Pre-Surgery ACL Rehabilitation Guidelines and Exercises

Successful recovery from a torn ACL begins before reconstruction surgery. Long-term ACL research clearly shows the stronger and more functional your injured knee before surgery, the further ahead you’ll be in your rehabilitation after.

What you do before surgery is referred to as prehabilitation or just prehab. The MOON Knee Group recommended prehabilitation exercises on this page will:

• Strengthen your muscles
• Increase your range of motion
• Increase blood flow around your knee to promote healing.

Pre-ACL Surgery Goals

The two most critical goals before and after ACL surgery are to:

• Work toward being able to fully straighten (achieve full extension) of your injured leg
• Walk normally

Other pre-surgery goals are to:

• Minimize pain
• Reduce swelling
• Develop good quadriceps control and strength

The exercises on this page will help you work toward these goals. These exercises are also used in the Phase 1 rehabilitation program that begins immediately following surgery. (See this chart for which exercises are recommended in prehab through Phase 3.)

Evidence-Based ACL Rehabilitation

The evidence-based MOON Knee Group anterior cruciate ligament post-surgery rehabilitation program has five phases plus prehabilitation. Each has specific goals, exercises and instructions based on two decades of research.

Success depends on completing each phase before moving on to the next. Your physician, physical therapist or athletic trainer will measure your progress and instruct you on when to advance.

On This Page

• Prehabilitation Guidelines
• Pre-Surgery Mobility Exercises
• Pre-Surgery Strength Exercises

Related Content

ACL Prehabilitation Guidelines

If you’ve torn your ACL, it is normal to experience discomfort, swelling and bruising. Here are ways to manage the discomfort and swelling to prepare your knee for surgery.

Crutch Use

• You may be asked to walk with two crutches. Crutches help you protect your knee and get around safely.
• When using crutches, place as much of your body weight on your leg as you can without increasing knee pain while walking. You might hear this called weight-bearing as tolerated or WBAT.
• Your physical therapist or doctor will guide you on using crutches before and after surgery.

Ice, Elevate and Rest

If you’ve torn your ACL, the recommendation is to ice, elevate and rest your knee to control swelling, inflammation and pain.

• For at least the first 24 hours after your injury or until severe inflammation is controlled, ice and elevate your leg at a level above your heart while lying down.
• Elevate and support your entire leg. Do not place a pillow or other support under your knee alone.
• If your medical professionals recommend compression, please ask them for specific instructions for use in your recovery.

Regain Mobility and Strength

The recommended exercises include ones to improve your mobility and ones to improve strength. Doing at least the primary exercises in both areas is important for successful rehabilitation.

Primary, Alternate and Optional Exercises

If you’ve injured your ACL, you might not feel like moving your knee. However, keeping knee motion and working toward full leg extension (straightness) are important in preparing for surgery and successful recovery after.

The MOON Knee Group ACL rehabilitation exercises are designed to move you step by step. Exercises are identified as primary, alternate and optional.

• Primary exercises are the minimum recommended for achieving a successful recovery.
• Alternate exercises achieve the same objective as primary exercises. Use these if your body is uncomfortable in the primary exercise position.
• Optional exercises provide additional strength and conditioning.

Consult with your medical team about which exercises are advisable for you, particularly if you experience increased pain and swelling.