10 ACL rehab exercises for a strong recovery

Undergoing ACL reconstruction surgery is a big step toward regaining comfort and confidence in your movement. Whether your ACL injury happened during an activity like skiing or from an unexpected knee movement, it can impact how you move around for a while. Surgery is often a positive turning point on the road to recovery.

Everyone’s recovery after ACL surgery is unique, but generally, it can take several months to a year to fully heal. But your body is resilient and designed to heal. Gradually strengthening the muscles around your knee after surgery can help restore your movement and get you back to the activities you enjoy.

Here, Hinge Health physical therapists share examples of ACL rehab exercises to do after surgery to help you recover with ease.

Note: These exercises are provided as general examples and may not be right for your individual needs. Always follow the guidance of your doctor or physical therapist regarding your exercise plan.

Interested in getting a personalized exercise therapy plan? Learn more about Hinge Health’s digital physical therapy program and see if you’re eligible.

Best ACL rehab exercises to do after surgery

After ACL surgery, many people work with a physical therapist in person who can help guide their recovery and suggest appropriate exercises. It’s important to note that different surgeons may have different post-op protocols depending on what tissue was used for your graft, which can influence what exercises are recommended. 

Be sure to discuss any at-home exercises with a physical therapist or other member of your care team. Gentle exercises at home may help support your recovery, but they should always be done in partnership with your surgeon and rehab team to ensure you’re choosing what’s best for you.

“These ACL recovery exercises are designed to help you rebuild strength, restore confidence in your movement, and gradually return to your usual activities,” says Paige Fortney, PT, DPT, a Hinge Health physical therapist. “Their main purpose is to help you feel stronger with each day, rather than just focusing on managing discomfort,” Dr. Fortney says.

You can start some of these movements early in your ACL recovery, while others are better introduced a few weeks or even months after surgery, as your body continues to heal and get stronger.

Some surgeons want patients to wear a brace after ACL surgery during certain activities or exercises, while others are moving away from bracing altogether. “Every surgeon may have a different preference for the type of brace you should use during exercises,” says Dr. Fortney. 

Most patients will also use crutches for a few weeks after surgery, until they are strong enough to walk safely without them. To be sure you’re following the right guidelines for your recovery, ask your surgeon and physical therapist for specific instructions about braces, crutches, and any other equipment you may need.

After ACL injury and surgery, it’s common for your knee to feel swollen, which can prevent you from properly recruiting your quadriceps (the muscles that run down the front of your thigh). As a result, these muscles can lose some  strength. “This simple exercise helps you lay the foundation for quad strength,” Dr. Fortney says.

How to do it:

• Sit on a couch or bed with one leg straight and your other leg bent with your foot flat on the surface.

• Squeeze your thigh muscles on the straight leg you’ve had surgery on as you press the back of your knee into the couch or bed. 

• Your heel may be lifting slightly off the surface as you hold this position. 

• Relax your thigh muscles.

This gentle movement targets your quads, helping to restore strength as you recover. “It’s usually safe to do shortly after surgery, but it can also support your knee as you gradually return to everyday activities,” Dr. Fortney says.

How to do it: 

• On a yoga mat, lie comfortably on your back with your surgery leg resting straight on the floor. 

• Bend the knee of your other leg so that your foot is resting on the floor. 

• Now raise your straight leg toward the ceiling, about 45 degrees off the floor. Focus on keeping your leg straight as you hold your leg high. 

• Then relax your leg back to the floor. 

• Repeat on the other side.

Get more information on how to do the straight leg raise here.

This functional movement helps you build strength in your glutes (butt muscles) and quads. “It prepares you for everyday movements like going from sit to stand after using the bathroom, for example,” Dr. Fortney says. 

How to do it:

• Stand with your feet a comfortable distance apart. 

• Move your hips back while slightly bending your knees, as if you are just starting to sit into a chair. 

• Squeeze your thigh muscles as you hold this position. 

• Push through your feet to return to a standing position. 

Get more information on how to do the mini squat here.

As you continue to heal, you’ll be able to bend your knee more comfortably. “Once you’re at this stage in your recovery, you can incorporate more weight-bearing movements that strengthen your quads, such as the wall squat,” Dr. Fortney says.

How to do it: 

• Stand with your back and shoulders against a wall and your feet several steps away. 

• Bend your knees so your back slides down the wall into a squat. Your knees should be bent around 90 degrees with your knees aligned over your ankles. Maintain the pressure between your back, shoulders, and the wall. 

