Range of motion is one of the top priorities in early rehab after an ACL reconstruction, or any knee surgery really! We rely on our range of motion for so much, and without it we will be very restricted in day to day activities like walking, going up and down the stairs, or standing up and sitting down, let alone higher level return to sports activities.
Immediately after surgery, your knee is going to feel stiff. It will be swollen, and working on your range of motion is going to be very uncomfortable. You may even find that your numbers fluctuate, and it may take a little bit of work to get to the range you reached yesterday. This is all normal, but reinforces how important it is to stay on top of your range of motion exercises.
Achieving full knee extension is important to get as soon as possible. Scar tissue has the potential to build up quickly, to the point it can hinder and block your extension. Here are my top three ways to achieve your full extension range of motion as soon as possible!
Towel or Foam Roll Prop
Prop your ankle on a small towel roll or foam roll, and do your best to relax! This lets gravity do the work to straighten out your knee. Start with a small towel roll, and if that starts to feel easy build it up. You can also utilize an ankle weight to place right above your knee for an extra stretch.
Hold this position as long as you can tolerate: one minute is a good place to start. When you are still working to get full extension, I will usually recommend working on an extension stretch for 30 minutes per day, and work your way up to 45 or 60 minutes over the next couple of weeks. This could be 6 sets of 5 minutes throughout the day, 30 sets of 1 minute, you get the picture!
Prone Hang
Lay on the stomach with your knee just off the edge of the table or your bed. This position again uses gravity to help straighten out your leg. Like the previous exercise, you can also utilize an ankle weight for an extra stretch. Again, hold as long as you can tolerate! This stretch is another way you can reach that goal of 30 minutes!
Quad Sets
Place a small towel roll underneath your knee. Then tighten your quad by pushing your knee down into the towel roll, and hold for 3-5 seconds. This should engage your quad muscle and straighten your knee. This is a quad activation and strengthening exercise, as well as an active extension exercise. Your quad is probably the most important muscle in recovering from an ACL injury, and sometimes after surgery it can feel like it’s fallen asleep. It may be challenging to coordinate this activation at first, but I promise it will get easier! It’s okay if your heel doesn’t prop up off the ground at first, keep working at it.
A good place to start with these ones are 30 repetitions per day, and work your way up to 60 or 100!
Stay diligent with these exercises, and I promise your extension will come. Feel free to send me an email with any questions about getting your extension back, or any other questions relevant to your ACL recovery. You’ve got this!
Dr. Jen Reed, physical therapist with Made Strong Physical Therapy & Wellness, has extensive personal and professional experience with ACL rehabilitation, and returning to an active lifestyle after recovering from an injury. She understands the recovery experience, mindset challenges, and what truly makes a difference in your physical therapy to not only get back to the activities you love, but feel stronger doing them than before your injury.
Contact Dr. Jen at jennifer@madestrongpt.com.