless there will always be an endless list of what if’s. I think one of my biggest fears is that right now is prime time to have surgery so if I put it off even longer and end up really needing the surgery and it’s my favorite time of year I’ll be really bummed.
All I really want is to be able to give 100% to all the activities and sports I participate in.
I have found a clinic out of Vail, CO that has one of the top sports knee surgeons and I’m thinking of visiting him for another opinion. I’m not sure if it will be helpful or not, but, maybe he will have some other information since he deals with knee injuries everyday.
I think I have read through those links you posted, but I am going to look at them again.
Thanks again Brian!
reddyb
February 2, 2016
Hey Britta,
It’s a tough decision no doubt. You’ll see me run through a lot of those questions in the previous links I sent. It’s unfortunately rare the decision is clear. And when it’s clear, that often means the injury was more severe!
As a tangent: A lot of people get wrapped up in looking for the “top doctor.” Often finding sport surgeons. Keep in mind the population these people deal with is very, very different than most who have the injury. For instance, many of these surgeons do patellar grafts, when for most in the general population, a hamstring graft is likely best. (Discussed here: http://b-reddy.org/2011/12/15/reconstructive-acl-surgery-which-graft-should-you-use/ .) The best doctor in your case wouldn’t necessarily be someone who only does skiers, but someone who does your type of population, often. You want someone who is familiar with you, not necessarily an olympic athlete.
Furthermore, other than perhaps some very specific elements of the surgery, it doesn’t appear there’s much room for deviation with this procedure. Meaning I don’t believe there is a whole lot of variation between being board certified and “the best.” (At least in this procedure.)
There are of course always the top performers in any profession, but don’t think it’s automatically the names you know about, or someone sports oriented.
I had an appointment to see the orthopedist for the San Diego Chargers after I tore my knee up. I got an appointment within 24 hours, which is very unusual for a good ortho, as they’re often busy enough at least a couple week wait will be needed. I googled his name after getting off the phone, and found out a DEA investigation was going on over him. Looked like he got the Chargers gig more for his “networking” than his surgical skills!
It’s often a good idea to get a second opinion. But overall, you want someone who 1) does the procedure often (minimum once per week) 2) is familiar with the population you fit into 3) someone you’re comfortable with.