• Focus on contracting the muscles in your thighs as you hold this position.

• Push through your feet and slide back up the wall to the starting position.

Get more information on how to do the wall squat here.

This dynamic movement helps prepare your leg muscles for everyday movements like climbing stairs. This exercise mimics that motion, while simultaneously strengthening your quads and glutes, which reduces pressure on your knees.

How to do it:

• Stand with the foot of your surgery leg on a step, with your knee bent. Your other foot on the floor with your knee mostly straight. 

• Most of your weight should be on your leg that is on the step. 

• Then, push through your leg that is on the step to lift your foot off the floor. 

• Your leg on the step will straighten, and as you balance on this leg, you will lift your other knee up toward the ceiling. Focus on balancing as you hold this position. 

• Relax your foot back to the floor to return to the starting position. 

• Repeat on the other side.

“This movement is typically added later on as an ACLrecovery exercise,” Dr. Fortney says. “It helps build strength in each leg, one side at a time.” Practicing reverse lunges can support your balance and help you feel more prepared for daily activities as you progress in your ACL rehab journey.

How to do it:

• Stand with your feet a comfortable distance apart and your hands at your side or on your hips.

• Step one leg backward to land on the ball of your foot. While bending your knees, lower into a lunge position. 

• Your weight should mostly be in your front leg, with your front knee positioned over your ankle. 

• Focus on your balance as you hold this lunge position. 

• Push through your front foot as you straighten your legs and return to standing. 

• Repeat this on the other side.

Get more information on how to do a reverse lunge here.

“This exercise is usually added later in your post-ACL surgery exercise, once your care team clears you,” Dr. Fortney says. Practicing side lunges can help you feel more confident and comfortable with side-to-side movements, which are important for getting back to everyday activities like getting out of a car or playing pickleball. 

How to do it: 

• Stand with your feet slightly wider than your hips. 

• Shift your weight to one of your legs and bend into that knee as you keep your opposite leg straight. 

• Hold this position. 

• Push through your foot to straighten your knee and come back to the starting position.

• Repeat on the other side.

Get more information on how to do a side lunge here.

As you move further along in your recovery, this ACL rehab exercise can help you get comfortable with controlled movements on one leg. “It’s especially useful for everyday tasks like going down stairs or navigating curbs with ease,” says Dr. Fortney.

How to do it:

• Stand with one foot firmly planted on a step. The other foot will be floating off the step.

• Your hips should be level from side to side as you do the exercise.

• Bend through your leg on the step to slowly lower your other leg toward the floor.

• The heel will lightly rest on the floor as you hold this position.

• Push through your leg on the step to raise your other foot off the floor and back to the starting position. 

• Repeat on the other side.

After an ACL injury or surgery, it’s common for your balance and coordination to feel off. Once you’re cleared by your care team, practicing standing on one leg can help you restore your sense of balance and feel steadier on your feet.

How to do it:

• Stand straight in a comfortable position. 

• Bend one of your legs to lift your foot off the floor by bringing the heel up toward your butt. 

• Grasp your foot with your hand as you reach out with your other arm to help with your balance. 

• Focus on your balance and your breath as you hold this position. 

• Relax your foot to the floor and return to standing.

• Repeat on the other side.

Get more information on how to do a single leg balance here.

This exercise is usually introduced later as an ACL recovery exercise. “It’s a great way to bring together balance and strength, helping you feel more confident and stable on each leg as you return to your usual activities,” Dr. Fortney says.

How to do it:

• Stand with one hand resting on a sturdy surface, like a countertop or table.  

• Lift one leg off the floor. 

• To perform the squat, bend through your knee as you lean your chest slightly toward the floor and hold in a squat position. 

• Push through your foot to straighten your knee and return to standing. 

Get more information on how to do a single leg squat here.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Phases of ACL rehabilitation after surgery

ACL rehabilitation after surgery is typically divided into four phases: immediate post-surgery (0–2 weeks), early rehabilitation (3–5 weeks), strengthening and control (6–8 weeks), and return to activity (9-12 weeks). However, timelines for each phase of recovery may vary depending on the specifics of your surgery. Each phase has specific goals and exercises designed to ensure a safe and effective recovery.

Rehabilitation is an important part of your recovery after ACL reconstruction surgery, and it’s normal for the process to take time. In the early days after surgery, the main focus is helping your leg feel comfortable with simple movements and gradually building up your activity from there. 

