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What is ACL Prehabilitation

ACL prehabilitation, or commonly known as ACL prehab, is an exercise or physical therapy program that patients go through before their surgery. Many orthopedic surgeons recommend a prehab program before major surgeries as a growing body of evidence suggests that prehab is beneficial for recovery.[1]

Why should I Do ACL Prehabilitation

ACL Prehab helps to maximize the function and the health of the knee prior to surgery. Generally speaking, the better your knee is before going into surgery, the better it recovers coming out of surgery.[2]

ACL rehab helps you to[3]:

  • Control pain and swelling
  • Get back to your normal knee range of motion (click here to read more about range of motion)
  • Get back to normal walking pattern
  • Improve your leg strength and coordination.
  • A group of researchers investigated the difference between people undergoing a prehabilitation program, the prehab group, and those who were not involved in any prehab, also called a control group. They found that the prehab group performed better at the single-legged hop test than the control group both before surgery and after surgery.[2] The single-legged hop test is a knee function test that's used to evaluate if a person is ready to return-to-sports.

    When Can I start?

    You may start prehabilitation exercises under the supervision of a qualified health care provider, such as a physical therapist, as soon as the swelling and pain in the injured site have been controlled. Remember that your physical therapist can help you get ready for prehab by teaching you ways to reduce your pain and swelling after injury. Click here to check out how you may manage your pain and swelling.

    What Exercise I can do?

    Here are some examples of typical exercises in an ACL prehabilitation program to help you improve your injured knee range of motion.[4] Please consult your health care provider before starting any new exercises on your own! Start your prehabilitation slowly to minimize the risk of increasing your pain and swelling.

    1. Heel Slides

    Step 1

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    Step 2

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    2. Lying Knee Bend

    Step 1

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    Step 2

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    3. Wall Slides

    Step 1

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    Step 2

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    What exercises I cannot do?

    Your knee may feel and look normal after prehabilitation. However, you have to remember that your knee is still injured and hasn’t regained all of the strength and stability used to have. You may be tempted, but please DO NOT run, cut, jump, or return to ANY sports that will involve any changing of direction, as you are risking sustaining further serious injury. Please speak to your health care provider if you feel you are ready for any of the above-mentioned activities.

    If you have been scheduled for your ACL surgery and are not sure what to expect, we have written a blog on what to expect after waking up from your ACL surgery. Click here to learn more!

    We also invite you to join our growing ACL Facebook community! It is a great place to get support from others going through a similar experience. Click the button below to join the family!

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    Reference

    1: Durrand, J., Singh, S. J., & Danjoux, G. (2019). Prehabilitation. Clinical Medicine, 19(6), 458–464. https://doi.org/10.7861/clinmed.2019-0257

    2: Shaarani, S. R., O’Hare, C., Quinn, A., Moyna, N., Moran, R., & O’Byrne, J. M. (2013). Effect of prehabilitation on the outcome of anterior cruciate ligament reconstruction. The American Journal of Sports Medicine, 41(9), 2117–2127. https://doi.org/10.1177/0363546513493594

    3: Failla, M. J., Logerstedt, D. S., Grindem, H., Axe, M. J., Risberg, M. A., Engebretsen, L., Huston, L. J., Spindler, K. P., & Snyder-Mackler, L. (2016). Does Extended Preoperative Rehabilitation Influence Outcomes 2 Years After ACL Reconstruction?: A Comparative Effectiveness Study Between the MOON and Delaware-Oslo ACL Cohorts. The American Journal of Sports Medicine. https://doi.org/10.1177/0363546516652594

    4: Dr. P. J. Millett et al. ACL Reconstruction Rehabilitation Protocol. Sports Medicine and Orthopaedic Surgery 2010.