The ACL, or anterior cruciate ligament, is the major ligament that prevents the lower leg from sliding forward in the knee joint. It is often injured in athletes who perform jumping and pivoting movements, like in basketball. Tears of the meniscus, which are cartilage pads in the knee, can also accompany ACL injuries, lengthening recovery time. Rehab for these injuries include strengthening of the muscles around the knee, but may also require surgery.
After Physical Therapy
Now that you have left physical therapy, hopefully with a list of home exercises in hand, you can get to work. Your recovery time will vary depending on the severity of your ACL injury. You should follow the instructions given to you by the physical therapist and your doctor and, in some cases, your athletic trainer. Strengthening your inner and outer thigh, quads, hamstrings and calves, as well as increasing the knee's range of motion, or ROM, should be your top priorities.
Exercises for Strengthening the Knee: Phase 1
Start by using exercise bands and your own body weight. Tie the band around something stable and loop it around your foot just above the ankle. Perform hip abduction and adduction, hip flexion and extension, hamstring curls and knee extensions for three sets of 10 repetitions. Increase the amount of resistance by changing the band color. Performing squats and lunges, as well as stepups and calf raises, will also help to increase leg strength safely.
Exercises for Strengthening the Knee: Phase 2
As your strength improves, and you get the OK from a professional, you can move on to machines. The leg press can significantly strengthen the quads and hamstrings, but always remember to start low and slow and stop immediately if you feel pain. The leg curl and hip abduction/adduction machines should be included. Avoid the leg extension machines until you are fully rehabbed, as they place too much torque on the knee. Avoid sliding and pivoting exercises as well. Jumping exercises are OK once you have increased the strength and stability in the knee. Practice landing on your toes with your knees bent to prevent future injury.
Range of Motion
Once swelling has subsided, you may find you are not able to bend or straighten your knee as far as before. Healthy knee ROM is from 0 to -5 degrees of flexion, meaning a straight leg to slight hyper-extension, to about 140 degrees of flexion. Ideally, both knees should have the same ROM. To improve ROM, hold the following stretches for 30 seconds, release, and repeat at least once a day: Standing toe touches, quad stretch, calf stretch, and side lunges; seated butterfly stretch, toe touches, and single leg toes touches; supine single and double knee hug; side lying IT-band stretch; and prone quad stretch and child pose.
Staying Safe
Ice and rest your knee often if swelling returns. Take an anti-inflammatory pain reliever as needed and see a doctor if pain or swelling does not subside. Take things slow and regularly check in with your doctor and/or physical therapist to check your progress.
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