ACL Reconstruction: Phase 1 (early strengthening)
After your first 1-2 weeks of surgery, your knee should start to feel more comfortable and you should be able to tolerate more exercise in physical therapy. During this phase you will continue to protect your recent ACL graft in PT by gradually progressing your knee flexion (bending) range of motion while maintaining full knee extension (straightening). In addition your therapist will begin to incorporate more strengthening exercises focused on the quadriceps, glutes, and hamstrings. Gait training is important in this phase as your therapist will teach you how to walk without any deviations. You will likely also initiate more exercises in standing pending your post-operative protocol to work on balance and weight bearing. This stage is crucial to lay the foundation for progression of strengthening so patience and persistence is key!
ACL Reconstruction: Phase 2 (intermediate strengthening and progression of weight bearing) 8-12 weeks after surgery
At this point in your rehabilitation you should be able to walk without a brace or assistive device and your leg should begin to feel significantly stronger than after surgery. You may still lack some knee flexion range of motion but the affected knee ROM should be nearing equal to your uninvolved side. Your physical therapist will begin introducing more difficult exercises through larger range of motion. Additionally in therapy you will be focusing more on dynamic stabilization to improve neuromuscular control of you hip, knee, and ankle. Some typical exercises you may see in this phase of your rehab include single leg heel raises, body weight squats, leg press, and balance challenges on one leg.
While the focus in this phase is largely on progressing your strength it will be important to maintain flexibility in your quad, hamstring, and hip/ankle musculature! Recovery days will be necessary to focus on motion.
ACL Reconstruction: Phase 3 (Progression of strengthening)
As you continue to get stronger in your affected limb you will begin to incorporate more resistance training, balance exercises,dynamic stabilization, and early plyometrics to prepare you to return to jogging. Your physical therapist will perform several tests with you to analyze your strength and stability to ensure your leg is strong and stable enough to tolerate agility training and running.
ACL Reconstruction: Phase 4 (Advanced Strengthening and Agility ) 16-24 weeks
At this phase of your rehabilitation you will begin practicing with agility exercises and plyometrics while you continue to progress your strength exercises. You should be comfortable with straight line running from Phase 4 and your therapist will begin working with you on lateral motions including cutting, hopping, and jumping. It is critical in this stage to monitor knee soreness and swelling given the increase in impact activities. The goals of this stage are to improve your power and stability with agility exercises so you can begin to perform sport specific activities at the final phase of your rehab
Disclaimer: If you continue to experience unbearable, reoccurring pain, be sure to schedule an appointment with your physician or join our physical therapy family and allow us to help you regain function.
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