ACL Reconstruction Rehabilitation Protocol

Post-Operative Positioning:
1. Compression dressing, ice to knee
2. Proper knee elevation
3. No pillow under knee
4. Immediate quad sets; encourage ankle pumps
Post operative Day 1:
1. Ankle pumps every hour
2. Quad sets, 30 reps, 5 seconds hold, at least 3 times daily
3. Weight bear as tolerated with crutches
4. Achieve 90 degrees of bending
-active assisted knee bend (sitting) to 90 degrees

5. Achieve full extension

-with pillow under ankle while in bed (15 minutes, 3 times daily)

Post operative Week 1:

1. Ice to knee every 2 hours, 20 minutes
2. Weight bear as tolerated with crutches
3. Active assisted bending exercises (90 degree)
4. Extension exercises
-quads set (30 reps, 10 seconds hold, 3 times daily)

(as

tolerated)

-straight leg raises (maintain full extension) (30 reps, 5 seconds hold, 3 times

daily)
-hamstring stretches (frequently)

Post operative 2 to 4 Weeks:

Goals:
1. Obtain full knee extension
2. Increase knee bending (120 degree)

knee bend, 10 reps, 10 seconds hold, 3 times daily

3. Improve quadriceps strength

Half squat (10 reps, 5 seconds hold, 3 times daily)

reps, 5 seconds hold, 3

Toe raises (10

times

daily)

Provided knee bend more than 100 degree. Start with low resistance, 20 minutes
daily.

Post operative Week 4-6

Goals:
1. Knee bend 125 degree to full range of motion
2. Continued strength building
3. Balance training

10 seconds hold, progress from eyes open to eyes closed.

Post operative Week 6 12
Goals:
1. Full knee extension to full knee bend ( as normal as unaffected leg)
2. Continued strength training
3. Treadmill
4. Hamstring strengthening

Post operative Week 12 20

Goals:
1. Continue all strengthening exercises
2. Start straight, forward and straight, backward jogging, and light running
programme
3. Start agility drills, zig-zags and cross over drills
Post operative Week 24
Goals:
1. Return to sports
-at least 80% of quadriceps strength compare to normal leg
-at least 80% of hamstring strength compare to normal leg
-full range of motion
-swelling free
-good balance and stability
-good endurance