Exercises After ACL Surgery for Dogs: The Week-by-Week Recovery Plan

Written by the PetFitness team and reviewed by our Certified Canine Fitness Trainers. Last updated October 26, 2026.

Your dog’s knee surgery is done. The part that decides whether it worked is the next twelve weeks, and that part is yours. A dog ACL surgery recovery goes well or badly on the same things every time: whether the dog was kept off the leg while the bone healed, whether it was moved enough to keep the muscle, and whether the owner knew which exercise belonged in which week. The exercises on this page are the ones we use with dogs after TPLO, TTA and lateral suture surgery in the PetFitness program, laid out week by week so you know what to do on day three and on day sixty, with the house setup that prevents most re-injuries, the signs that mean call the surgeon, and the plan for protecting the other knee, which is the part almost nobody tells you about.

What was actually repaired

Dogs don’t have an ACL, strictly speaking; the equivalent ligament in the knee (the stifle) is the cranial cruciate ligament, CCL, and “ACL” is just the name everyone uses. Its job is to stop the shin bone sliding forward under the thigh bone every time the dog puts weight on the leg. In people it tears in one bad moment on a ski slope. In most dogs it frays over months and finally gives, which is why a dog that “just started limping” often has a knee that’s been going for a year, and why the other knee is usually on the same road.

Surgery doesn’t stitch the ligament back together; it can’t be repaired. Instead, the surgeon changes how the knee works so the ligament isn’t needed. TPLO (tibial plateau levelling osteotomy) cuts and rotates the top of the shin bone and fixes it with a plate, so the knee is stable under load without the ligament. TTA (tibial tuberosity advancement) moves a different piece of the shin forward for the same effect. Both are bone surgeries, and recovery is really bone healing: the cut has to knit, which takes eight to twelve weeks, and until the X-ray says it has, the plate and screws are doing a job they weren’t designed to do alone. The lateral suture (extracapsular) repair, used mostly in smaller dogs, doesn’t cut bone; a strong suture outside the joint does the ligament’s job while scar tissue builds, so there’s no bone to heal but the suture can loosen or break if the dog overdoes it early. The surgeon may also have trimmed a torn meniscus, the cartilage pad inside the knee, which is common and changes nothing about the plan.

Knowing which operation your dog had tells you what the early restrictions are protecting: a healing bone cut, or a suture and scar tissue. Either way, the first eight weeks are about not loading the repair beyond what it can take, and everything after is about rebuilding the leg.

Set the house up before the dog comes home

Most post-surgery disasters happen inside the house, not on walks, and in the first two weeks: a scrabble across tile, a jump off the couch when the doorbell goes, a flight of stairs taken because nobody was watching. The plate, the suture and the bone cut can all fail from one of those, and a failed TPLO means a second surgery. Before the dog is home, or right now if it already is:

• Cover every slippery floor the dog will walk on with rugs, runners or yoga mats, including the route to the door, the feeding spot and the vet’s exam-room equivalent at home: wherever you’ll do the exercises.
• Block the stairs top and bottom with gates. Carry a small dog; use a sling for a big one if a few steps are unavoidable.
• Block the furniture or set up a pen or crate in the family room. The dog needs to be with you and unable to jump, both at once. Pet stairs or a ramp to the couch, like the ones in the photo at the top, are for later in recovery once the surgeon allows it, not week one.
• A sling or a towel under the belly for potty trips for the first week or two, so the dog can’t slip or lunge.
• A ramp for the car, or lift the dog in and out, for at least twelve weeks. Jumping out of a car is a hard landing on the front end and a push off the back.
• Keep the cone on. Licking an incision opens it. The cone, a surgical recovery suit or a leg sleeve like the one on the Akita further down this page stays on until the surgeon says the incision is healed, usually ten to fourteen days.
• Brain work instead of body work: stuffed food toys, lick mats, snuffle mats and stationary training (chin rests, nose touches, “look at me”) keep the dog sane in a pen.

The recovery timeline, week by week

This is the typical path after a TPLO or TTA with no complications in a healthy adult dog. A lateral suture repair follows the same shape with slightly earlier clearances. Your surgeon’s instructions override every line of it, and the week-8 X-ray is the gate between the first half and the second: nothing in weeks 8 to 12 starts until the bone has been confirmed healed.

