Comprehensive Approach to Rehabilitation After ACL Tear Surgery

Anterior cruciate ligament tears are very common knee injuries, especially for athletes and physically active individuals. The road to recovery from ACL surgery can be long and challenging and often requires a structured rehabilitation program to regain full knee function and strength. Pristyn Care’s effective rehabilitation protocol is designed to help patients recover quickly and safely from ACL surgery. This blog outlines a post-surgery rehabilitation plan, which spans from the first day after surgery to beyond 12 weeks.

Rehabilitation From Day 1 – Day 14:

The first two weeks following ACL surgery are crucial for recovery. The focus during this phase is on reducing swelling, regaining knee mobility, and beginning to restore muscle strength without putting excessive strain on the healing tissues. 

• Ankle Pumps – Ankle pumps are essential for promoting blood circulation and preventing blood clots. Patients are advised to perform this simple exercise frequently throughout the day.
• Heel Press (All-Day) – This exercise helps activate the hamstring muscles without moving the knee joint, providing gentle stimulation to the muscles involved in knee stabilization.
• Sitting Passive Knee Bending (>120 degrees) – Passive knee bending helps improve joint mobility and flexibility. The goal is to achieve a knee bend of more than 120 degrees by the end of this phase.
• Straight Leg Raise with Brace – Strengthening the quadriceps is critical, and straight leg raises help build this muscle group. The brace provides support and prevents unnecessary strain on the knee.
• Side Leg Raise with Brace – Similar to the straight leg raise, this exercise focuses on the hip abductors, which play a role in knee stability.
• VMO Exercise (Sitting Football Press) – Strengthening the vastus medialis oblique (VMO) muscle is important for knee alignment and stabilization.
• Prone Leg Hangs (Hold for 5 min) – This exercise gently stretches the knee joint and helps in reducing stiffness.

Rehabilitation From 2 Weeks – 4 Weeks: 

As the initial healing progresses, the focus shifts towards enhancing knee stability and strength. All exercises from the previous phase are continued, with additional activities introduced:

• Wall Squats – These help in building quadriceps strength and improving knee stability. Patients are encouraged to perform wall squats with support initially.
• Lunges with Support – Lunges help strengthen the quadriceps, hamstrings, and glutes. Using support helps maintain balance and reduces the risk of injury.
• Back Bridge with Football Press – This exercise targets the glutes and hamstrings, which are crucial for overall leg strength and knee support.
• Achieve Forceful Complete Knee Bending – Full knee bending is encouraged to ensure the knee joint’s complete range of motion is restored.

Rehabilitation From 4 Weeks – 6 Weeks: 

By this time, new exercises are added while the previous ones are still being continued:

• Start Jogging – Light jogging is introduced to begin the transition from walking to running, improving cardiovascular fitness and leg strength.
• Lunges – Continued emphasis on lunges helps in further strengthening the lower body muscles.
• Squats – Squats are crucial for overall lower body strength and knee stability. Different variations such as sumo squats are included to target different muscle groups.

Rehabilitation From 6 Weeks – 10 Weeks: 

As the knee heals and strengthens, the rehabilitation program becomes more intense, focusing on strength, agility, and coordination. New exercises might be introduced, such as:

• Open Chain Kinetic Exercises – These exercises target the quadriceps muscles directly, which are vital for knee support.
• Single Leg Squats – These exercises help in building strength and stability in each leg individually, which is important for balanced recovery.
• Balancing Training – Balancing exercises enhance proprioception, which is crucial for preventing future injuries.
• Jump and Land on One Foot – This exercise prepares the knee for high-impact activities by strengthening the muscles and improving coordination.
• Box Jumps (Both Legs) – Box jumps increase power and explosiveness, necessary for athletic performance.
• Side Walk with Theraband – This exercise targets the hip abductors, helping in lateral stability.
• Side Jump Squats/Lateral Squat Jumps on Stepper – These exercises further develop agility and lateral movement skills.

Rehabilitation From 10 Weeks – 12 Weeks:

During this phase, the focus is on high-intensity training that simulates sports and athletic activities. New exercises include:

• Lateral Squat Jumps on Bosu Ball – These exercises challenge balance and strength simultaneously.
• Box Jump on Bosu Ball – Using the Bosu ball adds instability, increasing the difficulty and effectiveness of the exercise.
• Single Leg Jump on Bosu Ball – Enhances single-leg strength and stability.
• Double Leg Cross Jumps – These exercises improve agility and coordination.
• Single Leg Balancing on Bosu Ball – Essential for building stability in the injured leg.
• Lateral Walk – Improves lateral movement and coordination.
• Jogging with Jump and Reverse Jogging – These drills simulate real-life movements and help in regaining athletic capability.

Rehabilitation After 12 Weeks:

After three months, patients are ready to gradually return to sports and high-level activities:

• Start Running –  Full running is resumed, focusing on technique and endurance.
• Single Leg Cross Jumps – Enhance agility and single-leg strength.
• Squat and Pivot with Theraband – This exercise mimics the pivoting motions often required in sports.
• Run, Jump, and Pivot – Prepares the knee for complex, multi-directional movements.
• Agility Drills (Zig-Zag, Side Running & Figure of 8) – These drills enhance agility, speed, and coordination.
• Agility with Football – Sports-specific drills help in regaining confidence and skills required for specific sports.

The ACL rehabilitation program at Pristyn Care ensures that patients not only recover from surgery but also regain their pre-injury level of fitness and function. By following this structured plan, patients can safely and effectively return to their normal activities, whether that be everyday tasks or competitive sports. The key to successful recovery lies in consistent effort, proper guidance, and patience, all of which are integral to ACL rehabilitation.