Episode 61 | When Can You Shower after ACLR?

What is up guys, and welcome back to another episode on the ACL Athlete Podcast. Today, we are tackling the question of when can you shower after ACLR (ACLR meaning reconstruction or ACL surgery). And if you guys have noticed, we are tackling this immediately, when can you do X after surgery? And the reason why is because I get these questions all the time, and I just wanted to create a streamlined resource for you guys to be able to think about this and to apply it to your own situation.

Now, as I’ve mentioned before, everyone’s situation is going to be very different based on the surgery, their specific context of home, and the resources and support that they have. But hopefully, we can talk about the general principles and also just the general trends that I see with people and ACL athletes that I work with, as well as what I went through myself. So that’s kind of the lens that we are looking through, and also communicating with surgeons who also do these surgeries. If you want to know when you can walk, drive, or even return to work after surgery, then go check out the previous episodes where we dive into those specific topics. 

Today, we are talking about when can you shower after ACL surgery. And as a disclaimer, this is just educational advice; this is not specific medical advice so make sure you consult with your surgeon and your PT for your specific case. And I’m hoping that this can help guide you in this process for your own situation. You smell, you feel dirty, you have that kind of greasy feel -it’s the worst. And you want to take a shower. I remember, especially after my second ACL surgery, I was itching to take a shower. I haven’t moved that much. I was laid up on the couch for so long, and you are just ready to take a shower. 

First, I want to talk about some goals. Number one goal: keep your wounds and your incisions dry. That’s going to be really important here, especially in this episode, because that’s the main goal with a lot of this. Is that if you get your wounds wet, then it can create some problems, whether it’s an infection or just an inappropriate healing environment. A good rule for you is don’t get them wet until you are a hundred percent confident. They are closed up, they are healed, and you’ve had the go ahead from your surgeon or from your physical therapist. You just want to make sure you provide a really good healing environment for the knee for your body and for those wounds. 

Number two: Do not fall in the shower. Don’t twist or compromise your knee just to get a shower in. Keep in mind that you might be possibly taking some medications, so that might throw some things off. You might feel some sort of sharp or weird pains immediately post-op, especially in those first few days, so that’s normal. But you just need to be aware and prepared just in case you do something like that your knee does feel that way, especially when you’re in a slippery environment. You just don’t want to fall and do something dumb. So that is something to just keep in mind. I know that seems very obvious, but it’s just something that I want to make sure you guys think about as you are approaching this.

Number three: Plan ahead. This is so huge for the ACL process in general, but make sure you have a plan. Get what you need before, think through all of the equipment and things that you might need for surgery, getting from wherever you’re going to be laid up to the bathroom into the shower, specifically, or the tub that will make a world of a difference. You got to get into this mindset, okay, I can’t really get this wet. I might not be able to get this in the shower so what is my environment going to look like and what are the things that I might need? Maybe it’s a shower chair, maybe it’s a plastic bag with some tape, all of these things that you’ll need to consider in order to make sure you are prepared for your surgery.

Now, we’re going to dive into some general advice here. For your first shower, you’re going to feel like you did a full workout. It’s going to feel exhausting, it’s going to feel like a lot. That’s where the planning does come into place. But because your body is fatigued after this first couple of days after surgery, it’s going to feel fatiguing. You might need a nap after. And just be prepared for that. It’s not just going to go nearly as smoothly. You’re going to have all the energy in the world maybe, but typically you’re just going to be pretty tired afterward. Be prepared for that. Most surgeons will say you can shower usually around two to three days after your surgery.

For day one, I would highly recommend if it’s pre-surgery, try and get a shower in that morning because you’re not going to be able to shower for at least the next 24, usually 48 hours. Try to get a shower before that. And then if we’re talking the next day, then you’re going to probably sponge shower, use a washcloth, maybe use some wipes just because the surgery itself is going to kick in from maybe the pain and you’re not going to want to move around. And the last thing you’re thinking about on that day is going to be a shower. Day three, usually you’re given the go-ahead. This is usually 48 hours after or three days after showering. But you need to protect the knee to make sure that you cannot get any of the incisions or the wounds wet to make sure that it is still healing and that it is protected. 

