The anterior cruciate ligament, or ACL, stretches from the femur, or thigh bone, to the tibia, the larger of the two shin bones. The ACL accounts for 85 percent of the force that prevents anterior translation in the knee, which means that athletic activity that puts extreme lateral pressures on the knee directly impacts the ACL and strains its ability to hold the knee straight relative to the upper and lower leg. More than 100,000 cases of ACL injury are treated each year, according to the University of Missouri-Columbia School of Health Professionals. Surgical reconstruction, if it’s required, is successful in most cases, but it’s only the beginning step of a long process of rehabilitation.
Rest for at least two full days following ACL reconstruction surgery. Elevate the injured leg whenever possible to prevent swelling and apply cold compresses or ice packs to the injury.
Use crutches at all times during the initial phases of recovery. Straining the repaired knee can cause reinjury, so even if you feel up to it sooner than you thought you would, don’t put your body weight on the injured leg. You may be on crutches as little as two weeks or as long as eight weeks, depending upon the extent of the procedure. Always follow your doctor’s guidance on what you should and should not do early on.
Begin physical therapy, either guided or with a sports medicine professional, as soon as your doctor clears the activity. Preserving healthy blood flow to the lower extremities is the goal of your initial activity, so you should take simple steps like flexing or rotating the ankle five to six times per day.
Passively bend the knee to restore range of motion. Rest your heel on an ottoman and relax the thigh muscles. The knee will sag and stretch the injured area.
Lie flat on your stomach on a bed, weight bench or medical table with your legs hanging off the edge. The knee should be over open space. Relax all the leg muscles and allow the leg to reach full extension using the force of gravity.
Bend the knee further as you progress through your rehabilitation schedule by doing heel slides several times per day. Lie on your back with your legs extended. Lift the injured leg and slide the heel toward the buttocks and hold it for five seconds. Repeat this exercise several times per day. As your rehab progresses, you can do this in a sitting position and use your arms to pull the heel as close to the buttocks as you can.
Ride a stationary to rebuild core strength in the knee after you’ve restored complete range of motion. Swimming is another low-impact exercise that builds strength at this early stage.
Build your exercise program to include weight training exercises like leg presses and leg curls when your doctor has cleared you to do so.
Return to light athletic activity after you’ve restored enough strength in the knee to support directional changes and sudden stops. Every case is different, so evaluate your progress with your doctor or physical therapist before resuming this type of activity.
Resume preinjury activity level only if you’ve adhered to each of the rehabilitation guidelines outlined by your physician or physical therapist. Most ACL reconstruction patients resume preinjury activity levels six months after surgery.