ACL Reconstruction:
Pre Surgery Exercises

ACL Reconstruction

Once you have decided to have an ACL reconstruction, you can start to prepare for the surgery by going through rehabilitation. The "pre-hab" has several important benefits, and can often make a large difference in how your post ACL surgery rehabilitation progresses.

Pre surgery exercises do not necessarily need to be done within a clinic. You may be referred by your physician for rehab, or you may not. The most important thing is that you do some type of exercises prior to surgery, whether on your own or with a clinicain.

Why It Is Important

After an ACL tear your knee is swollen, painful, and dysfucntional. You don't have full range of motion, and it is not in a good condition for surgery. Most physicians will wait several weeks after the initial injury before performing an ACL reconstruction.

The swelling and inflammation within the knee after injury must be reduced before surgery. If it is not, then the knee is more likely to develop excessive scarring, and more post operative complications.

The other reason pre surgical exercises are important is to restore normal range of motion and quadriceps strength. And it will also get you familiar with the exercises you will be doing after surgery, as they are often very similiar.

Types of Pre Surgery Exercises


Don't forget the need for R.I.C.E., as this will help to reduce swelling and pain as well.

There are lots of different types of exercises that can be done before ACL reconstruction. The most common ones, and the ones that I have my patients do include quad sets, towel pulls, straight leg raises, hamstring stretches and calf stretches.

Each of these exercises works to improve range of motion, decrease swelling, decrease pain, and improve strength.

Quad Sets

Quadricep sets involve contracting the quadriceps muscles isometrically, and holding for several seconds. This is best accomplished with the leg out straight.

Heel Slides

Heel Slide Start Heel Slide End

Heel slides help to improve range of motion. Start by placing a towel around your heel, holding each end with your hands. You should be able to slide your heel along the floor using the towel.

Now, relax your leg, and use your arms to pull the towel, and your heel, toward you. As your knee bends, you will feel a tightness in your knee, almost like it is going to explode. This is because of the swelling.

Pull your heel to the point of mild discomfort and tightness, and then let it sit for just a few seconds. Then, push your leg out straight, and repeat.

Straight Leg Raises

Straight Leg Raise

Straight leg raises start with a quad set, and then you lift your heel 8-10 inches off of the floor. Hold for 10 seconds and then relax. Try to concentrate on keeping your knee as straight as possible. When you first start this exercise, you may have trouble getting your knee straight, or lifting your heel. But keep trying.

Hamstring and Calf Stretching

Hamstring Stretch

Hamstring stretching before ACL reconstruction helps to improve your flexibility and to keep your muscles from spasming after injury. Any comfortable hamstring or calf stretch will work. The "figure 4 hamstring stretch in the picture is very simple and effective. Straighten your leg all the way out, and then reach towards your toes, bending at the waist, not at the back.

Calf Stretch Start

Calf Stretch End

You can stretch your calf by placing a towel around your toes, and using your arms to pull your foot back towards you.

Hold the stretch for several seconds and repeat. You can also do this with your heel propped up, and work on improving your extension range of motion.

ACL Surgery Stories
If you have had an ACL reconstruction, or are getting ready for this surgery, I want to hear your story. Whether you have questions you want answered, or just want to share your experience, this is the place for you.


Pre surgical exercises for ACL reconstruction surgery can be an important part of the process. It will get you started off on the right foot.

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