An anterior cruciate ligament (ACL) injury can be as complicated as the name sounds. It involves the ligament in the middle of the knee which prevents the shin bone from sliding out in front of the thigh bone. An ACL injury is caused by overstretching or tearing the ligament, either partially or completely and along with the ligaments, there is a high probability of meniscus tear.
An injury to the ACL affects the very stability of your knee, resulting in a loss of leg strength and a restriction in the knee's range of motion. Severe tears or ruptures will often require surgery and extensive rehabilitation to fully restore your mobility.
Grade 1: Stretched Ligament
Grade 2: Partially Torn
Grade 3: Completely Torn
Since I also had this injury in the past while playing football, I had undergone 2 knee surgeries on the same right knee (first one 6 years ago and the second one after 2 years as the joint lost stability without any impact).
Based on my experience with this injury recovery and fitness coaching knowledge(NASM CPT, CES) I have designed these phases to help others recover from their ACL injuries.
The major goals of rehabilitation of the ACL-injured knee:
Gain good functional stability
Regain muscle strength
Reach the best possible functional level
Decrease the risk for re-injury
Phase 1: Activation & Range Of Motion
Phase 2: Strengthening
Phase 3: Back To Gym
Phase 4: Back To Sports
Phase 1: Activation & Range Of Motion
If you’ve recently had ACL surgery, exercises are an important part of your recovery, in addition to a physical therapy program. These exercises should be done for 1-4 weeks after surgery or after injury if you are following a conservative approach for grade 1 tear after consulting your doctor. The goal of these exercises is to regain neuromuscular control of the quadriceps, strengthen the hip and maintain knee and ankle range of motion on the affected leg.
Perform these exercises 1-3 times per day, only within a pain-free range of motion. Stop the activity if it causes increased pain.
ACTIVATION EXERCISES
1.QUAD PUMPS
Sitting on the floor with a good posture extend both the legs forward.
Flex the ankles and squeeze that quadriceps muscle by pressing the thighs towards the floor and hold.
This will help you to activate those quadriceps muscles on the front thigh.
You can also use a cushion or make a fist and place it under your thighs just above the knees to elevate the leg for better activation.
TARGET : QUADRICEPS | HOLD : 10SECS | REPEAT : 5 TIMES
2. ANKLE PUMPS
Sitting on the floor with a good posture extend both legs forward.
Extend the ankles to contract those calf muscles
Flex the ankles to stretch those calf muscles.
TARGET : CALF | HOLD : 10SECS | REPEAT : 5 TIMES
3. HEEL PRESS
Sitting on the floor with a good posture extend both legs forward.
Keeping both the knees straight press the heels of the injured leg on to the floor and hold.
TARGET : CALF | HOLD : 10SECS | REPEAT : 5 TIMES
4. STRAIGHT LEG LIFT
Lie flat on your back and bend the non-working leg.
Lift the injured leg keeping the ankles flexed and the quadriceps pumped.
Lift it till both the knees get in line and hold there at the top.
TARGET : CALF | HOLD : 10SECS | REPEAT : 5 TIMES
5.STRAIGHT LEG LIFT(external)
Lift the injured leg by externally rotating it from the hips while keeping the ankles flexed and the quadriceps pumped.
Lift it till both the knees get in line and hold there at the top.
TARGET : VASTUS MEDIALIS | HOLD : 10SECS | REPEAT : 5 TIMES
6.STRAIGHT LEG LIFT(internal)
Lie flat on your back and bend the non-working leg.
Lift the injured leg by internally rotating it from the hips while keeping the ankles flexed and the quadriceps pumped.
Lift it till both the knees get in line and hold there at the top.
TARGET : VASTUS LATERALIS | HOLD : 10SECS | REPEAT : 5 TIMES
7.SIDE LYING LEG LIFT
Lie sideways on the floor keeping the working leg upward and bend the non-working leg in front of your torso.
Lift the injured leg such that it makes around 40 to 50 degree from the floor and hold there at the top.
TARGET : GLUTE MEDIUS,ADDUCTORS | HOLD: 10SECS | REPEAT : 5 TIMES
8.REVERSE LEG LIFT
Lie flat on your stomach keeping both the knees locked straight.
