Phase 2 of an ACL Reconstruction Recovery. Useful Exercises and Hints.
Phase 2 of an ACL Reconstruction Recovery (Weeks 3-6 Post Operation). Useful Exercises and Hints.
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 2" of an ACL Reconstruction Recovery
In the following I want to go over useful (home) exercises and hints that helped me during this second phase of the recovery process (Phases). Phase 2 is all about developing your mobility, getting that full range of motion back and strengthening both legs.
The Goal of Phase 2:
The goal is to achieve a full (or close to full) range of motion in your knee when straightening (extension) and bending (flexion). To do this, you will be working on some stretching exercises which will not only be limited to your knee, as your other joints and muscles will be tight too. The focus will lie on both legs, as your healthy leg will have lost strength as well. More strengthening exercises are added to those of Phase 1 and you will work on balance and coordination exercises (proprioception). During this phase, you will most likely achieve a normal walking pattern. You will be able to work on early cardio exercises using a stationary bike at home or with your physio (more for mobility, than resistance and exercise). You might progress to an elliptical trainer if you achieve the relevant strength and flexibility. Only progress if your physiotherapist confirms you can. You want to make sure you are not performing any compensation movements as hip hinges (hinging your hip upwards or back to avoid your knee bending fully).
If you haven’t read our post about phase 1, be sure to check out the part on setting goals. This is important in all phases of your recovery, to ensure you stay focused.
In the following I have the main exercises that helped me during this phase. Some things to keep in mind:
- Consult your doctor and physio therapist before performing these exercises
- Quality over quantity! Don’t worry about repetitions – listen to your body and do not over-do it. Rest is also an important part of recovering.
- Your knee might swell up a bit after working out. Cool your knee to decrease the swelling.
- Train both sides! Do all exercises on both sides to avoid muscle imbalances
- 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 your body will also need some rest to recover between physio sessions too - 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, strengthening and balance/coordination.
Continue with exercises from Phase 1 and slowly progress to those of Phase 2. Within the blocks Strength and Balance – the exercises are sorted from least to most demanding. Be sure to progress at your own pace and to consult your doctor or physio before progressing. However, you should still stretch and do a core workout daily. You will notice significant differences between weeks 3 and 6.
Strength
- Yoga Ball Weight Shift & Leg Raises (Warm-Up)
- Partial Squats & Partial Wall Squats (40°)
- Partial Squat Weight Shift & Walk
- Partial Lunge (40°)
- Calf Raises
- Yoga Ball Bridge (Bonus)
Balance
- Balance on 1 Leg
- Standing 747
- Standing Front Kick
- Standing Hip Exercises (Flexion, Extension, Adduction & Abduction)
- Toe Touches
Flexibility
- Heel Props
- Flexion Hangs
- Hamstring Stretch
- Calf Stretch
- Quad Stretch
- Yoga Ball Knee Mobility (alternatively Heel Slides)
Strength - Exercise 1: Yoga Ball Weight Shift & Leg Raises (Warm-Up) 
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Goal |
Mobility & Warm-Up |
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Description |
Seated on Yoga/ Physio Ball |
Sit on a Yoga/ Physio ball and shift your weight from one leg to the other. You can also make small circles while seated on the ball. Make sure to tighten your core and that you have good balance. Then try to lift each leg straight out in front of you. Alternate between your legs. |
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Repetitions |
Beginning |
3x Weekly. 1 Set of 10-20 reps. (Each leg = 1 rep) |
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Progression |
3x Weekly. 3 Sets of 10-20 reps. (Each leg = 1 rep) |
Strength – Exercise 2: Partial Squats & Partial Wall Squats (40°)
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Goal |
Strengthening |
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Description |
Standing free |
Stand with your feet about shoulder width apart. Activate your core and reach your arms out in front of you and now squat down, lower your butt until your knees have a bend of about 40°. Push back upwards to finish one repetition. (Increase your range of motion slowly in these weeks). |
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Standing against Wall |
Lean against a wall with your feet about shoulder width apart and shuffle your feet forward a bit. Now lower your butt until your knees have a bend of about 40°. You can hold this position isometrically. (Increase your range of motion slowly in these weeks). |
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Repetitions |
Beginning |
3x Weekly. 1 Set of 10-15 reps. Hold isometric for 30s |
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Progression |
3x Weekly. 3 Sets of 15-20 reps. Hold isometric longer |
Strength – Exercise 3: Partial Squat Weight Shift & Walk
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Goal |
Strengthening |
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Description |
Weight Shift |
Stand with your feet about shoulder width apart. Activate your core. Now squat down, lower your butt until your knees have a bend of about 40°. Slowly shift your weight from one side to the other. (Increase your range of motion slowly in these weeks). |
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Walk |
