Phase 1 of an ACL Reconstruction Recovery (Weeks 0-3 Post Operation). Useful Exercises and Hints.

If you are reading this post, chances are you probably tore your ACL (Anterior Cruciate Ligament) and have recently been operated. From personal experience, I know how frustrating this is. It happened to me back in 2017. The diagnosis back then hit me harder than the injury itself and I honestly felt slightly depressed. It was a long and strenuous journey back to the fitness level I have now, and I want to share some of my experiences and exercises that helped me, with you. In hindsight, I could have recovered much more effectively and better, if I had the knowledge I have now. In the following I want to go over these useful (home) exercises and hints that helped me during my recovery.

DISCLAIMER
Before I jump further into the content, I just want to mention you should consult your doctor and physiotherapist before doing any of the exercises I will be suggesting. Every injury is unique and requires a unique therapy, there is no one-size-fits-all model. Now that I have mentioned that, let's get going.

"Phase 1" of an ACL Recovery

What does that even mean "Phase 1"... Well it is a way for doctors and therapists to break down your recovery journey. Again, there are different approaches out there, and it is hard to categorize everyone and the unique reaction of the body to the operation and therapy. I will refer to the Phases which I described in an article already. When speaking of Phase 1 it is primarily the time you are still using crutches (approximately the first 3 weeks post operation).

This phase is one of the hardest and my best advice is that you accept the fact you are injured and start focusing on doing everything to get better. Don’t go down the path of willowing in your own misery (it doesn’t help you or anyone around you – trust me). Even if it seems hard, keep looking forward. This brings me to my first piece of Advice:

Set Goals.

Goals will help you through your recovery and this is something I didn’t do back when I was injured. In a quiet moment sit down and make a list of goals. What I would do is to go to the bottom of my page and set a bold goal. In my case, as a basketballer, something like: “dunking the basketball” (Note that this is something I was able to do before getting injured). From there I would work the list backwards to my current state: “jump to hoop, jump to backboard, jump to net […] walk bearing body weight, walk without crutches […] get operated”. Try to make these “sub-goals” as detailed as possible. The longer your list, the more steps you can check-off. I made a small template you can download here. I have added the “medical goals” too to give you an orientation for your goals. Lists also help me in everyday life, I think this is a great way of visualizing your recovery and seeing where you are in the process.

The Goal of Phase 1:

To give you some guidance for the first phase, the goal here is to decrease the swelling of the knee, manage full extension of your leg and being able to walk normally (normal gait pattern) again (without compensating, which can lead to muscle imbalances). You will probably still be using crutches (or one crutch) at the end of the 2-3 weeks. Concentrate on walking "normally" with the crutches. Take your time and follow your own pace and the recommendations of your doctor and physio therapist.

In the following I have 12 exercises that helped me during this phase. Some things to keep in mind:

1. Consult your doctor and physio therapist before performing these exercises
2. Quality over quantity! Don’t worry about repetitions – listen to your body and do not over-do it. Rest is also critical in this early phase after the operation
3. Cool your knee to decrease the swelling. 10 minutes every now and then help a lot!
4. Train both sides! Do all exercises on both sides to avoid muscle imbalances
5. Have regular check-ups with your doctor and as much physio as possible.

Exercises to do at home

As mentioned above, be sure to consult your doctor or physiotherapist before performing these exercises first. (Download my free Home-Exercise pdf here).

When choosing exercises I focus on the ones that can be done at home in order to make better progress between your physio sessions. However, be aware that in the beginning your body will also need some rest to recover, so do not over do it. Rule #1 listen to your body. If you are sore and not feeling well, rest instead and look for other ways to help reach your goals eg. cooling for decreased swelling, etc. Note, all repetition ranges are rough guides. Do not feel obligated to meet the numbers, focus more on the sensation and improving steadily. The exercises in this stage focus on mobility/flexibility, gentle strengthening and balance/coordination.

1. Heel Props - Flexibility
2. Quad Sets - Strength
3. Ankle Pumps - Strength
4. Straight Leg Raises - Strength
5. Heel Slides & Wall Slides - Flexibility
6. Calf Stretch - Flexibility
7. Massage Scars & Pattelar - Flexibility
8. Flexion Hangs - Flexibility
9. Side Leg Raises - Hip Abductions - Strength
10. Side Leg Raises - Hip Adductions - Strength
11. Hip Extensions - Strength
12. Weight Shifts - Balance 

Exercise 1: Heel Props - Flexibility

Exercise 2: Quad Sets - Strength

Exercise 3: Ankle Pumps - Strength

Exercise 4: Straight Leg Raises - Strength

Exercise 5: Heel Slides & Wall Slides - Flexibility

Exercise 6 Calf Stretch - Flexibility

Exercise 7: Massage Scars & Pattelar - Flexibility

Exercise 8: Flexion Hangs - Flexibility

Exercise 9: Side Leg Raises - Hip Abduction - Strength

Exercise 10: Side Leg Raises -Hip Adduction - Strength

Exercise 11: Hip Extensions - Strength

Exercise 12: Weight Shifts - Balance

I Hope this helps your recovery. I would be happy to hear your feedback and if you want to connect and help others going through the same experiences you are, please post and share your experiences in our community.

#recovertogether

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