The anterior cruciate ligament, called the ACL, supports and stabilizes your knee joints. Falls, twists and blows to the knee may tear the ligament. Treatment in most cases involves surgery, along with physical therapy exercises. The therapeutic exercise program has four stages, which includes the immediate period after your injury, the first two weeks after surgery, two to six weeks after surgery and the period beyond six weeks.
After the Injury
Your immediate, post-operative exercises help you regain the range of motion in your quadriceps and hamstrings. To perform quad sets, begin in a seated position, with your injured leg extended. Take a breath in, then exhale and try to press the back of your knee into the floor. Perform 10 repetitions. The Steadman Clinic in Vail, Colorado recommends the prone leg hang. Lie face-down, letting your knees hang off the edge of a table. The force of gravity helps you straighten your legs. Hold the position for as long as possible. Perform heel slides for the hamstrings. Sit upright and place a towel around the foot of the injured knee. Hold the ends of the towel and slide your knee along the floor, attempting to bend it. Perform 10 repetitions.
Post-operative Exercises
You doctor will advise you to begin physical therapy immediately after surgery. Since you may not be able to walk, physical therapists suggest non-weight-bearing exercises during this time frame. Continue performing the quad sets and heels slides, but add other types of exercises. Flexing your foot and pointing your toe, as well as drawing circles with your ankles, works your lower leg leg muscles, which play a key role in post-surgery rehabilitation. Straight leg lifts strengthen your quadriceps. Lie supine, contract the front of your thigh, and lift your leg a few inches from the bed. Perform 10 repetitions. To work your hamstrings, lie prone and attempt to bend your knee. Do 10 repetitions.
After Three Weeks
Provided that you are gaining range of motion and you are able to bear weight, your therapist begins strength training exercises two to three weeks after surgery. The stationary bicycle enhances leg flexion and extension. Placing the seat higher helps you straighten your leg and work your quadriceps; lowering the seat helps you bend your knee and work your hamstrings. Side leg raises performed with ankle weights strengthen your inner and outer thighs. To work your outer thighs, lie on your side and lift your top leg, keeping your hips stable and your knee facing straight ahead. To work the inner thigh, bend your top knee, place the foot on the floor in front of your bottom leg, contract your bottom inner thigh and lift the leg from the floor.
Six Weeks Later
Six weeks after surgery, your therapeutic exercise program depends on the equipment at the physical therapy clinic, and your fitness and athletic goals. Most physical therapists have their patients perform backward and forward walking on a treadmill, squats and lunges. Balance training, such as one-legged squats on a wobble board, helps athletes rehabilitate their knees and return to their sport.
Dr. Mladen Maksic, a specialist in orthopedic surgery at the Institute for Orthopaedic
Surgery and Traumatology of the Clinical Center of Serbia, uses plyometric leg press exercises eight weeks after surgery. Lie supine with your feet against the foot pad. Use an explosive movement to push-off and straighten your legs. Bend your knees to return, making sure that your heels and toes make full contact with the foot pad.
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