Lift the injured leg keeping the knees locked as much as it's possible for you.
Hold at the top position.
TARGET : HAMSTRING,GLUTES MAX | HOLD : 10SECS | REPEAT : 5 TIMES
9.HAMSTRING CURLS
Lie flat on your stomach keeping both the knees locked straight.
Bend the knee of the injured leg and try to reach your heel towards the hips as much as it's possible for you.
If it gets too easy then you can place the other leg on your ankles and then try to touch heels on your hips by providing this added resistance.
TARGET: HAMSTRING | REPS: 12 | REPEAT : 3 TIMES
10. WALL PUSH DRAGS
Lie flat on your back keeping both legs on the wall maintaining a 90-degree angle at your knees.
Now without changing the leg position press the leg into the wall and drag it forward and backwards alternately.
TARGET: HAMSTRING | REPS: 12 | REPEAT : 3 TIMES
STRETCHING AND RANGE OF MOTION EXERCISES
1.CALF STRETCH
Sitting on the floor with a good posture keep both the legs forward by extending the knees.
Wrap around the towel or band on the balls of your injured leg.
Pull it towards you, as you pull it further you will feel the stretch in your calf muscles.
TARGET : CALF | HOLD : 20-30 SECS | REPEAT : 3 TIMES
2.HAMSTRING STRETCH
Keeping the knee locked pull the band towards you.
As you pull it further, you will feel more stretch on your hamstring which runs behind the thighs, hold there at the maximum stretched position.
TARGET : CALF | HOLD : 20-30 SECS | REPEAT : 3 TIMES
3. QUAD STRETCH
Standing straight wrap around the towel or band on to your shins.
Without curving your lower back pull the towel or band upward while flexing the knee joint of the injured leg.
As you reach to the limit of your knee flexion hold there and squeeze your glutes.
The more you squeeze the glute the more stretch you will feel on the quadriceps muscle.
After your knee flexion increasing you can do the same without band or towel assistance.
TARGET : CALF | HOLD : 20-30 SECS | REPEAT : 3 TIMES
4. KNEE EXTENSION
Sitting on the floor with a good posture extend both the legs forward keeping the knees straight.
Place a cushion or foam roller just under the calf to elevate your injured leg.
Flex the ankle and squeeze the quadriceps allowing the knee to drop down(extension).
TARGET : KNEE EXTENSION RANGE | HOLD : 20-30 SECS | REPEAT : 3 TIMES
5. HEEL SLIDES(knee flexion)
Flex the ankle and squeeze the quadriceps allowing the knee to drop down(extension).
Wrap around the towel or band just above the ankle of the injured leg.
Pull the band towards you while allowing the knee to flex as much as its tolerable.
Once you get comfortable with the movement you can do the same without towel or band assistance.
TARGET : KNEE FLEXION RANGE | HOLD : 20-30 SECS | REPEAT : 3 TIMES
6. KNEE CAP MOBILITY
This will help you to improve the movement of the patella while flexing and extending the knee.
Hold the knee cap with town fingers and slide its sideways and make small circles.
This will help you to improve the knee range of motion.
TARGET : KNEE CAP | 20-30 SECS | REPEAT : 3 TIMES
7. WALL SLIDES(gravity assisted)
Lie flat on the floor and place both the legs on the wall such that even your hips touch the wall at the bottom.
Now allow the injured leg to slide downward by flexing the knee.
You can increase the flexion by taking support from the other leg and hold at the end range.
TARGET : KNEE FLEXION RANGE | HOLD : 20-30 SECS | REPEAT : 3 TIMES
Best Knee Support And Accessories To Help You With Recovery :
LP Hinged Knee Stabilizer, Medium (Blue): https://amzn.to/37G3D8N
LP Open Patella Knee Support: https://amzn.to/3meXnZM
Knee Immobilizer: https://amzn.to/35zpdsN
Elbow Crutches: https://amzn.to/3jucFYP
Foam Roller: https://amzn.to/2IW0Yxl
Resistance bands for assistance: https://amzn.to/3jvrx9a
Knee Support: https://amzn.to/3e9SCxX
To know more in detail about these exercises and how to perform them check out this video:
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