Injuries to the anterior cruciate ligament (ACL) are the most common type of ligament injury, affecting 100,000-200,000 people annually. This type of injury commonly afflicts athletes who participate in activities that require pivoting, lateral movement, or contact with other players. When the bones in the knee joint twist in opposite directions while there is weight on the leg, the ACL can become overstretched or torn.1 A doctor may recommend surgery in the case of a partial or full tear, especially for individuals who wish to continue participating in athletics.2
If you require knee surgery, your doctor may recommend ACL rehab exercises to help you regain full range of motion and increase stability in the knee joint. If you don’t need surgery or opt to delay surgical intervention, your rehab routine may determine whether or not you later need surgery. It’s important to try to closely follow the recommendations of your physical therapist because certain movements may actually inhibit your recovery from an ACL injury.
ACL Rehab Exercises to Avoid
Every athlete wants to recover as quickly as possible from any type of injury, but it’s important to have patience while your body heals. Even if you don’t experience significant discomfort or can push through the pain, try to avoid these exercises while recovering from an ACL injury:
1. Excessive weight-bearing before your body is ready
Early in the recovery process, perhaps even immediately after surgery, a doctor or physical therapist may instruct you to put some weight on the injured leg.3 Excessive weight-bearing, however, may reinjure the ligament. Use crutches or other assistive devices to help you stay mobile during the first couple of weeks of recovery until your doctor clears you for the next phase. Your doctor may also recommend a brace to help stabilize the injured knee.4
2. Walking without support too early
Walking may help you improve range of motion and gently exercise the knee joint. However, walking without an assistive device such as a crutch or stabilizing brace may place too much weight on a knee that is still recovering, increasing the risk of reinjury. It may also affect your gait, causing pain in other areas of the body. Most people may begin walking without assistance within 2-3 weeks after surgery.5 Ask a doctor or physical therapist when it is safe to walk with and without support.
3. Full-range open-chain knee extension
In an open-chain exercise, the end of the limb is free to move in space. In the case of an ACL injury, this is the foot. For example, a standing squat is a closed-chain exercise, because the feet are on the floor, whereas a seated quadriceps extension is an open-chain exercise because the lower leg is free to move. Experts disagree about the safety of this type of exercise. Earlier research suggested it was unsafe, but newer research finds that it may actually help an athlete return to their normal activities. Talk to a physical therapist about whether and when to include this type of exercise. They may recommend gradually working up to it, and avoiding it in the early recovery phase.6
ACL Rehab Exercises to Include
Depending on where you are in the recovery process, your physical therapist may likely recommend exercises such as:
The Game Ready blog has a more comprehensive list of ACL rehab exercises to do during the various stages of recovery.
After you have fully recovered, your doctor or physical therapist might recommend ongoing exercises to help prevent reinjury. Even if you have not suffered an ACL injury, it’s a good idea to try to be proactive with these types of exercises:
Be sure to warm up and stretch before participating in athletic activity and practice good alignment to avoid knee injuries.
Every injury is different, so it’s important to work closely with your healthcare providers in order to achieve the most effective recovery.
If you are planning to have ACL surgery, prepare for your recovery in advance by selecting a physical therapist who is a good fit for you and your injury.