Recovering from ACL (anterior cruciate ligament) surgery is a gradual process that demands patience, consistency, and the right approach to physical therapy. The ACL is a key ligament in the knee that provides stability during movement. When it’s torn—whether through sports, accidents, or trauma—surgical repair is often required, followed by months of focused rehabilitation. The goal of post-operative physical therapy is to restore strength, mobility, and flexibility while also reducing pain and preventing future injuries. Below is a list of the top 10 physical therapy exercises commonly recommended after ACL surgery, categorized by stages of recovery.
Heel Slides
Heel slides are typically introduced during the first two weeks after surgery. This exercise helps to gently improve knee flexion and restore range of motion without placing stress on the healing ligament. To perform it, you lie on your back with your legs straight, then slowly slide the heel of your operated leg toward your buttocks while keeping the foot on the floor. Once you reach a comfortable bend, hold for a few seconds and slide the leg back down. Repeating this 10 to 15 times daily helps regain movement early in the recovery phase.
Quad Sets
Right after ACL surgery, it’s common for the quadriceps muscles to weaken due to inactivity. Quad sets are a safe and effective way to activate these muscles. While lying flat with your leg extended, tighten the front thigh muscle by pressing the back of your knee into the bed or floor. Hold the contraction for 5 to 10 seconds, then relax. Repeat 10 times per session, several times a day. This simple yet powerful exercise builds strength without stressing the joint.
Straight Leg Raises
Once you’ve regained some quadriceps control, straight leg raises can help build further strength. Lie on your back with one leg bent and the other straight. Slowly raise the straight leg up to the height of the bent knee while keeping the thigh muscles tight. Hold for 3 to 5 seconds before lowering it. This exercise targets the quadriceps and hip flexors, and is usually introduced during the second or third week post-surgery.
Ankle Pumps
Ankle pumps are initiated immediately after surgery to promote blood circulation and prevent blood clots, a common risk during recovery. To perform ankle pumps, lie on your back and point your toes up toward your head, then downward like pressing a gas pedal. Do this continuously throughout the day, especially when resting. It keeps the calf muscles active and supports healthy blood flow in the lower legs.
Wall Slides
Around week three or four post-surgery, wall slides may be added to the routine under your therapist’s supervision. Stand with your back against a wall and your feet about a foot away. Slowly slide down the wall by bending your knees until they reach about a 45-degree angle. Hold the position briefly, then slide back up. Wall slides are effective in building both quadriceps and hamstring strength while promoting controlled knee bending.
Bridges
Bridges are excellent for engaging the gluteal muscles and hamstrings, two muscle groups that support knee stability. To do a bridge, lie on your back with your knees bent and feet flat on the floor. Raise your hips off the ground to form a straight line from your shoulders to your knees. Hold the position for a few seconds, then lower your hips. Begin with 10 repetitions and increase over time. This exercise can be introduced around the second or third week post-surgery.
Step-Ups
Step-ups help rebuild strength and control in the operated leg. They are typically introduced during weeks four to six. Using a low platform or step, step up with the affected leg and then bring the other leg up. Step back down in reverse order. Start slowly and increase repetitions as strength and confidence grow. This functional movement mimics activities like climbing stairs and helps prepare you for everyday motion.
Stationary Cycling
Stationary biking becomes a part of recovery around the third or fourth week, depending on your knee’s mobility. Begin cycling with no resistance for 10 to 15 minutes, gradually increasing duration and resistance. Cycling not only aids in regaining joint mobility but also improves cardiovascular endurance without placing excessive strain on the knee joint.
Hamstring Curls
Hamstring curls target the muscles behind the thigh, which play a crucial role in stabilizing the knee. These are often added during weeks five or six. You can perform them using a resistance band or a hamstring curl machine. Bend the knee by bringing the heel toward the buttocks, then slowly return to the starting position. Controlled movement is essential to avoid putting too much pressure on the healing ligament.
Single-Leg Balance
Balance training is essential for preventing future injuries and improving neuromuscular control. Single-leg balance exercises can start around weeks six to eight. Stand on the operated leg while keeping your balance for 30 seconds. To progress, try closing your eyes or standing on a soft surface like a pillow. Balance exercises challenge the smaller stabilizing muscles around the knee and ankle and help restore coordination.
Final Thoughts
Recovering from ACL surgery is a journey that demands discipline, care, and proper guidance. The exercises outlined above form the foundation of a structured physical therapy plan. While they may seem simple, each one plays a crucial role in building back strength, improving mobility, and ensuring long-term joint health. It’s important to follow the advice of your physiotherapist and not rush the process. Every knee heals differently, and a tailored approach is necessary for optimal results.
If you’re in need of post-surgical rehabilitation, consider visiting a qualified physiotherapist at Mednic Complex via Instacare. With expert guidance, you can safely navigate your recovery and return to your normal activities stronger than ever.