This article is useful for anyone who is in the early stages of anterior cruciate ligament reconstruction and needs to know what Anterior Cruciate Ligament Exercises should be doing.
Weeks 1 – 2 for anterior cruciate ligament reconstruction
Typically following anterior cruciate ligament reconstruction there are several stages of the early Anterior Cruciate Ligament Exercises. Typically someone following surgery would have had Nurse appt on day 2 for dressing change and review of the home program.
Ice/elevation every 2 hours for 15 minutes to minimise edema and promote healing.
Extensive patellar mobilisation anterior cruciate ligament reconstruction
- Passive mobilisation patella (medial glide)
In long sitting, place a cushion/towel under your knee so that it is flexed. Then use your hand to grip the kneecap and move it inwards in a gliding motion.
- Passive mobilisation patella (lateral glide)
In long sitting, place a cushion/towel under your knee so that it is flexed. Then use your hand to grip the kneecap and move it outwards in a gliding motion.
- Passive mobilisation patella (inferior glide)
In long sitting, place a cushion/towel under your knee so that it is flexed. Then use your hand to grip the kneecap and move it downwards in a gliding motion.
No direct scar mobilisation x 4 weeks.
- Crook Lying AROM hip and knee flexion
Lay on your back with both your legs fully extended. Now slowly slide your heel towards your bottom. Then return back to the starting position.
- Terminal knee extension, long sitting
Lay on your back with the injured knee bent at 45 degrees. Now gently slide your heel away from you and try to straighten your knee as much as you can.
- Supine, Active knee end-range extension with the heel on a towel
Lay on your back with your injured knee slightly bent. Then place a rolled-up towel or a foam roller under your foot. Now try to gently straighten your leg with the help of the roller.
- Active knee flexion-extension sitting with a small ball underfoot
Sit on a chair and place a small ball under your foot. Use the ball as assistance and try to move your knee forward and backward.
- Straight leg raise for anterior cruciate ligament reconstruction
Lay on your back with both the knees fully straightened. Now lift your injured knee as high up as you can whilst keeping a straight knee.
- Straight leg raise with core engagement for anterior cruciate ligament reconstruction
Lay on your back with both the knees fully straightened. With your arms, hold an elastic band that has been anchored behind your head (as shown in the video). Lift one leg at a time and simultaneously pull the band towards your body.
- Seated knee extension anterior cruciate ligament reconstruction
Sit on a chair. Use your hand to prop up the leg by supporting it at the back of the thigh. Now try to straighten your knee as much as you can.
- Seated knee flexion anterior cruciate ligament reconstruction
Sit on a chair. Use your hand to prop up the leg by supporting it at the back of the thigh. Now try to bend your knee as much as you can.
- Seated hip flexion anterior cruciate ligament reconstruction
Sit on a chair with bent knees. Now lift the injured hip up towards the ceiling with a bent knee.
- Side-lying hip abduction anterior cruciate ligament reconstruction
Lay on your side and place yourself where your body is fully straight. Now Lift your leg up in mid-air as shown in the video. Focusing on not to move the hip back and forwards.
- Prone Hamstring curls for anterior cruciate ligament reconstruction
Lay on your front. Now bend your knee towards your bottom as far as you can. Return back to starting position.
- Assisted walking with stick/crutches
In standing hold onto a stick/Crutches on your injured side. Move the stick forwards and place it on the ground. Then use your good foot to take a stride. Now use the support of the stick and move the injured leg in full stride forwards.
Upper body conditioning, well-leg stationary cycling, or Upper Body Ergometer.
Gait training progression towards minimising Assistive Devices (walker, crutches, etc).
NOTE: All progressions are approximations and should be used as a guideline only. Progression will be based on individual patient presentation, which is assessed throughout the treatment process.
Weeks 2 – 4 for anterior cruciate ligament reconstruction
Nurse appointment for suture removal on day 14.
Walking for exercise for 15-20 minutes if no limp or swelling present.
Extensive patellar mobilisation for anterior cruciate ligament reconstruction
- Passive mobilisation patella (medial glide)
In long sitting, place a cushion/towel under your knee so that it is flexed. Then use your hand to grip the kneecap and move it inwards in a gliding motion.
- Passive mobilisation patella (lateral glide)
In long sitting, place a cushion/towel under your knee so that it is flexed. Then use your hand to grip the kneecap and move it outwards in a gliding motion.
- Passive mobilisation patella (inferior glide)
In long sitting, place a cushion/towel under your knee so that it is flexed. Then use your hand to grip the kneecap and move it downwards in a gliding motion.
No direct scar mobilisation x 4 weeks.
Exercises for anterior cruciate ligament reconstruction
Range of motion and functional strengthening exercises:
- Standing AROM hip flexion
Stand next to a chair/table for support. Now stand on one leg and try to move your other hip forwards (you can keep the knee bent at the end of the movement.
- Standing AROM hip abduction
Stand next to a chair/table for support. Now stand on one leg and try to move your other hip sideways, away from your body (make sure to keep the knee straight throughout the movement.
- Terminal knee extension in stride stance with a band
In standing, Place a looped elastic band around your lower thigh. Now try to assume a split stance position. From this position, lift your injured knee up and try to straighten the leg against the resistance of the band.
- Seated knee extension with a band
Sit on a chair and anchor an elastic band behind your injured knee. Now attach the other end to the base of your foot. Now try to extend and straighten your knee against the resistance of the elastic.
- Seated knee flexion with a band
Sit on a chair and anchor an elastic band in front of your injured knee. Now attach the other end to the base of your foot. Now try to flex and bend your knee against the resistance of the elastic.
