10 Best Exercises To Do Before ACL Surgery With Pictures

An ACL injury or injury to the anterior cruciate ligament, is a frustrating injury that often requires ACL reconstruction surgery. A common misconception is that knee rehab starts after ACL surgery. Physical therapy and rehabbing the knee should start BEFORE ACL surgery. This article includes the 7 best exercises to do before ACL surgery for a speedy recovery.

Things I Wish I Knew Before ACL Surgery

As someone who has underwent 4 ACL surgeries there is a lot things I wish I knew before ACL surgery.

• Prepare yourself mentally
  • ACL surgery is a big surgery. You will be in pain and you will be frustrated at how difficult it is to just walk to the bathroom or get coffee with a friend, especially if you are used to being very active.
• Have a support system
  • Recovering fro surgery can be lonely and boring. Make sure to have a support system of people, whether it is someone helping you at home or just someone calling and texting you to check in.
• Clean your room and house or apartment
  • You may be loopy from meds and the last thing you want is to trip over a shoe you left in your room. It will be challenging to move around, so make it as easy as possible for yourself by having a clean house.
• Schedule PT
  • It can sometimes take 2-4 weeks to get scheduled for an evaluation for PT so schedule it before you have surgery so you can start right away.
• ICE
  • Ice is crucial in decreasing swelling and pain.
• Clothes
  • Bring baggy clothes to the hospital. I made the mistake of bringing pants for my first surgery and did not realize that my pants were not going to fit until I woke up in a hospital gown with a giant brace and swollen knee.
• Shoes
  • Wear sturdy, comfortable shoes
• Don’t overexert yourself
• Do your home exercises
  • Performing your home exercises from physical therapy early on will help to speed up your recovery.
• Amuse yourself
  • Gather a list of shows and movies to watch or books to read before you have surgery. Maybe take up a new hobby like knitting or create a scrapbook with your free time.
• Returning back to daily life will suck
  • Everyone expects the first week after surgery to be hard but most people do not think about how hard it will be once they return to work or school etc. Returning back to your daily life will be exhausting.

What Not To Do Before ACL Surgery

It is important to not overexert yourself the couple of days before ACL surgery. You want to limit as much swelling and inflammation in your knee as possible before ACL surgery.

It is typically ok to walk and participate in ACL prehab before surgery, however you should avoid jumping and cutting movements since your knee is more unstable without an ACL.

How Long To Prehab Before ACL Surgery

The duration of your prehab for an ACL tear will depend on how soon your surgeon wants to perform surgery, however typically the most successful prehab protocols for a torn acl will last for 4-6 weeks.

This timeline may be shorter depending on your progress or your insurance. Insurance may only give you a specific amount of visits a year and you do not want to use all of them before you actually get the surgery!

Torn ACL Exercises To Avoid

You should avoid jumping, pivoting and any exercises that require strong stability of the knee. Single leg exercises can be performed with caution as long as you have the stability in the knee. The important thing is to not further injury the knee.

Medical Disclaimer

Remember to always seek medical advice from your healthcare provider before starting any new exercise program, especially if you have pre-existing medical conditions or concerns. The advice of a doctor can provide personalized recommendations based on your individual needs and circumstances

If you do start a new ACL exercise program it is a good idea to see a physical therapist. They will be able to develop a plan of care that is specific to you and your deficits from your injury.

For example, you may need to focus on improving knee motion, while someone else may need to focus on knee stability or quad strength. A physical therapist will be able to modify the intensity of the exercises based on your specific needs.

Exercises To Do Before ACL Surgery

Engaging in specific exercises before ACL surgery can help strengthen the muscles around your knee, improve your range of motion, and prepare your body for a smoother recovery. These are the 10 most effective pre-surgery exercises.

Range Of Motion Exercises

Range of motion exercises are important in achieving full range of motion of the knee. When you have limited range of motion in the knee, it can cause compensatory gait patterns. The normal knee range of motion for knee flexion is typically 120-140 degrees. The normal full knee extension range of motion is 0 degrees, or when the knee is perfectly straight.

These knee range of motion exercises are 1. Quad Sets 2. Heel Slides and 3. Ankle Pumps.

1. Quad Sets

• This is a great strengthening exercise for the quadriceps muscle.
• Start by lying down with your knee straight out in front of you.
• Now tighten or active your quad muscles.
• These are the muscles on the top of your thigh.
• Try to push the back of your knee down straight into the surface below you.
• You can place a small rolled up towel underneath your knee for an added tactile cue to push into.

2. Heel Slides

• Start by lying down on your back with your injured knee straight.
• Now slowly bend your injured leg.
• Bend the knee as much as you can and then slowly straighten it back out to the starting position.
• You can also wrap a sheet, towel or strap around your foot to assist with bending the knee further.

