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Guide To A Strong and Healthy Knee: A Guide to Physical Therapy After ACL Reconstruction

Updated: Jan 30, 2023



After an ACL injury such as a tear of the anterior cruciate ligament (ACL), many individuals are overwhelmed with worry and confusion about their knee recovery. Rest assured, you’re not alone! With physical therapy and dedication to your recovery, you can make meaningful strides toward successful healing that results in a strong knee. So get motivated: it’s time to take the integral next step on your road journey back to freedom from pain. Let this guide lead you through the process of physical therapy following ACL reconstruction and ACL rehabilitation – helping you understand each stage, recognize when milestones have been met, and find out how powerful patience can be as part of your success story!


Overview of Anterior Cruciate Ligament (ACL) Tear and the Healing Process


The anterior cruciate ligament (ACL) is one of the four major ligaments that make up the knee joint. It is located in the middle of the knee, connecting the bones of the thigh to those of the lower leg. The ACL helps provide stability to your knee and protects it from abnormal motion or twisting forces. Unfortunately, anterior cruciate ligament rupture can be a common injury for anyone engaging in activities that involve sudden changes in direction or contact sports such as football, basketball, rugby and skiing.

When an anterior cruciate ligament tear occurs, it can cause pain and swelling due to inflammation and bleeding within the joint. An individual with an ACL tear may also have difficulty walking or putting pressure on their leg due to instability in the knee. In order to diagnose an ACL tear, a physician will typically perform a physical exam and order imaging tests such as an MRI or X-ray to confirm the diagnosis.


The healing process after ACL injuries depends on whether there are other injuries present such as meniscus tears or cartilage damage and whether surgical repair is necessary. If surgery is not required then a combination of rest, ice, compression and elevation along with physical therapy exercises can help reduce inflammation and improve strength in the affected area. Physical therapy may involve strengthening exercises for the muscles around your knee as well as balance drills to improve muscle control and coordination. Additionally, if surgery is necessary then it involves reconstructing or repairing torn tissues using grafts from either your own body or from a donor tissue bank. Post-surgery rehabilitation will typically involve physical therapy exercises focused on restoring movement, strength and stability within your knee joint so that you can regain full function over time.


Understanding the Different Stages of Physical Therapy Following ACL Injuries


Physical therapy for ACL injuries is an essential part of the recovery process following anterior cruciate ligament reconstruction surgery. It is important to understand the different stages of physical therapy in order to achieve a successful outcome and return to sports activities and daily activities as quickly and safely as possible.


The first stage of physical therapy, known as the protection phase, focuses on protecting the repaired ligament while it heals. The primary goals during this stage are to reduce pain and swelling, restore range of motion at the knee, and regain muscular strength in the affected limb. Treatment typically involves passive mobilization exercises such as flexion and extension exercises, calf stretching, quadriceps stretching, hamstring stretches, and resisted muscle strengthening exercises for both legs. Additionally, patients will be instructed on how to use crutches for support if needed. One of the key tools we use in early stage rehab to maintain quad muscle size and reduce atrophy is called blood flow restriction therapy. Not only will we do BFR on the injured leg bu we will do it on the non injured side at the same time to maximize the benefits. If you want to know more we have a full page on this topic.


The top 3 goals of the first stage of ACL rehab:

  1. Regain full knee extension range of motion

  2. Regain quad muscle recruitment

  3. Reduce swelling and pain

Once the healing process has started to take place, therapists will begin rehabilitation with more active exercises such as range-of-motion exercises, balance drills, leg press machines, leg extensions/curls machines, plyometrics drills (jump training), agility training (changing directions rapidly), closed kinetic chain strengthening exercises (squats), running drills/sprints in a straight line or figure 8 pattern (depending on strength level), sport-specific skills drills (cutting movements), static stretching exercises (for flexibility), plyometric drills (jumping/landing correctly) , dynamic stretching exercises (core stability training using exercise balls or bosu balls). The goal during this phase is to increase strength and coordination while improving proprioception at the injured ankle.


The last phase of physical therapy is known as functional training phase. During this stage therapists focus on returning athletes back to their chosen sport or activity by simulating game situations like cutting movements or jumping with landings while providing instruction on proper technique. Other exercises include accelerating rapidly from a starting position with good body posture and control then decelerating safely in preparation for a change of direction; pushing off from one foot into another; sprinting short distances with controlled stops; jumping high off both feet with good posture; landing quickly under control; balancing on one leg; pivoting rapidly; changing directions quickly; running backwards properly; kicking a ball accurately over long distances; performing quick starts and stops; controlling body placement while running fast in figure 8 patterns around cones etc.


At each stage of physical therapy it is important that patients listen carefully to their doctor’s instructions regarding what types of activities they should avoid during each phase of treatment in order to maximize their chances for a successful recovery without any complications or setbacks along the way.