Stand with your feet about shoulder width apart. Activate your core. Squat down until your knees have a bend of about 40°. Now take a step to the side by moving one leg further outward. Follow by bringing the other leg back to shoulder width apart. Now do the same movement in the other direction to get back to the original position. (Increase your range of motion slowly in these weeks). |
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Repetitions |
Beginning |
3x Weekly. 1 Set of 10-15 reps. (Each side = 1 rep) |
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Progression |
3x Weekly. 3 Sets of 15-20 reps. (Each side = 1 rep) |
Strength – Exercise 4: Partial Lunge (40°)
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Goal |
Strengthening |
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Description |
Standing |
Stand in a lunge position. Do this by standing with your feet about shoulder width apart and then taking a step forward or backwards. Now lower your body until your knee bends to about 40°. |
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Repetitions |
Beginning |
3x Weekly. 1 Set of 10-15 reps. (Each leg) |
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Progression |
3x Weekly. 3 Sets of 15-20 reps. (Each leg) |
Strength – Exercise 5: Calf Raises
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Goal |
Strengthening |
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Description |
Both Legs |
Stand comfortably with straight legs. Now lift your body upwards by only going on to your tiptoes, keeping your knee straight. Hold on to the wall, or a chair for more balance. Progress to single leg calf raises |
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Progression: Single Leg |
Same exercise, only on 1 leg for more resistance |
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Repetitions |
Beginning |
3x Weekly. 1 Set of 10-15 reps. (Each leg) |
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Progression |
3x Weekly. 3 Sets of 15-20 reps. (Each leg) |
Strength – Exercise 6: Yoga Ball Bridge (Bonus)
*IMPORTANT: If your surgery involved a Hamstring Gaft, you should consult your medical professional before doing these. You should wait at least 4-5 weeks post surgery to give your hamstring enough time to recover.
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Goal |
Strengthening |
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Description |
Hamstring Bridge |
Lie on your back with your feet propped on to a yoga ball. Now lift your pelvis upwards by activating your core, glutes and hamstrings. Hold in the top for a second before lowering again. Progress to curls, then the single leg versions of these exercises. |
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Hamstring Curls |
Lie on your back with your feet propped on to a yoga ball. Now lift your pelvis upwards by activating your core, glutes and hamstrings. When you reach the top position, move your heels toward your body. You should feel your hamstring muscles engage intensely. Straighten your legs again and lower your hips if necessary. Progress to the single leg versions of these exercises. |
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Repetitions |
Beginning |
3x Weekly. 1 Set of 10-15 reps. (Each leg) |
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Progression |
3x Weekly. 3 Sets of 15-20 reps. (Each leg) |
Balance - Exercise 1: Balance on 1 Leg
Balance - Exercise 2: Standing 747
Balance - Exercise 3: Standing Front Kick
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Goal |
Balance & Proprioception |
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Description |
Balance on 1 Leg |
Stand on 1 leg and hold your balance. |
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Standing 747 |
Stand on 1 leg and hold your balance. Spread your arms to the side (hold on to something in the beginning, for more balance) Now bring your leg up Infront of you, forming a 90° angle at the knee and the hip. |
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Standing Front Kick |
The front Kick is a progression of the Standing 747. Extend your leg at the knee when in the standing 747 position. Hold it in front of you for a second, before returning to the standing 747. |
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Repetitions |
Beginning |
3x Weekly. 1 Set of 10-15 reps. (Each leg). Hold your balance as long as possible. |
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Progression |
3x Weekly. 3 Sets of 15-20 reps. (Each leg). Hold your balance as long as possible. |
Balance - Exercise 4: Standing Hip Exercises (Flexion, Extension, Adduction & Abduction)
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Goal |
Balance & Proprioception |
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Description |
Flexion |
Stand on 1 leg. Hold onto the wall for more balance. Bring your straight leg up in front of you, bending at the hip. |
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Extension |
Stand on 1 leg. Hold onto the wall for more balance. Kick your straight leg back behind you. Engage your core – you should feel your glutes engage. |
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Adduction |
Stand on 1 leg. Hold onto the wall for more balance. Bring your straight leg from the outside towards the center of your body. You should feel the muscles on the inside of your thigh engage. |
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Abduction |
Stand on 1 leg. Hold onto the wall for more balance. Push your straight leg to the outside and away form your body. You should feel the muscles in your glutes engage. |
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Repetitions |
Beginning |
3x Weekly. 1 Set of 10-15 reps. (Each leg). |
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Progression |
3x Weekly. 3 Sets of 15-20 reps. (Each leg). |
Balance - Exercise 5: Toe Touches
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Goal |