3. Ankle Pumps

• Ankle pumps are great exercises to improve blood flow circulation and decrease swelling of the leg.
• Start by lifting your toes and ankle towards you and then push all the way down like you are trying to push down on a gas pedal.

Strengthening Exercises

Improving muscle strength of the quadriceps muscle or thigh muscles (muscles of the front of your thigh) and the hamstring muscles are important in ACL rehab. The following exercises focus on improving the muscles of the knee and hip.

These leg strength exercises include 4. Straight Leg Raises Flexion 5. Straight Leg Raise Abduction 6. Straight Leg Raise Adduction 7. Straight Leg Raise Extension 8. Hamstring Curls 9. Bridge and 10. Heel Raises.

4. Straight Leg Raises Flexion

• This exercise improves quadriceps strength.
• Start by lying down on your back with one leg bent and the leg that you want to strengthen straight.
• Now lift your leg up to the height of your other leg and then slowly lower it back down.

5. Straight Leg Raise Abduction

• Lie on your side with the leg that you want to strengthen as your top leg.
• Keep your bottom leg bent and your top leg straight.
• Now lift your top leg up towards the ceiling.

6. Straight Leg Raise Adduction

• This exercise works on strengthening your inner thigh muscles and improving knee stability inn the knee joint.
• Start by lying on your side with your bottom leg straight and your top leg bent over your bottom leg.
• Now keep your bottom leg straight and lift the leg off the ground.

7. Straight Leg Raise Extension

• This exercise works to strengthen the glute muscles and back of the leg muscles.
• Start by lying on your stomach with both legs straight.
• Now keep your leg straight and lift your leg up off the ground.

8. Hamstring Curls

• This exercise will improve your hamstring strength.
• You can perform this exercise in either standing or lying on your stomach.
• To perform this exercise standing start by standing next to a sturdy surface for support.
• Stand on one leg and slowly bend the other leg up towards your butt and then slowly lower the leg back down to the ground.
• To perform lying on your stomach start with both legs straight.
• Now slowly bend one knee towards your butt and then slowly return the foot back to starting position.

9. Bridge

• Start by lying on your back with both of your knees bent.
• Squeeze your butt and lift your hips and butt off the mat and then slowly lower yourself down to the starting position.
• You should feel this exercise in your butt, not your back. Be sure to push evenly with the knee with the knee injury and the unaffected knee.

10. Heel Raises

• Start by standing and holding a wall for balance.
• Push up onto your toes and then slowly lower yourself back down to the ground.
• Be sure to push up evenly with both your surgical leg and non affected leg.

Goals of Pre-Surgery Exercise

• Reducing Swelling and Inflammation
  • Swelling can limit your range of motion and make the knee stiff, which can complicate both the surgery and the recovery process.
• Regain Full Range of Motion
  • Ensuring that you can bend (knee flexion) and straighten (knee extension) your knee fully before surgery can significantly enhance the effectiveness of post-surgery rehabilitation.
  • If you lack knee extension, for example you will have gait abnormalities and limp every time you walk since you are walking on a bent knee.
• Improve Muscle Strength
  • Maintaining muscle strength around the knee is crucial before undergoing ACL surgery. Strong muscles, particularly the quadriceps, hamstrings, and glutes, support the knee joint. When these muscles are strong, they can better stabilize the knee, which will benefit you both before and after surgery.
• Improve Walking
  • The path to learning how to walk properly again will depend on the severity of your injury and your doctor’s protocol.
  • If you do not have any restrictions you will work on improving your knee range of motion so that you are able to complete the entire gait cycle without any compensations. You will also build up the strength in your affected leg to allow you to place your entire weight on that leg. Focus on walking with an even step length, meaning there should be equal distance between both of your feet regardless of which foot is in front.
  • If you do have restrictions it is best to ask your doctor about returning to walk. You doctor may want you to walk with a locked knee immobilizer brace. This will obviously impact your gait as you will be walking with a straight knee.

Summary

ACL injuries can be a significant setback for anyone. The anterior cruciate ligament (ACL) plays a critical role in stabilizing your knee joint, and when it’s injured, the road to recovery can be long and challenging. This exercise program will ensure a smoother recovery process.

Pre-surgery exercises are about preparing your body to handle the upcoming procedure and recovery phase more effectively. By strengthening the muscles around your knee, reducing inflammation, and improving your overall physical condition, you can significantly enhance your post-surgery rehabilitation outcomes.

Looking for ACL exercises after surgery? You can find them at 31 Best ACL Strengthening Exercises After ACL Surgery.