Every person is different. Every joint is different. Every surgery is different. At MSR in Arlington, VA, we treat the whole person and keep the nuances of personalization in mind but there are some common themes and patterns that emerge. Below is glimpse into what to expect in terms of goals and typical exercises to be performed after an ACL reconstruction surgery. These exercises can be part of your home exercise program or during your treatment visits and by no means is an exhaustive list. The exercises and goals have a compounding effect, meaning the goals and exercises are still in place when progressing phases. Keep in mind different grafts and other surgical interventions performed by your surgeon may change things.
Early mobilization is key for post-op knee surgery. We will educate you on “what to do & what to avoid” with certain activities. Achieving 0 degrees knee extension (straight knee) is very important in order to walk without a limp- which will be the focus during the early phase of rehab.
We follow evidence-based practice with each injury and post-op surgery while using cutting-edge technology such as BFR (Blood flow restriction training) for muscle strength and endurance, STEP principle for therapeutic exercises and various Manual Therapy Techniques including Dry Needling, IASTM, Cupping, Taping, Myofascial Release, etc to create a very personalized Rehab Program for you.
We will work closely with your Physician/ Surgeon team to ensure we are on the same page about your progress. We will listen to your goals and progress accordingly while addressing appropriate tissue healing. We see a variety of patient populations from the High-level Professional Athlete to the person whose goals are to walk, garden, and perform regular activities of daily living. We will personalize our rehab program just for you and your goals.
We will work closely with your surgeon team, but here is a breakdown of how the rehabilitation process will go.
Day 0 – 7
Goals:
• Maintain knee extension to 0 degrees.
• Manage pain/swelling/inflammation.
• Progress weight bearing.
Exercises:
• Ankle pumps
• Glutes sets.
• Quad sets
• Patellar mobilization
Week 1 – 2
Goals:
• Maintain knee extension to 0 degrees.
• Quad neuromuscular activation
• Begin flexing knee (~60-90).
Exercises:
• Heel slides
• Short arc quads
• Straight leg raises with knee extended.
• Gait training
Week 2 – 4
Goals:
• Restore full flexion (>120)
• Begin strengthening.
• Normalize gait pattern.
Exercises:
• Stationary cycling
• Mini squats
• Single leg balance
Week 4 – 6
Goals:
• Progress weight bearing strength exercises.
• Neuromuscular Re-Education
Exercises:
• Single leg balance
• Step ups
• Single leg balance on uneven surfaces.
Week 6 – 8
Goals:
• Progress strengthening in frontal and transverse plane.
• Increase load to exercises.
Exercises:
• Weighted squats
• Lateral lunges
• Single leg balance with rotation
Week 8 – 12
Goals:
• Introduction to sub-max sport specific training (sagittal)
• Plyometrics
• Begin return to running program (~10-12 weeks)
Exercises:
• Bilateral jumping
• Drops
**Battery of tests initiated after this phase to ensure physical and psychological readiness***
Examples of test/criteria:
- Quad, glute, and hamstring strength 80% of unaffected leg
- Single Leg Hop Test
- Psychological assessment
- Adequate knee control with functional movements
Months 3 – 6
Goals:
• Progressive return to sport (RTS) training in all planes
Exercises:
• Functional training dependent on sport
Ex: Acceleration/Deceleration drills
***Every month after 6 months RTS is delayed = 10% decrease in chance of re-tear***
Months 6 – 9
Goals:
• Graded exposure to playing sport (non-cutting athlete)
Exercises:
Functional training dependent on sport
Ex: Ladder drills
***8-9 months is typical RTS but must have 90% quad strength compared to unaffected leg.***
Months 9 – 12
Goals:
• Graded exposure to playing sport (cutting athletes)
Exercises:
• Functional training dependent on sport
Ex: Cutting drills
Contact us today at our Physical Therapy Center in Arlington on Edgewood St or Arlington on Walter Reed Dr to learn more!
Check Out What Our Patients Have To Say About Their Experience
Your Next Steps…
Request An Appointment
Receive A Custom Treatment Plan
Work Hard and Progress In Your Recovery
Recover & Enjoy Life Pain-Free!
