The anterior cruciate ligament (ACL) is one of the four major ligaments of the human knee. It is the knee ligament most commonly injured in athletics, and severe injury often requires surgery. After ACL surgery, the primary goal is to regain range of motion (ROM) back to a level comparable to or better than pre-surgical level. There are dynamic and static stretches that are a part of ACL protocol that your sports physician, physical therapist or athletic trainer will instruct you to do or prescribe as part of your home exercise program to improve your range of motion.
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Wall slides are done in the first stage of rehabilitation. Lie on your back and place the sole of the involved foot up against a wall, as high as you can comfortably place it. Wear a sock or place a towel between your foot and the wall. Slowly slide your foot down, bending your knee until you feel a stretch or tightness in the joint. Use the other foot to help push the foot back up to starting position. The farther away your hips are from the wall, the easier it will be. When you gain more range of motion and strength, perform the wall slides with your hips closer to the wall. Do 10 slides.
Heel slides are similar to wall slides, but they are done seated and are more dynamic. Use a stretch cord, towel, belt or even a dog leash, and place the foot on the ACL injured side in the middle of the cord or in the loop, if there is one, and hold one end of the cord in each hand. Slowly pull the cord while bending your knee until you feel a stretch. Hold for 10 seconds and then release. Repeat 10 times.
It’s best to perform hamstring stretches while lying on your back because it allows the muscles to relax. Place your foot through one of the loops of the stretch cord, or use a belt or towel and place your foot in the center, and while holding the ends pull the involved leg straight up in the air until a stretch is felt along the back of the thigh. Hold the stretch for 30 seconds. Repeat three times.
This static stretch improves knee extension. Lie prone (on your stomach) on a flat surface, such as a bed or weight bench, with the foot on the involved side hanging off. Place a pillow or rolled-up towel under your knee for comfort. Keep your leg straight—do not roll the hip in or out. Be sure to relax the muscles of the leg and keep your hips down. Stay in this prone hang for 10 to 15 minutes. Once range of motion of the knee improves, use an ankle weight to increase knee extension.
Adjust the seat of the bike higher than you normally would. Strap your feet into the pedals. Control the pedaling with the uninvolved leg. Pedal backward to start—it will be easier to make a complete circle that way. Ride the bike for 10 to 15 minutes. If it’s too painful or you can’t make a full revolution, raise the bike seat. As your knee ROM improves, lower the bike seat and begin to use the involved leg while pedaling.