Rehab/Recovery

Although every physician and physical therapist has their own unique protocol for ACL rehabilitation, everyone agrees that aggressive programs are necessary for full recovery. Today, it is important for patients who have ACL reconstructions to reduce the swelling, to immediately move their knee, to restore full knee extension, and to quickly begin weight bearing (8). A danger with knee surgery is not regaining your full range of motion (6). It is for this reason, that physicians send range-of-motion (R.O.M) machines to the patients home. The patient straps their leg into the machine, which passively bends the knee to a determined angle. This slow passive movement is repeated for hours to ensure that the knee regains full motion. Once range of motion is achieved it is important to concentrate on restoring hamstring and quadriceps strength. For every day that the quadriceps is not used it takes six days to regain that strength (6), so it is essential to begin rigorous strength exercises as pain permits with the assistance of a physical therapist. The types of exercises depend on the rehabilitation program, but in general the focus is on weight bearing exercises and neuromuscular control such as balancing and coordination (7).

Throughout the rehabilitation process it is important to protect the knee. Patients must avoid exercises that involve cutting or pivoting. After physical therapy sessions are completed, patients should continue their rehabilitation by jogging, swimming or bicycle riding (7). It is also beneficial to continue weight-training exercises. The question that everyone is most concerned with is when can the patient return to intense activity. It must be realized that the ACL graft does not become fully solidified until six months after the operation, so a return before that time is risky. In addition to allowing the graft to secure itself, the patient must regain full quadriceps and hamstring strength. Depending on the rigor of the rehabilitation program, rebuilding leg strength normally takes at least six months (6).