A Comprehensive ACL Reconstruction Rehabilitation Guidelines for Physiotherapists

ACL reconstruction surgery is traumatic to the knee and a period of rest and recovery is required after the operation. Whilst it’s tempting to want to get going and improve strength and range of motion, it’s best to let the knee settle for the first 1-2 weeks with basic range exercises, quadriceps setting drills, ice and compression. Typical exercises and management activities during this phase include regular icing of the knee and graft donor site (usually either the hamstrings, quad or patella tendon), compression of the knee and lower limb, basic quadriceps setting exercises, and gentle range of motion exercises to improve knee extension (straightening) and flexion (bending). Analgesics and other medications should only be used in consultation with your doctor. It’s important for clinicians and patients to ‘listen to the knee’ during this phase and only progress as quickly as the knee will allow. Increase in pain and/or swelling are the two main symptoms that indicate that the knee is not tolerating the workload.