10 knee exercises after anterior cruciate ligament surgery.

After anterior cruciate ligament surgery, rehabilitation begins. Rehabilitation is characterized by various exercises to improve knee flexion and extension and build muscle strength. An overview of 10 knee exercises after anterior cruciate ligament surgery can be found here.

Do the knee exercises in consultation with your physical therapist as each rehabilitation is an individual process.

The various components:

1. circulation
2. Mobility
3. Strenght
4. Walking exercise
5. Prevention secondary complaints
6. Nutricion

circulation

You will notice that the lower leg is swollen and probably discolored from a hematoma. It is essential to stimulate blood circulation. Through the blood, nutrients and building materials are supplied and waste products are removed. After surgery you sit mostly still on the bed or couch, this does not promote blood circulation in the leg. It helps to do regular exercises. The following exercises can help:

Foot pump: move foot up and down as if pressing and releasing gas pedal. Target circulation lower leg and ankle mobility.

Do the exercises one set of 20-30 repetitions every 60 to 180 minutes.

Tighten upper leg muscles. Concentrate mainly on the inner part of the muscle (vastus medialis). Goal: learn upper leg muscle tightening, knee extension and fluid circulation.

Do the exercises one set of 20-30 repetitions every 60 to 180 minutes.

Cycling is the exercise to make the knee flexible and reduce fluid. On average, can be started after 2.5-3.5 weeks. Goal: circulation and. improve mobility.

Try cycling 2-3 times a day for 15-30 min (build up)

Mobility

Because of anterior cruciate ligament surgery, the knee becomes stiff and stretching and bending are limited. To regain this mobility, regular exercise is essential. The focus should be on extending the knee. Flexion is also important, of course, but it generally recovers more easily than extension.

Heel slides with the help of the hands. With this exercise, bending as well as stretching is practiced. 

Do the exercises one set of 20-30 repetitions every 60 to 180 minutes.

Using the other leg to bend and stretch the operated leg. With this exercise, bending as well as stretching is practiced.

Do the exercises one set of 20-30 repetitions every 60 to 180 minutes.

Strenght

In the first few weeks, the strength and size of the thigh muscles decrease. You will also notice that it is more difficult to tighten the thigh muscles. Building strength in the first few weeks is difficult because of swelling, pain and immobility. Therefore, the focus is on maintaining muscle strength. 

Straight leg raises zorg voor voldoende voorspanning door de knie goed te strekken, bovenbeen aan te spannen en de enkel te flexen. Lift het gestrekte been op en wissel dit na 5 seconden af met het andere been.

Do the exercises 5 times a day 1-3 minutes. 5 seconds the operated leg and 5 seconds the other leg. Resistance can be gradually built up with weight bags.

In side position, bend both legs. Open the upper leg. Fixate the hips and twist over the heel. 

Try 4-5 times a day 4×15 repetitions both ways.

In side position both legs extended. Raise the upper leg. Do the exercise both ways.

Try 4-5 times a day 4×15 repetitions both ways.

Walking exercise

Usually, immediately after anterior cruciate ligament surgery, you may put 50 percent load on the knee. As soon as possible after surgery, aim for a symmetrical and normal walking pattern with crutches. Obviously this will be difficult for the first few weeks, but keep focusing and trying yourself on it.

Marching in place. Stay upright and extend the stance leg. The floating leg should remain relaxed.  The exercise is aimed at improving the gait pattern.

Do the exercises 3x a day 3 sets and 10 repetitions.

Strengthen calves. Stand upright on two legs. Put the crutches in front of you for balance. Lift the heels off the ground. Exercise is not appropriate if you have calf pain.

Do the exercises 3x a day 3 sets and 10 repetitions.

Preventing secondary complaints

Most of the attention and time in knee rehabilitation obviously goes to the knee, but don't forget the rest of the body. Sitting still for long days is not good for the body. Ankle, back and/or hip pain due to inactivity and asymmetrical loading is a lurking complication. Furthermore, inactivity leads to a decline in your overall fitness. Exercises aimed at endurance and upper body strength can help with this. Moreover, this also encourages better circulation.

Stretched leg alternate lifting. Note; lift from the glutes and do not bend the knee. This activates the hamstrings and will hurt. If this exercise is still painful, wait a few days.

Try to do 4 sets of 15 repetitions 5 times a day.

With assistance from the non-operated leg bending and stretching the knee. The prone position is a pleasant change from prolonged sitting and/or lying on the back.

Try to do 4 sets of 15 repetitions 5 times a day.

Actively bend and stretch the knee. This exercise can usually be started after a few weeks. With a patellar or quadriceps tendon, often earlier.

Try to do 4 sets of 15 repetitions 5 times a day.

Don't do: Do not place pillows or other objects under the knee. This can cause a restriction in extension.

Do:sag to promote stretching possibly in conjunction with circulation exercises. Always provide a firm surface and do not make the towel too high. A few centimeters is often enough.

Try letting the knee sag for several minutes 5 times a day.

Please note that the above exercises are optional and the list of exercises is not exhaustive. Always consult with your own physio which exercises apply to you. 

Nutricion

Eat healthy and varied foods. Be careful with fats and carbohydrates. Because of the inactivity after surgery, your body needs less of these. Eat enough protein to promote recovery and fight hunger pangs. For more information about proteins click here

If you still have questions after reading this blog "10 knee exercises after anterior cruciate ligament surgery," always discuss it with your physical therapist.

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