- Standing hip extension with a band
In standing, anchor an elastic band in front of you. Attach the other end to the base of your foot. Whilst keeping the knee straight, move your hip backward and extend your hip. Return slowly back to the starting position.
Squats for anterior cruciate ligament reconstruction
- Front squats
In standing place your feet hip-width apart. Now try lower your bottom towards the floor without moving your knees forwards as shown in the video. Try to gradually increase the depth that you could cover. Make sure to have the natural curvature of your spine throughout the movement.
- Leg Press for anterior cruciate ligament reconstruction
Sit on the machine with your back against the support. Place your feet slightly wider than hip-width apart. Your legs should form roughly an angle of 90 degrees from the knee. Push the plate platform away with your feet by extending the knees and hips, and pushing back into the seat. Bring your knees back towards your chest and allow the footplate to return to the starting position.
Bridges for anterior cruciate ligament reconstruction
- DL Hamstring Bridge
Lay on your back with your knees bent, Now pull your core muscles in and squeeze your glutes. Then raise your body up and off the floor to make a right angle. Return slowly back to the starting position. NOTE. You can place the feet further away from the body to increase the challenge.
- DL hamstrings bridge on a box
Lay on your back with your knees bent, place your feet on top of a step/Box as shown in the video. Now pull your core muscles in and squeeze your glutes. Then raise your body up and off the floor to make a right angle. Return slowly back to the starting position. NOTE. You can place the feet further away from the body to increase the challenge.
- Single-Leg Hamstring Bridge
Lay on your back and place one knee bent and the other leg straightened. Now pull your core muscles in and squeeze your glutes. Then raise your body up and off the floor, using only one leg to support. Return slowly back to the starting position. NOTE. You can place the feet further away from the body to increase the challenge.
- SL hamstrings bridge on a box
Lay on your back and place one knee bent and the other leg straightened. Then place your bent knee on top of a box/step as shown in the video. Now pull your core muscles in and squeeze your glutes. Then raise your body up and off the floor, using only one leg to support. Return slowly back to the starting position. NOTE. You can place the feet further away from the body to increase the challenge.
- DL Hamstring Bridge On Roller
Lay on your back with your knees bent, place your feet on top of a foam roller/ Rolled up cushion, as shown in the video. Now pull your core muscles in and squeeze your glutes. Then raise your body up and off the floor to make a right angle. Return slowly back to the starting position. NOTE. You can place the feet further away from the body to increase the challenge.
- SL Hamstring Bridge On Roller
Lay on your back and place one knee bent and the other leg straightened. Then place your bent knee on top of a foam roller/ Rolled up cushion, as shown in the video. Now pull your core muscles in and squeeze your glutes. Then raise your body up and off the floor, using only one leg to support. Return slowly back to the starting position. NOTE. You can place the feet further away from the body to increase the challenge.
- DL bridge on the swiss ball
Lay on your back with your knees bent, place your feet on top of a swiss ball, as shown on the video. Now pull your core muscles in and squeeze your glutes. Then raise your body up and off the floor to make a right angle. Return slowly back to the starting position. NOTE. You can place the feet further away from the body to increase the challenge.
- Prone hamstring curl isometrics
Lay on your front with both knees bent. Now hook your non-injured foot behind the injured foot. Then try to move the injured foot towards your bottom. And simultaneously try to resist this movement with our opposite foot.
- Step up and down (march)
Stand in front of a 2-inch box. Now step up onto the box as if you’re a]marching. Use alternating feet to complete the exercise.
- Step up drill with hip flexion SL
In standing, place one foot on the step. Now try to transfer your weight onto that foot and go up onto the step. When you are on top of the step, balance yourself on the same leg, and perform a hip flexion movement as shown in the video.
Intense core training – Please read the core strength article for further information.
Proprioception/Balance for anterior cruciate ligament reconstruction
Single leg balance for anterior cruciate ligament reconstruction
- Unipodal/single-leg stance with eyes open
Stand next to a chair, and try to balance yourself on one foot. Try not to hinge yourself through the hip, Instead, let the ankle correct your position. Aim for 60 seconds.
- Unipodal/single-leg stance eyes closed
Stand next to a chair, and try to balance yourself on one foot, then close your eyes. Try not to hinge yourself through the hip, Instead, let the ankle correct your position. Aim for 60 seconds
Aerobic exercises as tolerated (bilateral stationary bike, Elliptical, arm bike).
Active range of motion equal extension to uninvolved side and flexion to 120 degrees.
No edema.
Full weight-bearing; normal gait without an assistive device.
How much of these exercises should I be doing for my anterior cruciate ligament reconstruction
To find out more about how many of each of these exercises I should be doing based on my condition then you can use this as a rough guide to finding out more about how to know this.
How to plan exercises, sets, reps and rest intervals.
At this stage, you need to be thinking about visiting someone who can assess your condition and diagnose it properly to ensure you categorise your condition correctly, and then you can apply the correct type of exercises for this.
For more information about Anterior Cruciate Ligament Reconstruction
This article was written by our team of specialist therapists at Perfect Balance Clinic. If you would like more specific advice about how our team can help you with this condition or symptoms you may be having, please complete the contact form below and one of the team will get back to you shortly.
Perfect Balance Clinic accepts no responsibility for self-prescribed exercises. The information contained in this article or any others on this website should not be used in isolation to self-manage conditions but are provided for reference only to accompany a specialist managing your condition specifically and a review of the current advice surrounding each condition.
