Posted by Dr Manu Bora

The ACL is one of the four major ligaments of the knee that connect the tibia to the femur. Ligaments are �cords� which join one bone to another, helping to form a joint. They guide , control and limit the motion of the bones . The role of the ACL is to prevent forward movement and rotation of the tibia on the femur. A torn ACL has serious implications for the mobility and function of the knee joint , causing the knee to buckle and give way.

After an ACL injury the knee will usually be swollen , painful , weak and have limited movement and lose stability.

As the pain and swelling decrease , gentle exercise and stretching will encourage a return to normal movement. .

It is more important to regain leg strength and movement as soon.

Pre-operative exercise to regain strength and movement in your knee before surgery will improve recovery after ACL reconstruction surgery . The stronger your muscles are before surgery , the faster you will recover post operatively.

These exercise programs have several important benefits:

• Return range of motion to normal and decrease the risk of postoperative stiffness.
• Increase muscle strength in your legs and core.
• Improve balance
• Maintain fitness in preparation for surgery.

There are some specific exercises . Remember before doing any exercise always consult with your Orthopedic doctor / Physiotherapist.

1- ANKLE PUMPS

2- HEEL SLIDES

3- HEEL RAISE(calf raise)don

4- QUADRICEP AND HAMSTRING ISOMETRIC

5- QUADRICEP AND HAMSTRING CURL

6- GLUTE BRIDGE ( Bridging)

7- STRAIGHT LEG RAISE .

8- ROTATED STRAIGHT LEG RAISE

9- QUADRICEP , HAMSTRING AND CALF STRETCHING

10- SQUATS .

ANKLE PUMPS -

• Ankle pumps are a simple and effective exercise.
• Sit with your back straight against a chair or lie on your back with legs extended in front of you , spread slightly apart.
• Pull your toe up towards your head then point your toes down .
• Do 15 repetitions 3 sets 2-3 times in a day .

HEEL SLIDE-

• Lie on your back with legs extended and your feet slightly apart .
• Slide your affected leg as close to buttocks as you can hold this position for 5 seconds then slide your heel back to the starting position.
• 15 repetitions and 3 sets one time per day .

HEEL RAISE -

• Stand with support of a wall or table.
• Stand about 12 inches away from the wall or table .
• Lift your heel off the floor until you feel a strong tightening in the back of your leg or calf muscle keep your toes on the floor and knee straight. Hold for 5 seconds then lower your heel slowly . Repeat 15 times .

Note -

• Don't lock your knee / don't arch your back .
• Stop the exercise if your muscle cramps.

QUADRICEP ISOMETRIC

• Lie on your back with knee straight place towel roll under your knee then tighten the muscle at front of the thigh as you press the back of your knee down against the towel roll and pull your ankle towards your head at the same time hold for 10 seconds then relax.
• Do 3 sets of 10 repetitions per day .

HAMSTRING ISOMETRIC -

• Lie down on your back with both legs extended then slightly bend your affected knee and then press your heel against the bed feel a strong tightening back on your thigh or hamstring muscle and hold for 10 seconds then relax .
• Do 3 sets of 10 repetitions per day .

STRAIGHT LEG RAISE-

• Lie down on your back with one leg straight and one leg bent . With your toes pointed to the ceiling , keep your knee straight and lift your leg up to 45 degrees . Don't raise it higher than the bent knee.
• Slowly lower your leg back to the floor.
• Do 12-15 repetitions , 3 sets .

STRAIGHT LEG RAISE WITH EXTERNAL ROTATION -

Follow these instructions to do a straight leg raise with external rotation

• Roll out the whole leg about 30 degrees
• Follow the detailed step- by -step instructions above.

QUADRICEP CURL ( knee extension)

• Sit in a chair with a resistance band around one of the chair's legs and an ankle on the same side as the chair . Slowly straighten your leg and hold for 5 seconds ,and slowly return to starting position.
• Do 3 sets, each set 10 repetitions .

HAMSTRING CURL-

• Lie on your stomach one end of a medium band around your foot to stabilize , and the other around your ankle .
• Keep the bottom foot on the mat as you bend your knee against the band .
• Hold for 5 second and slowly return to the starting position .

BRIDGING

• Lie face up on the floor with both knees bent and feet placed on the ground/ floor , keep your arms at your side with your palms down.
• Lift your hip off the ground until your knee ,hips and shoulder form a straight line.
• Squeeze Glute hard and keep your abs down in so you don't overextend your back during the exercise hold for 10 seconds .
• Do 10 repetitions one time a day.

KNEE BENDING BALL PRESS-

• Lie on your back in bed both legs should be straight then bend your knee around 80-90 degrees and place the ball between both knees.
• Press both knees as you can do and hold for 10 seconds .
• Do 3 sets, each set 10 repetitions.

Static and dynamic Calf muscle stretching

Static Calf stretch with resistance band- Sit on the floor with your leg Stretched out in front of you .

• Take a resistance band and wrap it around your foot .
• Hold the other end of the resistance band and push your foot against the band while simultaneously pulling on the resistance band.
• Hold for 30 seconds and relax on another leg
• 10 repetitions one a day.

Quadriceps stretching ( Quadriceps stretch prone)-

• Lie face down .
• Reach back and grasp your ankle .
• Relax your legs and gently pull your ankle towards your buttocks .
• Hold end position for 10-15 seconds
• Repeat 6-8 times .

Hamstring stretching - (Seated hamstring stretch)-

• Sit on the floor, and extend your legs out in front of you,maintaining a neutral spine.
• Reach forward to touch your toes and maintain a straight leg as much as possible .

Squats - (basis squats )-

• Stand up straight with your feet shoulder - width apart and your chest up .
• Bent at your knees and hips , sticking your butt out like you are sitting down in a chair and your knee should be stacked over your ankles.
• Pause for a second . Your back should be straight- not rounded.
• Press into your heel and straighten your legs to return to the upright , st