(65) 8896 3604

Call Us
(65) 6836 6636

(65) 8896 3604

Call Us
(65) 6836 6636

ACL Reconstruction Rehabilitation Protocol

ACL reconstruction surgery takes between 1 hour to 1 1/2 hours to perform.

The next 6 months is very important if the athlete wants to get back to high level sports.

A proper rehabilitation protocol is needed to allow the graft to heal, mature and strengthen while the knee becomes stronger.

The importance of post-ACL reconstruction rehabilitation cannot be over emphasized.

Stage 1 – Pre-surgery physiotherapy

Stage 2 – Week 1 to 2 immediate post-surgery

Stage 3 – Week 2 to 6 Hamstring and Quadriceps Control

Stage 4 – Week 6 to 12 Proprioception

Stage 5 – 3 to 6 months Sports-specific activities

Stage 6 – 6 to 9 months Return to Sports

Stage 1 – Pre-surgery

Goals Physiotherapy
Reduce pain and swelling Cryotherapy
Achieve full ROM Heel slides
Improve quads strength Isometric quads

Stage 2 – Week 1 to 2

Goals Physiotherapy
Reduce swelling & Pain ICE, Cryotherapy
Restore ROM: 0 – 90 Heel slides, active/passive knee flexion, prone hangs, Achieve full knee extension
Restore patella mobility Patella mobilisation
Hamstrings and quadriceps muscle control to 4/5 Isometric quads, electical stim on VMO, SLR, hamstring stretches

Watch out for: infection, stiffness, over-stretch graft, bleeding, DVT

Stage 3 – Week 2 to 6 Hamstring & Quadriceps Control

Goals Physiotherapy
Continue to reduce swelling and inflammation Cryotherapy
Increase ROM 0 to 130 Heel slides, active/passive ROM, prone hangs, heel prop
Normal gait pattern in FWB Gait training, pool exercises
Increase hamstring and quads control Quads/hamstrings co-contractions, Hamstring curls, Leg presses, hip strengthening, Step ups/downs, stationary cyclingMini lunges

Wall squats up to 70 degrees knee flexion

Commence proprioceptive work Static balance exercises, progress to wobble board or balance pad, trampoline

Stage 4 – Week 6 to 12 Proprioception

Goals Physiotherapy
Full ROM Able to sit on heels pain free
Quads strength 85% of non-injured knee Progressive strengthening exercises in gym and pool, Begin endurance training
Improved neuromuscular control and proprioception Start treadmill walking – flat and slowly increase to 12 degrees incline, Progress to jogging in straight line, Swiss ball exercises, Swimming – light kick, no breast stroke, Dynamic balance exercises with balance pad, wobble board
Increase hamstring strength Increase weight and repetitions of hamstring curls, Cycling on road

Stage 5 – 3 to 6 months, Sports-specific activities

Goals Physiotherapy
Preparation for return to sport. Improve skill level. Functional sport-specific exercises in controlled situation (no pivoting)
Improve agility and reaction time drills More advanced agility drills (Figure of 8s, start-stops, change directions forwards and backwards, low speed cutting), Plyometrics – hopping, jumping, skipping
Increase total leg strength and fitness Progress to strength and conditioning programme
Develop patient confidence Isokinetic test

Stage 6 – 6 to 9 months, Return to sports

Goals Physiotherapy
Return to full agility. Functional test 80% of non-operative leg. Prioprioception 100% of non-operative leg Increase speed with figure of 8s, sprint stop-start, change surfaces, jumping bilaterally and unilaterally with increase height and surface
Return to Sport Sport specific training – drills with equipment on sport-specific surface, Unrestricted training, match play
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    First Consultation $150 (before GST) | Subsequent Consultation $90 (before GST)
    *Medications, Investigations & Treatments are charged separately.