Anterior cruciate ligament (ACL) surgery is a surgical procedure to repair a tear or other damage to the ligament. ACL surgery is usually an arthroscopic procedure in which a surgeon makes a small incision and performs the surgery using a small camera and tools threaded through the incision. ACL surgery requires a period of postoperative physical therapy to restore proper motion and function in the knee.
First Couple of Weeks
The first couple of weeks after ACL surgery is the early phase of rehabilitation. Immediately after surgery, you will likely be placed on crutches, and initial therapy will be fairly light to allow for proper healing of the surgical graft or other ACL repair. The exercises in this phase of therapy are intended to maintain and increase your range of motion and to help maintain and increase your muscle strength. The exact exercises will be defined by your physical therapist and may include stretching exercises. Depending on your surgery and progress, your physical therapist may have you begin using a cane instead of crutches either part way through this phase or at the end of this phase.
Weeks Three and Four
Most of the pain in your knee should have subsided by weeks three and four. The focus of this phase of therapy is to ensure that the knee is protected. Because the pain is mostly gone, you may be tempted to try things that your recently repaired knee is not yet capable of . Although the goals of this phase will vary, many physical therapists will work with you to improve your ability to bend your knee between zero and 100 degrees. Recommended exercises may include water exercises, mini wall squats, leg presses, or stair machines.
Four to Six Weeks
Four to six weeks after your surgery, you will likely continue the exercises performed in previous physical therapy phases. Your physical therapist will likely try to increase the range of motion in your knee to between zero and 130 degrees. Resistance on exercises like stair machines and stationary bicycles will likely increase. In addition, in this critical portion of your rehabilitation, your therapist will likely recommend home exercises to improve your balance, strength, and range of motion.
Six to Eight Weeks
Six to eight weeks after your surgery is often called the moderate protection phase. During this phase, your physical therapist will continue to work with you to bring you full range of motion in your knee. Resistance will likely increase on machine exercises. Your therapist will likely add weights to other exercises.
Eight to Ten Weeks
At week eight to ten, you are getting very close to the end of your therapy. This phase, sometimes called the light activity phase, emphasizes strength and balance. Your therapist may expand exercises to include lunges and stepping exercises with greater heights than before.
Return to Activity
At this point, after ten weeks of therapy, your therapist may recommend a return to activity. Therapy and exercise will likely continue for some time, but it is more of a maintenance and strengthening program. In some cases, your physical therapist may recommend a brace for a time to protect your knee when you engage in athletic and work-related activity. Your physical therapist and surgeon may recommend physical function testing at the three and six month anniversaries of your surgery.
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