Five Exercises You Can Do To Restore Range of Motion after ACL Surgery

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So you’ve torn your anterior cruciate ligament and you’re out for the season. Now you have a decision to make. Do you opt for the non-surgical route where you train your knee to adapt to its more limited capabilities? Or do you go for reconstruction—followed by weeks on crutches and months of rehab—in hopes of returning to your usual intense sporting exercises after ACL surgery?

How you decide has a lot to do with your age, your lifestyle, and your plans for the future. Plenty of people do just fine with a damaged ACL because they’ve got no interest in playing soccer or basketball or other high-level athletics, and they don’t mind putting up with a bit of knee instability. You’ll need to take into consideration the advice of your own doctor, who best knows the specifics of your injury and your prognosis for recovery.

If You Choose Surgery for Your ACL

For those who do commit to ACL surgery, there’s a lot to look forward to, including multiple stages of rehab that could last as long as nine months. But one of the earliest things you’ll need to concern yourself with—even before the surgery—is increasing your range of motion.

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When it comes to range of motion, there are two terms to know: extension and flexion. Extension is the motion of straightening your leg toward zero degrees (or in some cases even beyond into hyperextension). Flexion is when you bend your knee away from extension.

Your doctor will want you to have a good range of motion going into surgery, so you’ll need to start your extension and flexion exercises well before the procedure. And you’ll need to continue those exercises in the days and weeks that follow. Of the two exercises, extension is most important. The loss of even three to five degrees of extension after surgery has been linked to adverse outcomes, so dedication to range of motion exercises is crucial.

Range of Motion Exercises after ACL Surgery

Your physical therapist will develop an exercise plan to optimize your success through the many stages of rehab. There are plenty of options for range of motion exercises after ACL surgery, though, and here are some of the those you might see.

Stationary Bicycle

For variations on this exercise, raising the bicycle seat can help you work on extension and lowering the seat can help with flexion.

Hamstring and Calf Stretches

Stretching the hamstring and calf muscles is a great way to maintain soft tissue flexibility in the back of the knee, which is important for range of motion. First, elevate the leg with a block under the heel. For a calf stretch, try wrapping a towel around the ball of your foot and using it to pull your toes toward yourself. You can also try a long-duration stretch where you lie back (with your heel still supported by the block) and let a five to ten pound weight rest on your thigh. Try this for ten to fifteen minutes at a time, two to four times a day. Your goal during these stretches should be full, pain-free extension of the leg.

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Range of Motion Pulley

The Home Ranger Knee Pulley allows for easy, assisted exercises for both extension and flexion to increase range of motion in both directions.

Prone Hangs

A prone hang is a simple exercise to increase and maintain extension. Hold the position for five minutes or more and allow the leg to gently relax into full extension.

Functional Tasks

Your physical therapist may also suggest walking backwards to work on your range of motion and extension. Under your PT’s guidance, you might walk backwards while stepping over small objects, eventually graduating to walking backwards on a treadmill for ten to fifteen minutes. This is one of the more advanced exercises after ACL surgery, but it can be helpful for difficult cases.