Weeks	What’s happening	Exercise	Not yet
0 to 2	Incision healing, swelling and bruising (often tracking down to the hock, which is normal), pain control. Most dogs toe-touch within days and bear some weight by two weeks.	Leash potty trips only, 5 minutes, slow, sling support. Cold packs 10 to 15 minutes, 3 or 4 times a day for the first 72 hours. Passive range of motion and gentle massage once the surgeon has shown you.	Everything else. Sutures out and incision check at 10 to 14 days.
2 to 4	Incision closed. Dog should be placing the foot and starting to use the leg at a walk. Thigh muscle visibly smaller than the other side; that’s expected.	Slow leash walks, 5 minutes building to 10, two or three times a day. Warmth before, PROM daily. Weight shifts. Standing weight-bearing holds. Cookie stretches.	Sit-to-stands (most surgeons wait until week 4), stairs, trotting, any off-leash.
4 to 8	Bone cut knitting. Dog walking fairly normally at a slow pace. Muscle starts to come back if it’s being used.	Walks building to 15 or 20 minutes. Square sit-to-stands, 3 to 5 building to 10. Three-leg stands. Backing up. Underwater treadmill once or twice a week from about week 3 or 4 if available.	Hills, cavaletti, balance equipment, swimming, trotting.
8	Recheck X-rays. If the bone has healed, the plate is no longer carrying the load and the second half of recovery begins. If it hasn’t, you stay in the 4 to 8 week plan until it has.	As above until cleared.
8 to 12	Rebuilding. The leg can take more load; the goal is to get the thigh back to the size of the other one.	Walks to 30 minutes with gentle hills. Cavaletti poles on the ground. Standing on a cushion. Figure-eights. Backing up. Short controlled trots late in the phase if cleared.	Fetch, jumping, dog parks, rough play.
12 to 16	Return to normal. Most dogs look sound. The inside of the knee is still remodelling.	Trotting on leash, then short off-leash time in a quiet fenced area, building weekly. Swimming if cleared. Core work twice a week.	Ball launchers and frisbee, still. Ideally for good.
4 to 6 months	Full activity for most dogs. Some stiffness after hard days is normal for a while; arthritis in the operated knee is common long-term and is managed with weight and muscle.	Normal life, with the house rules for the other knee below.

The exercises, and how to do them after a knee repair

These are the same movements used in any injury recovery, with knee-specific details that matter. The two things a cruciate repair needs most are knee flexion (bending) and the back-leg muscle, mostly the quadriceps and hamstrings, that holds the joint. Every exercise below is chosen because it does one or both. Always on a non-slip surface, always slow, always after a few minutes of walking to warm the leg up.

1. Controlled leash walks (week 1 on)

The foundation. Short leash, harness, sling under the belly for the first week or two, and a speed slow enough that the dog puts the operated foot down and pushes off it on every step. If the dog is hopping or carrying the leg, you’re too fast; slow to a crawl until it uses the leg. Flat, even, soft surfaces: grass, dirt, carpet. Add about five minutes a week from week two on. Two or three short walks a day beat one long one, and the dog’s pace sets the rules, not yours. Later, from week eight, choose routes with a gentle slope at the end.

2. Cold, then warmth (week 1 on)

For the first 72 hours after surgery, a wrapped cold pack on the knee for 10 to 15 minutes, three or four times a day, keeps swelling down. After that, switch to warmth before exercise and range of motion: a warm damp towel or a heat pack with a cloth between it and the skin, 10 to 15 minutes, which loosens the joint and the muscles around it. Cold again afterward if the knee looks puffy. Never directly on the incision.

3. Passive range of motion (week 1 on, once shown)

With the dog lying on its good side, operated leg up, support the leg above and below the knee and slowly bend it, hold two or three seconds, slowly straighten it, hold again. Ten to fifteen cycles, two or three times a day, only within the range the dog accepts without tensing. Do the hip and the hock on the same leg too; they stiffen alongside the knee. This is the exercise that stops the knee locking up in the first month, and it only works if it’s done daily and gently. Your surgeon or a rehab therapist should show you the first time; the safe range depends on the repair.

4. Massage (week 1 on)

Five to ten minutes of slow, firm stroking along the thigh above the knee and the muscles below it, always toward the heart, and along the back and the other back leg, which are working overtime. Keeps the muscles from tightening, improves circulation to the healing tissue, and most dogs relax into it. Stay away from the incision until it’s fully healed.

