Few things feel more frustrating than finally getting home after ACL reconstruction and realizing that a full night’s sleep is suddenly the hardest part of the day. Pain, swelling and the bulky post-op brace can all make drifting off—and staying asleep—difficult. Yet quality rest is exactly what your body needs to heal. Below are eight patient-tested strategies we routinely share in clinic to help you reclaim those Z’s.

1. Keep the Leg Slightly Elevated

Propping your calf on a stack of firm pillows or a foam wedge so the foot sits just above heart level encourages fluid to drain and eases throbbing. Make sure the pillow is under the lower leg, not directly under the knee.

2. Use the Brace—But Loosen the Straps

Unless otherwise directed, wear your brace at night for the first few weeks. Snug, but not tight. A looser fit can relieve pressure while still protecting the knee.

3. Back-Sleeping Is Best (for Now)

Sleeping on your back keeps the knee stable and makes icing easier. Side-sleepers can place a large pillow next to them to avoid rolling during sleep.

4. Side-Sleeping? Do It the Safe Way

After pain improves, usually 10–14 days, you may sleep on your non-operative side. Use a firm pillow between your knees to keep your surgical leg level with the hip.

5. Chill Before You Chill

Ice 20 minutes before bedtime to help lower inflammation. Never fall asleep with ice still on—follow the “20 on, 40 off” rule.

6. Time Pain Meds Wisely

Take your next dose 30–60 minutes before bed so it peaks as you settle in. Talk to your provider if pain persists despite medication.

7. Create a Sleep-First Bedroom

Lower lights, reduce noise and keep the room cool (around 65°F). These cues help your body shift into sleep mode naturally.

8. Keep Moving—Gently—During the Day

Simple exercises improve blood flow and reduce nighttime stiffness. Ask your Blackrock Orthopedics physical therapist what’s safe for your current phase of recovery.

When to Call Your Surgeon

Severe calf pain, fever, or unusual swelling could signal a complication. Don’t wait—contact us immediately if you’re concerned.

Still having trouble sleeping after ACL surgery? Our team at Blackrock Orthopedics is here to help with tips, rehab support, and personalized care plans to help you rest easier and recover faster.