Balance & Proprioception |
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Description |
Standing |
Stand on 1 leg. Now try touching your toes as for to the front, side, and back as possible. In the progress your knee needs to stabilize and balance and also bend a bit. Try reaching a little further each time. When you progress, try to do the movements without your toes touching the ground. |
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Repetitions |
Beginning |
3x Weekly. 1 Set of 3-5 reps. 1 rep = all 3 directions (Each leg). |
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Progression |
3x Weekly. 3 Sets of 5-7 reps. 1 rep = all 3 directions (Each leg). |
Flexibility - Exercise 1: Heel Props
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Goal |
Mobility & Stretching |
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Description |
Lying down |
Set (“prop”) your foot onto either a black roll, pillow or rolled up towel, so it is high enough to lift your thigh off the ground you are lying on. Now let gravity do its job and allow your leg to ease into extension. Relax, focus on your breath. Hold the stretch for a couple of seconds and ease out of the stretch if you feel any discomfort. |
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Seated |
Prop your leg up onto another chair while seated. |
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Repetitions |
Beginning |
1-2x daily. 10-15 reps. |
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Progression |
1-2x daily. 10-15 reps. Hold stretch a little longer. |
Flexibility - Exercise 2: Flexion Hangs
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Goal |
Mobility & Stretching |
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Description |
Sitting on table or high chair |
While sitting on a table or higher chair let your feet hang down, creating a natural bend in the knee. Do as long as you are not feeling any pain |
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Repetitions |
Beginning |
2-3x daily. Hold the stretch as long as you are not feeling any discomfort or pain |
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Progression |
Hold stretch longer and even stretch further by adding weight through the other leg |
Flexibility - Exercise 3: Hamstring Stretch
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Goal |
Mobility & Stretching |
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Description |
Seated |
Sit on the floor with your straight legs in front of you. Now try tilting forward at the hip, lowering your upper body above your knees. You can reach forward with your hands. Do not “force” the stretch, rather ease into it slowly. |
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Repetitions |
Beginning |
1-2x daily. Hold 30s. |
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Progression |
1-2x daily. Hold stretch longer |
Flexibility - Exercise 4 Calf Stretch
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Goal |
Mobility & Stretching |
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Description |
Seated |
Sit upright on the floor with your straight legs in front of you. Wrap a towel, thera- or fitness band around your foot and gently pull it towards you, your leg staying as straight as possible. Do not “force” the stretch, rather ease into it slowly. |
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Repetitions |
Beginning |
1-2x daily. 30s (each leg). |
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Progression |
1-2x daily. Hold stretch longer (each leg). |
Flexibility - Exercise 5: Quad Stretch
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Goal |
Mobility & Stretching |
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Description |
Lying down on belly |
While lying on your belly, lift one leg towards your glutes while the other stays extended. You can use a towel or exercise band if you cannot reach your foot. Bring your leg up until you feel a stretch. Do not force yourself into the stretch, simply relax and hold it. |
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Lying down on Side |
While lying on your side, move one leg towards your glutes while the other stays extended. You can use a towel or exercise band if you cannot reach your foot. Bring your leg up until you feel a stretch. Do not force yourself into the stretch, simply relax and hold it. |
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Repetitions |
Beginning |
1-2x daily. 30s (each leg). |
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Progression |
1-2x daily. Hold stretch longer (each leg). |
Flexibility - Exercise 6: Yoga Ball Knee Mobility (alternatively Heel Slides)
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Goal |
Mobility & Warm-Up/ Cool-Down |
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Description |
Lying down |
Place your extended legs on a yoga ball while lying on your back. Now carefully try to move your heels towards your body, bending at the knee. Go as far as it is comfortable, before extended your legs to a straight position again. You should not be feeling pain. There can be a stretching sensation in your knee though. This exercise is great as a warm up or cool down before and after doing the other exercises. |
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Repetitions |
Beginning |
1-2x daily. 1 set of 10-15 reps. |
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Progression |
1-2x daily. 2-3 sets of 15-20 reps |
Core Circuit
You can do the following exercises as a circuit. You can choose to do the stated repetitions of an exercise and then resting 15-30 seconds between exercises or you can time each exercise for 30 seconds and rest 10 seconds between exercises. Do as many rounds as you can while keeping propper form (or as long as your schedule allows you to).
