ACL Rehabilitation – Patient Information

ACL Rehabilitation: Post ACL Reconstruction

The rehabilitation is milestone based
You need to complete the requirements of each phase before moving on to the next
Approximate time frames are outlined
At each post-operative appointment, your progress will be assessed
You will be referred to an appropriate physiotherapist (or osteopath as an alternative) who will guide you through this programme and outline details of specific exercises which you may perform yourself at the gym
The physiotherapist will also give your surgeon feedback with regards to your progress
Not everyone attends a physiotherapist (such as if you don’t live close enough to any physiotherapists). Please discuss with your surgeon for your at-home ACL rehabilitation plan

Patients should wait 6 weeks before driving if their “braking” leg has undergone surgery

Week 0 – 2 (approximate)

The aim of this stage is to recover after ACL reconstruction surgery. You should spend the time at home resting. Stay mainly on the couch. Wear your tubigrip
Take pain killers as required. Stay well hydrated
Regular ice to control swelling. Apply ice to your knee for 30mins, 5 or 6 times a day
Take pain killers as required. Stay well hydrated
Use crutches but weight bear as tolerated
Try to lock your knee out straight and tighten the quadriceps
Pump the calf muscles every chance you get

Week 2-6 (approximate)

The main aim here is to achieve a good ROM in your knee. Most importantly complete extension (knee out straight equal to the opposite healthy knee).
Practice your knee extension locking exercise (most important), knee bending and prone hanging. Ask your physiotherapist or surgeon for details
You should attempt to achieve a normal walking style. Full weight bearing
You may commence stationary cycling when comfortable
Resume normal daily activities
Continue icing the knee. Swelling MUST be minimised
This phase usually lasts about 6 weeks but may vary between 3 and 12 for example
The simple thing is to do your best and don’t worry about your progress or lack of it. Each person has a unique road to recovery after ACL surgery
Sometimes you will be told to slow down or speed up
You will have regular reviews with your surgeon and your physiotherapist
GOALS: A good ROM, complete extension, no swelling
If you achieve all the desired goals you may move on to the next phase of rehabilitation

Week 6 – 12 (approximate)

This phase usually lasts about 6 weeks, but may vary between 3 and 12 for example
You should now be walking normally and performing normal activities of daily living
It is now time to commence a gym based programme emphasising strength of all muscle groups including quadriceps, hamstrings, calf, gluteals, core strength. Balance exercises are also important
Activities include walking, cycling, swimming (no breaststroke), rowing
Don’t over do it. Ice after activity
GOALS: Normal gait, swimming, cycling, one leg squat to 90º
If you achieve all the desired goals you may move on to the next phase of rehabilitation

Week 12 – 20

Week 20+

Increase intensity of training, strengthening
Isokinetic testing; aim for quads to be 90% normal between 6-9 months
Endurance. Fitness
Sport specific exercises. Refer to your surgeon and your sport physiotherapist
Fifa “The 11 ExercisesThe prevention programme “The 11″ was developed by FIFA’s medical research centre (F-MARC) in cooperation with a group of international experts. “The 11″ is a simple, catchy and time-efficient preventive programme that comprises ten evidence-based or best-practice exercises and the promotion of Fair Play

Once you have completed Phase 4 you have essentially completed your ACL rehabilitation.

From about month 9 onwards, you can aim for return to competitive sport, based on strength, proprioception and symptoms.

However, we need to know that you have achieved a state of recovery good enough to protect your “new” knee.

We have developed a score that accurately predicts whether or not you have attained a full recovery after your injury and surgery:

If you pass the test, you are ready to start training.

Once having completed full training, you may PLAY!