ACL Rehabilitation

Whether choosing a surgical or nonsurgical approach to treatment, physical therapy is a vital part of healing from an ACL tear or injury. When it comes to ACL rehabilitation, there are three main treatment goals your physical therapist and orthopaedic surgeon will work towards for you to be cleared to return to normal activity.

The three main treatment goals include:

  • Stabilizing the knee if it is unsteady, to help you return to your daily activities.
  • Strengthening the muscles that support your knee, to help you return to the same level of activity as prior to your ACL injury.
  • Reducing the risk that your knee will be reinjured when returning to daily activity, including sports.

Your doctor and physical therapist will design a comprehensive physical rehabilitation (rehab) program that takes into consideration the following:

  • Desired level of activity
  • Physical fitness
  • Extent of the ACL injury
  • Treatment method
  • Athletic background

Throughout the next several months, you will work with your physical therapist on incorporating strength and flexibility exercises, including sport-specific exercises. UPMC Sports Medicine’s science-based approach to rehabilitation from ACL injury typically involves five phases. The duration of each phase will depend on your approach to treatment.

The first two months of rehab are crucial to the healing process after ACL surgery.

You'll learn exercises that will help you:

  • Regain strength in your knee.
  • Control the quadriceps and motion of the knee.
  • Start to improve flexibility in the knee.

Based on how severe your ACL injury, you should attend PT at your local rehab center one to three times a week. You should also practice your exercises at home.

When you regain control of the quads and range of motion in the knee, the focus of rehab changes to:

  • Gaining more strength in the quads.
  • Improving control of the hamstrings and hips.
  • Conditioning on the stationary bike or elliptical trainer.

At this time, your physical therapist might let you do more rehab on your own at the gym. You'll only need to come to the rehab center for routine check-ins.

Based on your progress, you'll start running as early as four months after ACL surgery.

Your physical therapist will work with you in a controlled setting on a treadmill to assess leg movement and function.

As fitness and performance improve, he or she might ask you to start low-level agility training. These basic footwork drills and simple direction changes will help you move on to sport-specific exercises.

Five to eight months after ACL surgery, your doctor and physical therapist will see if you're ready for jumping.

Phase 3 adds jumping and landing on two feet versus the low-level agility drills from phase 2. This may include simple exercises like jumping on flat ground all the way to complex drills like jumping on and off boxes.

In this phase, it's vital to work on movement patterns to prevent future knee injuries.

Six to nine months post ACL surgery, you'll start drills that focus on single leg jumps and landings, and sports-specific cutting.

Cutting drills involve speed and sudden changes in movement.

Your physical therapist will add cutting drills towards the last two months of rehab. By now, your hurt leg should have the same strength and flexibility as your healthy leg.

The last phase of rehab takes place at nine to 12 months. The focus of this phase is to steadily add sports movements at slow speeds and then faster speeds.

You'll start doing sport-specific drills with teammates.

If you play contact sports (like football, soccer, or basketball), your physical therapist can help design a plan to introduce contact slowly.

These are the common guidelines we suggest after ACL surgery. They may vary based on each person and their desired activities. Athletes should follow them closely to help return to play on schedule.

ACL Rehab Exercises

When rehabbing from ACL surgery, your physical therapist will include drills at each phase of recovery that will help:

  • Strengthen your injured leg.
  • Achieve full range of motion in your knee.
  • Increase flexibility, coordination, and agility.

During rehab from ACL reconstruction, you'll learn:

  • Quad sets
  • Straight-leg raises
  • Heel slides
  • Squats and lunges
  • Deadlifts and bridges
  • Planks and side-planks
  • Ladder drills
  • Box jumps
  • Agility grids

Exercise tips after ACL surgery

  • Start slow. Gradually increase intensity and duration.
  • Do not push yourself to the point that you feel pain.
  • Talk to your knee surgeon and physical therapist on how to best progress through each phase of ACL rehab.

Learn More About ACL Injuries and Rehab

Contact the UPMC Sports Medicine ACL Program today to learn more or make an appointment.