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Patient exercises

ACL reconstruction protocol


General Information

  • You may or may not wear a brace for a short while. This depends on your surgeon.
  • You will usually be fully weight bearing with crutches as needed in the first few days.
  • You may require 2-3 weeks off work depending on your transport arrangements and your occupation.
  • It is important that you adhere to the programme given to you by your physiotherapist. The outcome of your surgery will only be as good as the effort you put in to it.

PROTOCOL



Immediately post-operatively:



This will depend on where the operation is performed, but usually you will be up and about with a physiotherapist the day following the operation. You may have ice applied to your knee and you may have a machine to help you bend and straighten the leg.



0-2 weeks

  • Passive hyperextension - this means the knee should fully extend with the help of your physiotherapist
  • 90� flexion by two weeks
  • Active straight leg raise
  • Static quadriceps
  • Isometric quadriceps from 90-40� flexion
  • Isometric hamstrings from 0-90�
  • Gait re-education
  • Small knee bends PWB
  • Heel raises PWB

Ideally you should see your physiotherapist at least twice per week during this stage.



2-4 weeks

  • 0-120� flexion
  • Progress knee bends to increase loading
  • Progress heel raises to increase loading
  • Prone knee bends
  • Bridging
  • Step ups +/- support
  • Controlled knee flicks in prone
  • Stationary cycle with low resistance
  • Wobble board and theraballs

Your physiotherapist may be happy to see you just once a week if all is progressing well.



4-8 weeks

  • Lunges
  • Progress to step downs
  • Increased single leg work
  • Increase load on hamstring work, progress to single leg work
  • Proprioceptive work in standing, fast knee bends to predetermined angle
  • Watch for patello-femoral symptoms as increase patella-femoral load
  • The graft is still weak therefore care should be taken not to overstress by isolated quadriceps contraction i.e. no leg extensions in the gym 8-12 weeks
  • Progress the above activities by increasing the load further
  • Increase the speed of activity such as step ups and step downs

12-16 weeks

  • Commence landing techniques in preparation for running. Focus on good technique i.e. adequate knee flexion and alignment
  • Bouncing on a trampoline
  • Increase proprioceptive work using the wobble board, theraballs16 weeks onward
  • Commence jogging on a treadmill. Initially a treadmill is preferable as it provides good shock absorption and is a consistent surface
  • Commence direction changes - obstacle courses
  • Commence stop-start activity - shuttle runs
  • Hopping - vertical hop, horizontal hop, hopping up/down stairs
  • Sport specific - your physiotherapist will guide you through activities to mimic your sport and get you ready for training first followed by your first game
  • Generally you will be allowed to commence some non-contact sports from 6 months
  • Contact sports and skiing are usually allowed from 9-12 months


Please contact us to book an appointment or for more information on any of the services available at our clinic in Kensington.



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Areas covered

Our services cover the following locations (if your location is not listed please don't hesistate to get in touch and ask us if we can help you):

Kensington - W8 - W14 - SW7 - Notting Hill - W11 - W2 - W10 - Chelsea - SW10 - Knightsbridge SW1 - SW3 - Fulham - W6 - Hammersmith - W6 - W12 - Hyde Park and Holland Park, Paddington, Bayswater, Marylebone W1, W2


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Kensington Clinic
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2 Drayson Mews
West London
W8 4LY
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