Post Operative ACL Rehabilitation- what to do and what to expect

Most surgeons would agree that proper rehabilitation after reconstruction is as important as the surgery itself. The patient needs to be aware of what is involved before embarking upon surgery and be willing to put in the time and effort to ensure a good result. It is essential to have th

Is period supervised and directed by a physiothaerapist.

You may hear your physiotherapist talk about and direct you for:

Range of Movement (ROM) - this is the amount of movement of the knee from fully extended to fully bent

Muscle power - both muscles at the front of the thigh (Quadriceps) and muscles at the back of the thigh (Hamstrings)

Weight bearing - from partial or assisted weight bearing to full (Unassisted ) weight bearing

Proprioception -  awareness of the position, movement, co-ordination  and balance of knee (or other joint) function. This is mostly an unconscious ability we have which is damaged after ligament injury. Specific activities and practice , will regain this essential component of your rehabilitation.

Plyometric- the means of improving both the strength and speed of muscle contraction as a means of improving performance (Sport related)

Isokinetic testing - a means of measuring muscle function, it is a relatively accurate measure of overall muscle power and function using machines that measure strength during an exercise where the speed of muscle contraction is controlled

The following indicates a typical rehabilitation programme

Phase 1 (0-2 weeks)

Reduction of Swelling

- Elevation

- Use of cryo-cuff- provides cold compression

Weight-bear fully without support (crutches and braces)

Regain Range of motion

Start regaining quadriceps and hamstring strength

-Isometric Contraction of Quads

-Quad Sets

-Wall Slides

-Assisted Knee Flexion

-VMO Strengthening Exercise

Phase 2 (2-12 weeks)

Reduction of swelling

Weight-bear fully without support (crutches and braces)

Regain normal range of motion

Start regaining quadriceps and hamstring strength

-Isometric Contraction of Quads

-Quad Sets

-Wall Slides

-Assisted Knee Flexion

-VMO Strengthening Exercise

Phase 2 (2-12 weeks)

Reduce swelling.

Regain full knee extension and towards the end of this period, full flexion

Be able to squat

Regain balance

Re-establish proper walking pattern (gait)


- squats

- lunges

- leg press

- Step ups

- wobble board

- introduce cycling/ rowing

Phase 3 (3-6 months)

The goals of this phase are to:

Regain full range of motion

Regain full strength and power

Increase agility and adaption to direction change, acceleration and deceleration

Be able to perform restricted sports-specific drills

Begin plyometric drills

- Continue exercises from Phase 2, progressing to

- Jump & Land drills

Plyometric Drills

- Jumping over blocks, sideways & forward

- Hopping up & down steps/stairs

Isokinetic Testing

This is used to evaluate muscle strength.

The individual should have at least 90% quadricep strength of the uninjured leg

They should also have equal hamstring strength to their uninjured leg as well

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