There's not an injury out there that's pleasant, but ACL tears are unique in that they make your knee feel incredibly vulnerable. The ACL is instrumental in holding your knee in place, which means tearing it can make you feel very wobbly.
After surgery — which will very likely be required — it's time to get back into the gym to build back your muscles and confidence. Start with easy exercises and progress slowly to more advanced moves like squats and lunges.
ACL Recovery Process
Tearing your ACL, or anterior cruciate ligament, will keep you from doing your regular lower-body workouts for months. During that time, there are still things you can and should do to speed up the recovery process and prevent your leg muscles from getting too weak.
From the time you get out of surgery to the point where your knee is fully recovered, you'll keep progressing the difficulty of your leg exercises. For the first month or so, there aren't many exercises you can do. After that, though, start with light machine and bodyweight exercises. Once that feels mastered, move onto full bodyweight exercises like squats.
Once you're comfortable with these leg exercises, you can move on to lateral exercises, in which you move side-to-side. This tests the strength of your ACL because it resists side-to-side movement of your knee. You can also begin walking after about a month to get used to putting weight on your leg again. After that, you move on to biking and, finally, running.
Low-Intensity Recovery Workout
After about a month, you can start to get into the gym and lift some light weights. These exercises give you a smooth segue into some of the advanced movements you'll be doing in the months to come.
Start by adjusting the machine to the proper height. The seat should be close enough to the platform that you start in a squat position. Use light weight to avoid damaging your knee. Sit in the chair and place your feet on the platform in the same stance you would use to squat. Press for 15 repetitions.
Sit on a leg extension machine with the bottom pad against the bottom of your shin and your knees bent as much as possible. With a light weight, kick your legs out straight until your knees are locked out, then slowly lower the weight. Do 15 reps.
This is the opposite of the leg extension motion and works your hamstrings. Sit in the leg curl machine with your legs straight at the top. Pull the machine down, bringing your heels towards your butt for 15 reps.
You can use this machine to work both the inside and outside of your thighs. Start with the pads half a foot from each other and squeeze your legs between them. Press out to the side to work your abductors for 10 reps.
Then, start with the pads out as wide as you can and pull them in close together to work your adductors for 10 reps.
Picking an aerobic exercise that's low-impact, but still works your legs will help move blood through your injury and boost recovery. You can start by riding the bike, swimming or walking on the treadmill for 30 minutes to an hour at a moderate intensity.
Higher-Intensity Recovery Workout
After six to eight weeks, you should be ready to put some weight on the knee in the form of squats or step-ups to a low box. Go slow with these and avoid anything that feels uncomfortable.
Start standing, not holding any weight. Squat down as low as you feel comfortable, then stand back up. Perform 20 repetitions. If you can do that without pain, try holding a dumbbell at chest-height for 10 reps.
When you begin this exercise, use a 2 inch box and step up and down with the same foot 10 times on each side. You can go up to 6 inches during the rehab phase, without any weight.
Start standing and hold a light dumbbell, under 20 pounds, between your legs. Step out to the side, sticking your butt back. Lean towards the side you stepped to and straighten out the other leg. Step back to the center and step out to the other side. Try to keep your feet pointed forward the whole time. Do 10 reps on each leg.
In addition to walking, swimming, and riding an exercise bike, you can start using an elliptical or even a stair climber for your aerobic workout. Jogging still isn't the best idea because of the sudden impact to your knee. Try to up the intensity slightly in this workout and keep the cardio portion between thirty minutes to an hour long.
- Journal of Orthopaedic and Sports Physical Therapy: Recent Advances in the Rehabilitation of Anterior Cruciate Ligament Injuries
- Mike Reinold: 6 Keys to the Early Phases of Rehabilitation Following ACL Reconstruction Surgery
- Stone Clinic: ACL reconstruction rehab protocol
- Center for Orthopaedics: Anterior Cruciate Ligament Reconstruction Rehabilitation Protocol