Anterior Cruciate Ligament: Page 2 – Post operative physiotherapy

The early phase following anterior cruciate ligament (ACL) reconstruction focuses on protecting the surgical graft while restoring normal knee movement and muscle function. One of the most important goals is regaining full knee extension, as difficulties straightening the knee can affect walking mechanics, muscle activation and long-term recovery.

Early rehabilitation also aims to reduce swelling, improve range of movement and re-establish activation of the quadriceps muscles, which are often inhibited after surgery. Gentle, progressive exercises help restore confidence in the knee while building a strong foundation for later strength, running and return-to-sport rehabilitation.


Post operative Physiotherapy (outpatients)

On your first outpatient physiotherapy appointment your therapist will conduct a needs analysis so your rehabilitation is tailor made to you.  Regular physiotherapy and exercise will be extremely important to achieve your specific goals.

The main aim of physiotherapy immediately after injury/surgery is to:

  • Evaluate/test dysfunction: using a specific needs analysis for your specified goals

  • Reduce swelling: ICE, anti-inflammatory medication

  • Reduce pain: pain medication provided following your injury or surgery from the doctor

  • Protect the graft

Regain full range of mobility/movement (especially full extension of the knee)

Re- educate muscles and begin muscle activation


The Exercises

Participating in an exercise program carries a certain element of risk for some people. You should consult with your physiotherapist before initiating this program to ensure your safety.

If you have any issues please do not hesitate to contact the physiotherapy department. If you feel light headed, dizzy or have issues with your breathing please contact your general practitioner (GP) immediately.

When carrying out this exercise program you may feel some discomfort in your knee. It is important that the pain does not exceed 3-4/10, where 10/10 is the maximum and 0/10 is no pain. Remember some levels will overlap, this is normal.


Level One: Immediately post op, duration 1 - 2 weeks

Movement and waking your muscles up.

Range of Motion

Remember to give 5 - 10 minutes rest before going from each type of movement as it can be quite painful. You are not causing any harm to the knee pushing into some low levels of pain.

Extension

Static quad, with opposite leg lift

Inner range quad in lying

Inner range quad in standing

Flexion

Flexion in lying

Flexion on wall

Function

Stand up from a chair

Bridge

Clam

Hip Abduction

Heel Raises

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Anterior Cruciate Ligament: Page 3 – level 2 muscle activation

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Anterior Cruciate Ligament: Reconstruction (ACL – R)