5. Standing weight-bearing holds (week 2 on)

Simply standing square on all four feet on a non-slip surface for 30 to 60 seconds, two or three times a day, with the dog’s weight evenly spread. Sounds like nothing; for a dog that’s been holding the leg up for two weeks, it’s the first real load through the knee. Use a treat held level with the nose so the dog stands straight rather than craning. If the dog keeps lifting the operated foot, a hand gently supporting under the belly helps it settle into using it.

6. Weight shifts, especially backward (week 2 on)

With the dog standing square, gently press a hand on the chest to push the dog’s weight back onto its hind legs, a centimetre or two, then release and let it recentre. Then side to side at the hips, pushing gently toward the operated leg so it has to take the load. Five to ten slow shifts in each direction, twice a day. The backward shift is the one that matters most for a knee repair because it loads both hind legs evenly and teaches the dog to stand off its front end, which it has been leaning on for weeks.

7. Cookie stretches (week 2 on)

Standing square, lure the nose slowly round toward the hip on each side, then down between the front paws, then up, holding two or three seconds at each, feet still. Three rounds. Turning toward the operated side loads that leg; this is a gentle way to get weight onto it before the sit-to-stands start.

8. Square sit-to-stands (usually week 4 on)

The most important strength exercise after cruciate surgery, and the one with the most rules. A dog with a sore knee sits with the operated leg kicked out to the side to avoid bending it. That “lazy sit” is exactly what you don’t want: the exercise only works if the sit is square, both back legs tucked evenly, which forces the operated knee to bend fully under load. Do it in a corner or beside a wall on the operated side so the leg can’t swing out, lure a slow sit, hold a second, then lure a slow stand with the treat moving forward at nose height so the dog pushes up from the back legs with the front feet staying still. Three to five reps to start, once a day, building to two sets of ten by week eight. If the dog can’t sit square yet, it isn’t ready; stay on weight shifts and holds another week and try again. Full technique in our core strength guide.

9. Three-leg stands (week 4 on)

Lift a healthy leg an inch off the floor for three to five seconds so the dog has to carry more on the operated one. Start with the front leg on the opposite side (operated right knee, lift left front), which shifts the least, and progress to lifting the other back leg, which shifts the most. Three to five holds per session.

10. Backing up (week 6 on)

Walking backwards loads the hind legs and bends the knees with no impact. Stand facing the dog and step gently into it; mark and reward each step back. Build to five, then ten steps, along a wall so the dog stays straight. Our guide to helping a dog with weak back legs covers building it up for a dog that finds it hard.

11. Underwater treadmill (from about week 3 or 4, once the incision is healed)

If there’s a canine rehab clinic within driving distance, this is the thing to book. Water to hip height takes well over half the dog’s weight off the knee, so it can walk with a full, even stride and bend the joint through its normal range while the muscle rebuilds, weeks before it could do the same on land. A therapist sets the depth and speed, sessions run 10 to 20 minutes once or twice a week, and most TPLO and TTA dogs start three or four weeks after surgery. The same clinics do the land-based work in the photo above: supervised weight-bearing on platforms, braces where they’re indicated, and a trained eye that catches a compensating limp early. A single assessment with a certified rehab therapist (CCRT or CCRP) in the first month, with a home programme to follow, is some of the best money in the whole recovery, and it’s what we’d suggest for every large dog, every overweight dog and every dog whose owner isn’t sure the exercises are being done right.

12. Cavaletti poles (week 8 on, after the X-ray)

Four to six poles on the ground, a body length apart, walked over slowly on a leash. Stepping over something makes the dog lift the operated leg higher and bend the knee more than a flat walk ever does. Three to five passes each way. Keep the poles on the floor; raising them is a week-12-plus progression. More in our guide to improving a dog’s balance.

13. Gentle uphill walking (week 8 on)

Walking slowly up a slope you’d barely notice shifts the dog’s weight onto the back legs and makes the thigh muscles push. Add it to the end of a walk, up and down a few times at a walk, then zigzag across it. Avoid steep downhills for now; they load the front end and brake hard through the knees.

14. Standing on a cushion (week 8 on)

A firm couch cushion or a lightly inflated balance disc under the back feet, or all four, for 10 seconds building to 30. The unstable surface fires every small stabilising muscle round the operated knee. Add a cookie stretch while standing on it once the dog is steady. Two or three holds a session.