Now, we’re jumping into how to actually shower. For day one, and day two, you can use a washcloth or get some wipes like some body wipes. Those can be very helpful just to maintain not smelling so terribly and feeling that greasiness. The other piece to this is that you’re probably not going to want to shower standing up as you have to deal with your balance. There’s going to be some pain and swelling in the knee. Obviously, you can risk slipping, and we just don’t want to compromise anything. And when you think about when you’re standing, we have gravity to work with and water just trickles down our body. We just want to make sure that that doesn’t squeeze into the wound and the site area. Just something to think about. And if you can be able to be seated whenever you take your shower, it’s going to be easier to navigate. You could straddle a tub or even prop your leg up out of the shower. A lot of people will get shower chairs. That’s just kind of depending on you and your situation. You can get a handheld shower head which was very helpful. I had one, so that helped me in my second ACL surgery. These are just things to potentially prepare for as you’re moving ahead because there might be a little bit of time where you’re not going to be able to fully stand in the shower and you’re going to have to protect that wound site.

And that leads me to the next part, which is covering your wounds. When we have surgery, we have scabs that formed after. Ensure it’s all protected with gauze and with wraps and things like that. But we want to make sure that these scabs and these wounds are really staying dry and that they have a good environment to heal. Whenever we add water to a scab, it creates some maceration. And then that could impact either the scab falling off or just delaying some of the wound healing. We want to make sure that these are covered really well and that water does not hit those wounds. Some way you can cover up the wounds is to use a plastic covering or a bag over the knee to ensure that you can keep this incision dry at all times. And just a heads up, just because you have a water-resistant dressing doesn’t mean you want to get it wet. I’ve had some people where they’re like, yeah, I just kind of did the shower because it was water resistant. But let me ask you this, is your iPhone water-resistant? Probably. Do you want to get it wet? No. It’s just there to help for protection. The same with your wounds here. It’s just in case, but don’t submerge your leg. Make sure that you keep it dry if you can. You want to be careful and make sure that you have that plastic sheet or bag that is completely sealed. You can use tape or some sort of elastic band above the knee and below the knee to make sure that water doesn’t drip down and seep underneath the bag onto that dressing. After your shower, you can remove the bag. But then make sure that there could be excess water around it so then you just need to make sure that that doesn’t touch the dressing or the site as well.

Some things to think about for my own ACL surgery and trying to take showers. I used a trash bag and some duct tape. As a side note, I broke my ankle twice in the eighth grade. I was casted for a pretty long time, roughly around 14 weeks on separate occasions. It was like eight weeks and six weeks. I got really used to wrapping a plastic bag and duct-taping the top of it. And so this is something that you can use as long as you make sure you do it really well. You could also use Saran wrap and duct tape. If you want to be super extra, you can get a knee cast cover from Amazon for 20 or 30 bucks. I’m just going to give you a heads-up. If you’re going to spend that money, you might as well go buy a neuromuscular electrical stimulation unit for 50 bucks off of Amazon instead, that you’re going to get way more out of, which is just a side note. But if you’re going to spend the money, might as well do that instead of getting a knee cast cover, that will be so temporarily used. 

And then usually around three weeks or so, if all has gone well, you’ll probably be able to submerge your knee underwater for a bath or even potentially start swimming again. That’s usually the timeline based on just healing and wound care. But this is just something that you need to keep in mind you need to make sure that the wounds are fully healed. So that might even mean, you remove that gauze and it’s not draining anymore, but you might still have stitches and the wounds still might be slightly open. So those need to be closed and starting to scar down a little bit before you really start trying to risk, getting water. And that way you can protect that joint. Ultimately, you can prevent any infection and you can move ahead with your ACL rehab. Remember the goals: keep the wound dry, don’t fall, and plan ahead. Always check with your surgeon and physical therapist for your specific case. 

If you guys have any questions, please feel free to send them my way. Otherwise, that will do it for today, guys. As always, I appreciate you listening. This is your host, Ravi Patel, signing off.