Achieving Milestones in the Recovery Process

Achieving milestones in the recovery process is essential to staying motivated and on track with making progress. It’s easy to feel overwhelmed when attempting a difficult task, such as recovering from addiction or overcoming depression. Taking it step by step, instead of trying to tackle everything all at once, makes success more achievable. Celebrating small wins along the way can be incredibly encouraging and help maintain motivation. Whether it’s being sober for one week or going to therapy for the first time, understanding that any progress is worth acknowledging and celebrating can help keep you focused on getting better.

It can also be helpful to make goals that are both short-term and long-term so that each step of the healing process feels like a success. Setting tangible objectives gives you a sense of accomplishment when achieved, which will then encourage you to keep going. Revisiting these goals regularly can remind you how far you have come in your journey and remind you what still needs to be done in order for successful recovery.

It is important to remember that achieving milestones does not always mean being “done” with recovery or reaching a certain point in the process; it just means continuing forward towards progress despite setbacks encountered along the way. Acknowledging even small steps helps build momentum towards lasting change and provides encouragement needed during difficult times on the road to healing


The Importance of Patience During Recovery


Patience is an invaluable asset when it comes to recovering from any injury or medical condition. Without patience, it can be difficult to stick to treatment plans, as they often require a certain amount of time and dedication in order to get the best results. Patience also ensures that you don’t over-stress your body during recovery, which can lead to setbacks and extended recovery times.


When dealing with any kind of physical injury or illness, it is important to understand that recoveries are often gradual processes, meaning that progress may come slowly or in spurts. This is why it is important to remain patient throughout the entire process and not become frustrated if progress isn’t immediate. Understanding that healing takes time and that progress might not happen overnight helps ensure that you keep a positive attitude towards your recovery journey and stay motivated on the path towards health.

In addition to being beneficial mentally, having patience during recovery can also help improve physical outcomes as well. By taking things slowly and allowing yourself plenty of rest and recovery time between workouts or treatments, you will be better able to prevent further injury due to overexertion. Additionally, by allowing your body enough time to heal naturally before returning back into exercise or other activities, you will reduce the risk of re-injury and unnecessary pain caused by rushing back into physical activity too soon.


Finally, being patient during recovery can also help boost overall confidence levels as well! Knowing that you have taken the necessary steps towards recovery—with patience—can help give you the peace of mind needed in order for your body (and mind) to truly heal itself without feeling rushed or anxious about reaching goals too quickly. Being patient throughout each step of the way allows you to trust both yourself and those around you who are helping support your journey back into health—ultimately leading towards a more successful recovery!


Summarizing the Benefits of Physical Therapy Following ACL Reconstruction


Physical therapy greatly contributes to improved outcomes following ACL reconstruction. The primary goal of physical therapy is to restore full range of motion, decrease pain, improve muscle strength and coordination, and most importantly help patients progress back to pre-injury activity levels. In addition to the aforementioned benefits, research has shown that physical therapy can also help minimize swelling by increasing circulation and fluid movement around the knee.


Through a combination of stretching exercises and strengthening activities, physical therapists help patients gradually regain their range of motion while minimizing muscular imbalances at the same time. By helping the patient gain control over their muscles surrounding the knee joint, they are able to work on improving stability in order to return safely to all activities without risking re-injury or excessive stress on any component of the knee.


Physical therapists also play an important role in educating patients about proper form and technique when returning back to activities like running or jumping. This helps prevent future injuries caused by incorrect movements or overloads on weak areas in the body. Through regular visits with their physical therapist, patients are monitored for progress as well as possible setbacks due to improper technique or inadequate warm ups prior to activity. With this knowledge, patients can make corrections before further damage is done.

Overall, physical therapy after ACL reconstruction helps restore function in a safe and effective manner, allowing patients to return back to desired activity levels with less risk for re-injury down the road.


For anyone who has recently undergone ACL reconstruction, it is important to understand the different stages of physical therapy and what to expect in terms of recovery. By understanding the milestones that need to be achieved during each stage of rehabilitation, patients can better set expectations for themselves and remain motivated throughout the process. Patience is also key – rushing through rehab could lead to long-term problems down the road. If you or someone you know is starting physical therapy following ACL surgery, read more here about what they can expect.


If you are looking for a physical therapist in the greater Seattle area, at HIDEF Physical Therapy we specialize in ACL rehab. We have physical therapy clinics in Renton, Seattle, and Bellevue.


Our Renton physical therapy clinic is within a 10,000 sq/ft gym, which provides us all the access we need to equipment to help you get back from day 1 post op all the way to return to sport. Our Seattle physical therapy office is inside of a 5,000 sq/ft CrossFit gym and our bellevue Physical therapy clinic was designed specific to treat athletes who have undergone surgery. Contact us today to find the physical therapist for you!

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