15. Swimming (week 12 on, only if cleared)

Most surgeons hold swimming until the bone is healed and the dog is strong on land, because the dog controls the intensity, it’s much harder work than it looks, and the kicking action loads the knee in a way that isn’t right early on. When cleared: life jacket, calm shallow water, a ramp or gentle entry rather than a jump, a few minutes to start. Our guide to whether dogs are natural swimmers covers introducing it.

What to avoid, and for how long

Avoid	Why	Until
Slippery floors	The splits on tile is the number one way a TPLO fails in the first month.	Always, for a cruciate dog. Rugs stay down.
Stairs	Uneven loads on a healing bone; a slip on stairs is a bad fall.	8 weeks minimum; then a few supervised steps at a walk.
Jumping on or off furniture, in or out of the car	Push-off from the hind legs and a hard landing.	12 weeks; then ramps or pet stairs for life.
Off-leash time	One lunge at a squirrel is enough.	12 weeks, then short supervised sessions in a quiet fenced area.
Trotting and running	Load the repair before the bone has healed.	After the week 8 X-ray, and then on leash in short bursts.
Play with other dogs	Unpredictable twisting and body-slams.	16 weeks, then one calm dog at a time.
Fetch, frisbee, ball launchers	Sprint, skid, twist, leap. The exact movement that tears cruciates.	Ideally never again. Rolling a ball a few yards on grass is the replacement.
Human painkillers	Ibuprofen, acetaminophen and naproxen are toxic to dogs.	Ever. Only what the surgeon prescribed, finished as prescribed.

Signs it’s going well, and signs to call the surgeon

On track looks like this: toe-touching within the first few days and some weight on the leg by two weeks; walking with a slight limp but using the leg by four weeks; a nearly normal walk by eight; the square sit coming back; and the thigh slowly catching up with the other side. Measure the circumference of both thighs at the same spot with a tape measure every two weeks if you want a number; most dogs lose a couple of centimetres in the first month and get it back over the next three. Some swelling and bruising that drifts down the leg toward the hock in the first week is normal. A soft fluid swelling over the incision (a seroma) is common and usually settles on its own, but mention it at the recheck.

Call the surgeon the same day, rather than waiting for the next appointment, if: the dog was using the leg and suddenly stops, especially with a click or pop (a late meniscus tear or an implant problem, both fixable, both urgent); the incision opens, oozes, smells or gets red and hot; the swelling gets worse after day three instead of better; the dog cries out when the knee is handled; it won’t eat or is unusually flat for more than a day; or there’s no progress at all across any two-week stretch. After any new exercise or increase, watch for 48 hours: more limping, stiffness or swelling means step back a level for a week.

The other knee

Here is the part that gets left off most discharge sheets. Around half of dogs that rupture one cruciate ligament go on to rupture the other, usually within a year or two, because the same slow degeneration that took the first one is happening in the second, and because the second knee has been carrying extra weight for months. You can’t change the dog’s anatomy. You can change the two things that have the biggest effect on the odds.

The first is weight. Being overweight is the single biggest controllable risk factor for cruciate disease, and every extra pound is a pound on a knee that’s already degenerating. If your dog is carrying any extra, the months of restricted exercise after surgery are the time to fix the food, because the walks aren’t going to do it. Check with our body condition guide and, if the ribs aren’t easy to feel, run the weight loss plan alongside the rehab. The second is muscle. The strength work in weeks 8 to 16, sit-to-stands, backing up, cushion stands, hills, isn’t just for the operated leg; done evenly, it builds the hamstrings and quadriceps on both sides, and strong muscle around a knee takes load off the ligament. Keep two short sessions a week going for the rest of the dog’s life, and keep the rugs down, the ball launcher in the bin and the ramps by the couch and the car. Arthritis in the operated knee is the usual long-term outcome of a cruciate repair, and the same two levers, lean and strong, are what keep it mild; our arthritis exercise guide covers the years after.

A sample day at four stages

For a medium or large dog after TPLO or TTA with a normal recovery. Illustrative; your surgeon’s sheet sets the real dates.

