Rehab Exercises for ACL Reconstruction

Reconstructive surgery on the anterior cruciate ligament, or ACL, of the knee is an intense and serious procedure. It requires extensive post-operational care that includes a strict physical rehab program. If rehabilitation therapy isn't completed under the guidance of a trained physical therapist, you run the likely risk of never fully regaining correct motion in the knee. During the rehab process, there are several types of exercises that can be used to bring back full use of your knee.

Initial Weeks

• For the first couple of weeks after surgery, the exercises should be very light in intensity, and should focus on regaining motion and flexibility in the knee joint. Once the incisions from surgery have healed and swelling doesn't pose a problem anymore, the exercises can begin.

  Knee extensions will have you simply extend your leg and rest it on something while you remain in a lying or seated position. The leg should be kept in this manner for several minutes. The goal is not to build or work the muscles so much as it is to train the ligament to extend itself once more.

  Additionally, you can perform some gentle leg-lift exercises. Lying flat, lift your legs into the air, trying to keep them even with each other. Then gently lower them back down and repeat. This works your quad muscles while also helping keep your knee straight and extended.

Several Weeks After Surgery

• During this period, the goal is to achieve and maintain a full range of motion from the knee. You can do daily stretching exercises, such as knee extensions. These are usually performed with the assistance of a trainer, so that some pressure can be applied to the joint, helping loosen it as you extend and contract. This, in turn, will enable a better range of motion.

  Once you are comfortable with moving the knee to a normal degree, you can move to more standard exercises, such as stairsteppers and a stationary bike. Do these very slowly and under supervision for about 30 minutes at a time. The goal is still not to build muscles in the normal sense but to build strength in the ligaments and areas that are responsible for those normal flexing and extending ranges of motion.

  Some resistance exercises also may be performed, such as extensions with exercise bands, to add some pressure and resistance to the knee.

In the Future

• In the months after ACL reconstruction, once full movement and flexion is regained in the knee, more strength-specific exercises can take place. Initially, these should always be under the supervision of a therapist because improperly performing them can put strain on the wrong areas of the knee and negatively affect the repaired ligament.

  Starting with low amounts of weight, you can perform squats and leg presses. These are ideal because when doing them correctly, the feet are planted completely flat against the floor. This allows you to evenly distribute and control weight on the knee as well as move it in a more straight and fluid motion.

  From here on out, you can begin focusing more on strength exercises than in the initial weeks, and eventually will have regained full use of your knee.