What Equipment Do You Need After ACL Surgery in NZ?
The three pieces of equipment most New Zealand physios recommend after ACL reconstruction are a cold compression machine, a neuromuscular electrical stimulation (NMES/EMS) device, and compression boots. Each targets a different problem in ACL recovery — swelling, muscle wasting, and circulation. Here's what each one does, when to start, and how long you'll need them.
Why ACL Recovery Equipment Matters
ACL reconstruction is one of the most demanding surgical recoveries in orthopaedics. The graft needs time to heal, but the muscles around the knee — particularly the quadriceps — deteriorate rapidly in the first weeks post-surgery through a process called arthrogenic muscle inhibition. Swelling in the joint interferes with the nerve signal to the quads even when you're actively trying to contract them. Meanwhile, the inflammatory response peaks in the first 72 hours and can delay early rehabilitation if not managed well.
The equipment most commonly recommended by New Zealand physiotherapists addresses these two overlapping problems: controlling swelling early, and maintaining muscle activation throughout.
1. Cold Compression Machine (CryoPush)
Cold compression therapy is the first line of equipment after ACL surgery. A motorised cold compression machine like the CryoPush circulates chilled water through a knee wrap while simultaneously applying intermittent pneumatic compression. This does two things simultaneously that ice alone cannot: it delivers sustained, consistent cold to reduce swelling and pain, and it applies compression to assist lymphatic drainage and venous return.
A 2023 systematic review and meta-analysis in Frontiers in Surgery pooling seven RCTs with 519 patients found continuous cold compression devices produced significantly better outcomes than traditional ice packs after knee surgery — including improved pain reduction and faster functional recovery (Liu et al., 2023).
When to start: Ideally within 24 hours of surgery, as soon as you're home.
How long: 20–30 minutes per session, 3–5 times daily for the first two to four weeks. Taper to as-needed after that.
How long to hire: Most ACL patients hire for two to four weeks. Your physio may recommend longer if swelling persists.
2. Compex EMS Muscle Stimulator
Neuromuscular electrical stimulation (NMES) is the most evidence-backed tool for preventing the quad wasting that follows ACL surgery. The Compex delivers electrical impulses through electrode pads placed on the thigh, directly triggering a muscle contraction — bypassing the inhibited voluntary signal that arthrogenic muscle inhibition disrupts.
A 2024 systematic review and meta-analysis in the American Journal of Sports Medicine pooled 11 randomised controlled trials (202 NMES patients vs 200 standard rehab controls) and found NMES combined with exercise significantly improved quadriceps strength and physical function after ACL surgery, with the benefit holding at both short and long-term follow-up (Li et al., 2024). A separate RCT showed early NMES use reduced muscle fibre atrophy at a cellular level — preserving the muscle itself, not just its output.
When to start: As early as your surgeon or physio clears it — the evidence favours starting in week one or two rather than waiting.
How long: Several sessions per week, timed around your physiotherapy exercises.
How long to hire: Most ACL patients use the Compex for four to six weeks through the critical early rehab phase.
3. Normatec 3 Compression Boots
Normatec boots deliver sequential pneumatic compression to the whole leg — from the foot upward — which assists lymphatic drainage, reduces lower limb swelling, and improves circulation. After ACL surgery, particularly in the first two to three weeks when the whole limb tends to swell rather than just the knee, full-leg compression adds a benefit that a knee wrap alone does not cover.
Some patients use Normatec boots instead of a CryoPush if their surgeon's protocol focuses more on compression than cold. Others use both — particularly athletes wanting to optimise recovery at every stage. Your physio or surgeon's recommendation should guide which is most appropriate for your procedure and recovery phase.
When to start: Once cleared by your surgeon, typically from day two or three post-surgery.
How long: 20–30 minute sessions once or twice daily.
How long to hire: Two to four weeks for the acute phase; some patients continue longer into return-to-sport phases.
What About the ACL Recovery Package?
RecoveryTec's ACL Recovery Package combines the Compex EMS muscle stimulator with either a CryoPush cold compression machine or Normatec 3 boots — depending on your surgeon's protocol — in one hire. It's designed to cover both the swelling management and muscle activation sides of early ACL recovery from day one at home.
The package is $200 for the first week and $150 per additional week. No bond, no lock-in. Most patients hire for two to four weeks and extend if their physio recommends it.
Available for pickup in Lincoln or Belfast, Christchurch — or couriered anywhere in New Zealand.
View the ACL Recovery Package →
Do You Need All Three?
Most patients don't need all three at once. The most common setup is:
Weeks 1–4: CryoPush (or Normatec) + Compex — swelling control and muscle activation together
Weeks 4–12+: Normatec boots on demand after training sessions as rehab intensity increases
If your surgeon has recommended specific equipment, follow their protocol. If you're not sure, call or text Mike on 027 340 6233 — he's a physiotherapist and can help you work out what's right for your recovery stage.
Sources
Liu M-M et al. (2023). Continuous cryotherapy vs. traditional cryotherapy after total knee arthroplasty: a systematic review and meta-analysis. Frontiers in Surgery, 9, 1073288. https://doi.org/10.3389/fsurg.2022.1073288
Li Z et al. (2024). Effects of Neuromuscular Electrical Stimulation on Quadriceps Femoris Muscle Strength and Knee Joint Function in Patients After ACL Surgery. American Journal of Sports Medicine. https://doi.org/10.1177/23259671241275071
Quesnot A et al. (2024). Randomized controlled trial of compressive cryotherapy versus standard cryotherapy after total knee arthroplasty. BMC Musculoskeletal Disorders, 25, 182. https://doi.org/10.1186/s12891-024-07289-x
