Physical Therapy Protocol After ACL Surgery

ACL injury is a sprain or tear of the anterior cruciate ligament. It is a common knee injury among athletes participating in high-demand sports such as basketball, football, and soccer. Because the tear will not heal on its own, it usually requires surgery.

ACL reconstruction rehab is not a quick process. In most cases, it can take up to 6 months of physical therapy to strengthen the muscles around the knee and regain full function. For optimal recovery, follow your physician’s and physiotherapist’s orders.

Preparing for ACL surgery? Dubai physiotherapy clinics use this post-op approach to ensure adequate recovery.

Day 1-7

Following hospital discharge, it is crucial to control swelling. Do not sit for long periods of time with your foot in a dangling position. This will increase swelling of the knee and leg. Rest with the affected leg elevated. Keep the knee iced 4-5 times a day for 20 minutes.

During this phase, you should focus on learning to walk with your crutches. Your physical therapist may initiate gentle exercises, such as passive extension, active-assisted extension, and passive flexion, to help restore your range of motion. The use of neuromuscular electrical stimulation (NMES) is also recommended.

Day 8-10

After the sutures are removed, outpatient physical therapy will be scheduled. You will be instructed to remove your legs from the knee immobiliser 4-6 times daily for 10-15 minutes to achieve full extension. Exercises such as active-assisted extension, quadriceps isometrics, SLR, and active flexion will continue.

Week 2

Maintaining full extension and developing muscular control at this time are crucial. Expect to perform exercises that strengthen your hamstrings. Your therapist will also help you work toward 90-100 degrees of flexion. You should have weaned off the immobiliser by now and progress from using two crutches to using one.

Weeks 3-4

By the end of week 3, you are expected to walk with a standard heel-to-toe gait. The expected range of motion should be a full extension to 100-120 degrees. Your therapist may introduce you to more advanced hip exercises. Lightweights may be used during straight leg raises. You will also progress to using the BAPS board while standing.

Weeks 4-6

Exercises during this phase are designed to improve balance. You will also work to strengthen your quadriceps and gluteal muscles through exercises such as squats and lunges. Advanced hip-strengthening exercises and straight leg raises are continued. By the end of week 6, NMES and icing are no longer needed. Expect to transition to gentle plyometrics and hopping exercises.

Weeks 7-12

Continue all the strengthening exercises from week 6, including quad sets, straight-leg raises, partial squats, toe raises, etc. If you no longer experience pain, a jogging program can be initiated by week 8, progressing to light running. You should be careful not to overstep your abilities. Participating in high-level sports around this time is not yet recommended.

Weeks 12-20

All strengthening exercises from weeks 6-12 are continued, along with a jogging and light running program. An ACL functional brace is optional. Your therapist may begin introducing agility drills, such as zig-zag and crossover drills, after assessing the integrity of your ACL.

At 6 months after surgery, you and your health provider may start planning your return to full sports. To get approval, you should display good stability, full-motion, quadriceps and hamstring strength of at least 80% of the normal leg, and the ability to complete a running program.

Physiotherapy Clinic Dubai

At Scandinavian Physiotherapy Center, we offer a tailored treatment program for your injury to help you get back to doing your desired activity. Whether it’s a simple strain, tennis elbow or torn ACL, return to sport with improved functional and neuromuscular control!

Please call us at +971 4 551 6126 to schedule an appointment.