Core - Exercise 1: Crunch
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Goal |
Strengthening |
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Description |
Lying down |
Lie on your back. Bring your legs up to about 90°. Make sure your lower back is flat on the ground. No contract your ab muscles and lift your shoulders off the ground. (Your fingertips are just gently touching your ears. No yanking on your neck!) |
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Repetitions |
Beginning |
Daily. 1 set of 10-15 reps. |
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Progression |
Daily. 2-3 sets of 15-20 reps |
Core - Exercise 2: Leg Raises
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Goal |
Strengthening |
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Lying down |
Lie on your back. Make sure your lower back is flat on the ground in all positions. Engage your core and lift your legs. Make sure your lower back stays on the ground! Lower them from the top position again. If you feel your lower back arc, that means your core is not strong enough. In this case only perform a partial movement, making sure your lower back touches the ground at all times. |
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Beginning |
Daily. 1 set of 5-15 reps. |
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Progression |
Daily. 2-3 sets of 15-20 reps |
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Core - Exercise 3: Reverse Crunch
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Goal |
Strengthening |
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Description |
Lying down |
Lie on your back. Bring your legs up to about 90°. Make sure your lower back is flat on the ground. No contract your lower ab muscles and lift your pelvis off the ground. Make sure you do not use momentum or a swinging movement and engage your core. |
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Repetitions |
Beginning |
Daily. 1 set of 10-15 reps. |
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Progression |
Daily. 2-3 sets of 15-20 reps |
Core - Exercise 4: Bug
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Goal |
Strengthening |
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Description |
Lying down |
Lie on your back. Bring your legs up to about 90°. And your arms straight in front of you too. Now simultaneously lower your right arm and left leg. Bring them back to the original position and alternate sides. Make sure your lower back is flat on the ground at all times. You can progress this exercise by jamming a ball between your hand and knee. This builds up constant resistance. Do not let the ball fall (indicated as red circle) |
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Repetitions |
Beginning |
Daily. 1 set of 10-15 reps. |
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Progression |
Daily 2-3 sets of 15-20 reps |
Core - Exercise 5: Hollow Hold
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Goal |
Strengthening |
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Description |
Lying down |
Lie on your back. Bring your legs and shoulders a couple of inches/ centimeters off the ground. Tighten your entire core and make sure your lower back stays flat to the ground. Hold isometrically in the contracted position. |
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Repetitions |
Beginning |
Daily. 1 set of 10-15s |
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Progression |
Daily 2-3 sets of 15-30s |
Core - Exercise 6: Superman
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Goal |
Strengthening |
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Description |
Only Upper Body |
Lie on your stomach. Now contract your core and lower back, lifting your chest off the ground. Hold in the top position for a second before lowering again. |
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Only Lower Body |
Lie on your stomach. Now contract your core, lower back, and glutes, lifting your legs off the ground. Hold in the top position for a second before lowering again. |
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Upper and Lower Body |
Lie on your stomach. Now contract your core, lower back, and glutes, simultaneously lifting your legs and chest off the ground. Hold in the top position for a second before lowering again. |
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Repetitions |
Beginning |
Daily. 1 set of 10-15 reps |
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Progression |
Daily 2-3 sets of 15-20 reps |
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Author
Chris
Author
Hi! My name is Chris, I am 25 years old and I created Athletic-Recovery.com, because I want to help people recover from sports injuries. Personally, I ruptured my ACL in 2017 and my Achilles Tendon in 2020. Both injuries were great set backs, but motivated me to create something where people going through the same struggles all around the world can share their experiences and knowledge to help each other get through their personal injury. #recovertogether