Phase 1: Gradually regain mobility and return to weight-bearing (0-2 weeks after surgery)

During this phase post ACL surgery, the focus is on gently restoring your knee mobility, getting comfortable with how you walk, and beginning to activate your leg muscles. Just like tending to a garden in the spring, this early recovery phase is about gentle movement and care, helping your leg muscles “wake up” and get ready for the growth ahead. During this phase, you can expect to start moving and bending your knee. Your surgeon will give you instructions on how to progress with knee bending. 

Phase 2: Build back strength (3-5 weeks after surgery)

As you move into this ACL rehab phase, the focus shifts to gradually rebuilding strength in your legs and getting comfortable putting weight on your knee again. The muscles surrounding your knee may feel less strong. Exercise therapy is used to help you regain stability and strength.

Exercises often begin lying down or sitting, then progress to standing. Eventually, you’ll progress to movements on one leg. The goal of this phase is to work on building strength throughout your whole leg and core — preparing your body for the next steps in recovery.

Phase 3: Advanced strengthening and balance (6-8 weeks after surgery)

At this stage, your ACL recovery exercises will focus on building even more strength and improving balance and coordination. After surgery, it’s common for your body to feel a little less steady or in tune with movement. This phase includes exercises with added resistance and activities that help you feel more confident as your endurance grows. The goal is to help you feel secure and capable as you move toward more advanced activities.

Phase 4: Focusing on functional movements and returning to exercise (9-12 weeks after surgery

This phase is all about preparing your body for a return to more demanding activities. Your rehab plan may vary based on your surgeon’s guidance and your personal goals, but it often includes movements like jumping, running, sports-specific drills, and agility exercises. The focus is on making sure you feel strong, steady, and ready for any higher-intensity activities you enjoy. 

Safety tips for post-ACL surgery exercises 

To ensure a healthy recovery after ACL surgery, follow your surgeon's guidance, monitor your incision site for signs of infection, and maintain patience and consistency with your ACL recovery exercises. 

Rebuilding strength and regaining confidence in your movement after ACL surgery is a gradual process. Movement is an essential part of recovery, but so is listening to your body. As you move through the different phases of recovery, keep these tips in mind so you can return to the activities you love stronger than ever.

• Follow your surgeon’s guidance. Everyone’s recovery is unique. Your surgeon will recommend a rehab plan that’s tailored to your procedure and personal needs and goals. Timelines for each phase of recovery may vary depending on the specifics of your surgery. Stay in close communication with your care team to help ensure you’re moving forward at a pace that’s right for you.

• Watch for signs of infection. As you heal, pay attention to your incision site. Let your care team know if you notice redness, warmth, swelling, unusual drainage, or if you develop a fever or chills. These are often signs that you need immediate medical attention to support your recovery.

• Be patient and consistent. Recovering from ACL surgery takes time. It’s normal for it to take several months to feel fully confident returning to your usual activities. It often takes six to 12 months to get back into high-intensity sports and competitions. Practicing patience and staying consistent with your exercises can make a big difference, Dr. Fortney says.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Kruse, L. M., Gray, B., & Wright, R. W. (2012). Rehabilitation After Anterior Cruciate Ligament Reconstruction. The Journal of Bone & Joint Surgery, 94(19), 1737–1748. doi:10.2106/jbjs.k.01246

2. Hourston, G. JM., Kankam, H. KN., & McDonnell, S. M. (2022). A systematic review of anterior cruciate ligament primary repair rehabilitation. Journal of Clinical Orthopaedics and Trauma, 25, 101774. doi:10.1016/j.jcot.2022.101774

3. Glattke, K. E., Tummala, S. V., & Chhabra, A. (2021). Anterior Cruciate Ligament Reconstruction Recovery and Rehabilitation. Journal of Bone and Joint Surgery, (8). doi:10.2106/jbjs.21.00688

4. Physiopedia. (2010). Anterior Cruciate Ligament (ACL) Rehabilitation. Physiopedia. https://www.physio-pedia.com/Anterior_Cruciate_Ligament_(ACL)_Rehabilitation

5. Massachusetts General Brigham Sports Medicine. (2021). Rehabilitation Protocol for ACL Reconstruction. https://www.massgeneral.org/assets/MGH/pdf/orthopaedics/sports-medicine/physical-therapy/rehabilitation-protocol-for-ACL.pdf