Anterior Cruciate Ligament (ACL) Injury Rehabilitation Exercises

You may begin with the first 2 exercises immediately. When swelling in your knee has gone down and you are able to stand with equal weight on both legs, you may do the remaining exercises.

• Heel slide: Sit on a firm surface with your legs straight in front of you. Slowly slide the heel of your injured leg toward your buttock by pulling your knee to your chest as you slide. Return to the starting position. Do 3 sets of 10.
• Quadriceps isometrics: Sitting on the floor with your injured leg straight and your other leg bent, press the back of your knee into the floor by tightening the muscles on the top of your thigh. Hold this position 10 seconds. Relax. Do 3 sets of 10.
• Wall squat with a ball: Stand with your back, shoulders, and head against a wall and look straight ahead. Keep your shoulders relaxed and your feet 1 foot away from the wall and a shoulder's width apart. Place a rolled up pillow or a soccer-sized ball between your thighs. Keeping your head against the wall, slowly squat while squeezing the pillow or ball at the same time. Squat down until you are almost in a sitting position. Your thighs will not yet be parallel to the floor. Hold this position for 10 seconds and then slowly slide back up the wall. Make sure you keep squeezing the pillow or ball throughout this exercise. Repeat 10 times. Build up to 3 sets of 10.
• Passive knee extension: Do this exercise if you are unable to fully extend your knee. While lying on your back, place a rolled up towel underneath the heel of you injured leg so it is about 6 inches off the ground. Relax your leg muscles and let gravity slowly straighten your knee. You may feel some discomfort while doing this exercise. Try to hold this position for 2 minutes. Repeat 3 times. Do this exercise several times per day. This exercise can also be done while sitting in a chair with your heel on another chair or stool.
• Prone knee bends: Lie on your stomach with your legs straight out behind you. Bend your knee so that your heel comes toward your buttocks. Hold 5 seconds. Relax and return your foot to the floor. Do 3 sets of 10. As this becomes easier you can add weights to your ankle.
• Static and dynamic balance exercises
  1. Place a chair next to your non-injured leg and stand upright. (This will provide you with balance if needed.) Stand on your injured foot. Try to raise the arch of your foot while keeping your toes on the floor. Try to maintain this position and balance on your injured side for 30 seconds. This exercise can be made more difficult by doing it on a piece of foam or a pillow, or with your eyes closed.
  2. Stand in the same position as above. Keep your foot in this position and reach forward in front of you with your injured side's hand, allowing your knee to bend. Repeat this 10 times while maintaining the arch height. This exercise can be made more difficult by reaching farther in front of you. Do 2 sets.
  3. Stand in the same position as above. While maintaining your arch height, reach the injured side's hand across your body toward the chair. The farther you reach, the more challenging the exercise. Do 2 sets of 10.
• Knee stabilization: Wrap a piece of elastic tubing around the ankle of your uninjured leg. Tie the tubing to a table or other fixed object.
  1. Stand on your injured leg facing the table and bend your knee slightly, keeping your thigh muscles tight. While maintaining this position, move your uninjured leg straight back behind you. Do 3 sets of 10.
  2. Turn 90° so your injured leg is closest to the table. Move your uninjured leg away from your body. Do 3 sets of 10.
  3. Turn 90° again so your back is to the table. Move your uninjured leg straight out in front of you. Do 3 sets of 10.
  4. Turn your body 90° again so your uninjured leg is closest to the table. Move your uninjured leg across your body. Do 3 sets of 10.

  Hold onto a chair if you need help balancing. This exercise can be made even more challenging by standing on a pillow while you move your uninjured leg.

• Resisted knee extension: Make a loop from a piece of elastic tubing by tying it around the leg of a table or other fixed object. Step into the loop so the tubing is around the back of your injured leg. Lift your uninjured foot off the ground. Hold onto a chair for balance, if needed.
  1. Bend your knee about 45 degrees.
  2. Slowly straighten your leg, keeping your thigh muscle tight as you do this.

  Do this 10 times. Do 3 sets. An easier way to do this is to perform this exercise while standing on both legs.