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Lower Extremity: Rehabilitation Exercises following ACL Reconstruction or Knee Surgery

These instructions are for Children's Hospital of Philadelphia (CHOP) patients to improve mobility and strength in the knee after ACL injury or surgery.

Patient instructions:

These exercises are designed to increase the range of motion and muscle strength in your knee following ACL (anterior cruciate ligament) injury or surgery. If you have any significant pain or swelling after doing the exercises, please contact your physical therapist or physician.
All the exercises below are for your affected knee.
Complete the exercises as instructed. Your therapist will tell you how long to hold each exercise, how many times you should repeat each one, and how many times you should perform the exercises each day.
Keep your brace on at all times locked fully straight, unless you are performing your exercises. Never place a pillow behind your knee. To elevate leg place pillow at lower calf/ankle.
Wear the compression garment on your knee as instructed to help control swelling.
Elevate and ice the knee for 10 to 15 minutes after exercising.

Knee extension stretch	Place your heel on a towel or pillow. Try to relax the muscles of the back of your leg to allow the knee to straighten out further. Hold and release as instructed. You may bend the knee slightly at times for comfort.
Knee extension hang	Lie on your stomach. Position your thigh on the edge of the bed. Use the unaffected leg on top to provide an extra stretch. The goal is to get your knee as straight as possible. You may bend the knee slightly at times for comfort.
Quadriceps set	Straighten your leg, pull your toes toward you and try to tighten your thigh muscle. Try to push your knee down and try to lift your heel. Avoid tightening your buttocks during this exercise.
Knee flexion stretch	Wrap a towel around your ankle to help glide your heel towards your buttocks to bend your knee. The goal of this exercise is to increase knee bending over time.
Wall knee flexion stretch	Place both legs on the wall with the knee to be stretched on top. Use your bottom leg to support the top leg and control how much you bend your knee. Bend until you feel a stretch. Use your unaffected leg to help straighten your knee.
Hamstring stretch	Straighten your leg. Lean forward at your hips and reach toward your toes. Try to keep your back straight. You should feel a stretch behind your knee or thigh.
Straight leg raise	Lie on your back. Straighten your leg. Pull your toes toward you and tighten your thigh muscle. Lift your heel about 8 to 12 inches, slowly lower and repeat.
Side-lying leg raise	Lie on your side with your leg straight. Tighten the muscles on the front of your thigh. Pull your toes toward you and lift your leg towards the ceiling. Keep the leg in line with your body or slightly behind.
Standing heel raise	Stand with both legs straight. Place your hands on a wall or chair for balance. Rise up onto your toes and slowly lower. For an extra challenge, do this exercise with the balls of your feet on a step.
Standing mini squat	Stand with your feet shoulder width apart with your weight even on both legs. Straighten your back and slowly squat down as if sitting in a chair. Keep your buttocks behind you. Your knees should stay in line with your toes.
Standing step-ups	Stand with your leg on a step, like the bottom step on a staircase. Slowly lower your opposite leg to the floor or as low as you can go. Keep your hips level and back straight. Try not to let your knee move side to side. It should stay in line with your second toe.