Stage	A typical day
Week 1	Four 5-minute slow leash potty trips with sling support. Cold pack 10 minutes, three times a day for three days, then warm pack. PROM 10 cycles on knee, hip and hock, three times a day once shown. 5 minutes of massage. Pen with a stuffed food toy. Cone on. Pain meds as prescribed.
Week 3	Three slow 8-minute walks on grass. Warm pack before the main walk, then PROM. Two 45-second standing holds. Weight shifts, backward and sideways, 10 each, twice. Cookie stretches, 3 rounds. Snuffle mat dinner.
Week 6	Two 15-minute walks. Warm-up, then 8 square sit-to-stands in a corner. Three-leg stands, 4 holds. Backing up, 6 steps x3. Weight shifts. Underwater treadmill once this week. Puzzle feeder in the evening.
Week 10 (after the X-ray)	Two 25-minute walks, one ending with a gentle hill up and down three times. Every other day: two sets of 10 sit-to-stands, cushion stand 30 seconds x3, cavaletti 4 passes each way, backing up 10 steps x3, figure-eights x5. Underwater treadmill once. One minute of leash trotting at the end of the week if cleared.

Frequently asked questions

How long does dog ACL surgery recovery take?

About 12 to 16 weeks to normal walks and short off-leash time, and four to six months to full activity, for a TPLO or TTA. Bone healing is confirmed by X-ray at around eight weeks, and that’s the gate to the second half of recovery. Lateral suture repairs run a little faster.

What is the TPLO recovery timeline week by week?

Weeks 0 to 2: strict rest, leash potty trips, cold packs, PROM once shown. Weeks 2 to 4: 5 to 10-minute slow walks, weight shifts, standing holds. Weeks 4 to 8: walks to 15 or 20 minutes, sit-to-stands, backing up, underwater treadmill. Week 8: X-rays. Weeks 8 to 12: walks to 30 minutes, hills, cavaletti, cushion work. Weeks 12 to 16: trotting, gradual off-leash. Full activity at four to six months.

When can my dog walk after ACL surgery?

Short, slow leash potty walks from the first day home, five minutes at a time with a sling under the belly. Proper walks build from about week two, five minutes at a time, adding roughly five minutes a week. No off-leash walking until the surgeon clears it, usually after twelve weeks.

Is it normal for my dog not to use the leg after surgery?

For the first few days, yes. Most dogs toe-touch within a week and put real weight on the leg by two weeks. A dog that still won’t bear weight at two weeks, or that was using the leg and suddenly stops, needs a call to the surgeon.

How do I know if my dog is overdoing it?

More limping than the day before, stiffness getting up, new swelling at the knee, licking the leg, or reluctance to do something it did happily two days ago. Use a 48-hour rule after any increase. If any of those show up, drop back a level for a week.

Can my dog climb stairs after TPLO surgery?

Not for at least eight weeks, and then only a few supervised steps at a walk. Gate the stairs, carry a small dog, use a sling for a big one. Ramps and pet stairs for the couch and the car are a permanent change for most cruciate dogs.

Does my dog need physical therapy after ACL surgery?

A structured home programme is essential; a professional is strongly recommended. Dogs that get formal rehab after cruciate surgery tend to regain muscle and normal gait faster. At minimum, one assessment with a certified rehab therapist in the first month, and the underwater treadmill if there’s one within reach.

Will my dog tear the other ACL?

Around half of dogs do, usually within a couple of years. The two things that lower the odds are keeping the dog lean and keeping the hind-leg muscle strong with two short sessions a week for life, plus retiring the twist-and-land games like fetch and frisbee.

What about a dog ACL brace instead of surgery?

Custom stifle braces exist and some dogs, especially small ones or those that can’t have surgery, manage with a brace, strict rest and rehab. The evidence for braces is limited and most surgeons recommend surgery for medium and large dogs. It’s a conversation for your vet, not a decision to make from a website.

Can I stop the exercises once my dog looks normal?

Finish the programme, then keep a lighter version going for good. Looking normal at week ten means the limp is gone; the muscle and the inside of the knee are still catching up for months. Two short core sessions a week for life is the cheapest insurance there is for the other knee.

Where this fits in your dog’s plan

A PetFitness recovery plan after cruciate surgery takes your surgeon’s timeline and turns it into a day-by-day programme: the right exercises for each stage, the progression after the week-8 X-ray, the house setup, and the weight and strength work that protects the other knee for the rest of the dog’s life. If you’d like the plan built for your dog’s recovery, build your dog’s plan here. If you’d rather start on your own tonight: put a rug on every slippery floor between the dog’s bed and the back door, gate the stairs, find the tape measure for the thigh check, and make tomorrow’s first potty trip five slow minutes with a towel under the belly.