Reviewed by Dr. Karan Raj Jaggi
Dr. Karan Raj Jaggi is a triple board-certified, internationally trained orthopaedic surgeon super-specialising in regenerative orthopaedics, sports injuries and fast-track joint replacements.He currently serves as the Chief Medical Officer and Head, Regenerative Orthopaedics at Osso Orthopaedic Centres, where he leads cutting-edge orthopaedic care with a focus on holistic, patient-centric treatments.
December 18, 2025
What Specific Exercises Are Included in Each Phase of ACL Rehab?
What is ACL?
Anterior cruciate ligament (ACL) injuries are common among athletes and active individuals, often resulting from high-impact sports that involve sudden stops and changes in direction. Following an ACL injury or surgical reconstruction, a structured rehabilitation program is essential for restoring knee function, strength, and stability. Understanding the specific exercises included in each phase of ACL rehabilitation can help patients navigate their recovery effectively.
What can be the cause?
The ACL is a critical ligament that stabilizes the knee by connecting the femur (thigh bone) to the tibia (shin bone). It prevents excessive forward movement of the tibia and provides rotational stability. When injured, the ACL compromises knee stability, leading to pain, swelling, and functional limitations. Rehabilitation focuses on regaining strength, range of motion, and proprioceptionβthe bodys ability to sense its positionβcritical for preventing further injury and ensuring a successful return to activities.
What are the phase-wise goals?
The rehabilitation process for an ACL injury typically consists of five key phases, each with specific goals and exercises:
1. Pre-operative Phase: Focus on preparing the knee for surgery.
2. Phase 1: Recovery from Surgery: Emphasis on reducing swelling and regaining range of motion.
3. Phase 2: Strength and Neuromuscular Control: Building strength in the muscles surrounding the knee.
4. Phase 3: Running, Agility, and Landing: Preparing for dynamic movements.
5. Phase 4: Return to Sport: Gradual reintroduction to sport-specific activities.
6. Phase 5: Prevent Re-injury: Strategies to maintain strength and prevent future injuries.
Which exercises in which phase?
Pre-operative Phase:
- a. Exercises: Gentle range of motion exercises (heel slides), quadriceps sets, and aerobic conditioning (cycling).
- b. Importance: These exercises help minimise swelling, maintain mobility, and strengthen muscles around the knee in preparation for surgery.
Phase 1: Recovery from Surgery:
- a. Exercises: Quadriceps setting exercises, gentle range of motion exercises (e.g., heel slides), and straight leg raises.
- b. Importance: The focus is on regaining full knee extension and reducing swelling; these exercises activate the quadriceps muscle, which is crucial for knee stability post-surgery.
Phase 2: Strength and Neuromuscular Control:
- a. Exercises:
- – Calf raises
- – Hip abduction exercises
- – Step-ups
- – Squats
- – Lunges
- – Balance training (single-leg stands)
- b. Importance: This phase emphasizes strengthening the muscles around the knee while improving balance and coordination; strong muscles provide better support for the knee joint.
Phase 3: Running, Agility, and Landing:
- a. Exercises:
- – Agility drills (hopping, shuttle runs)
- – Ladder drills
- – Plyometric exercises (two-footed jumps)
- b. Importance: These exercises prepare individuals for dynamic movements required in sports; they enhance coordination and ensure proper landing mechanics to prevent re-injury.
Phase 4: Return to Sport:
- a. Exercises: Sport-specific drills that mimic actual game situations (e.g., cutting drills), running progressions (walking to jogging), and plyometric training.
- b. Importance: This phase focuses on gradually reintroducing sport-specific movements while ensuring that the knee is stable; it builds confidence in returning to competitive activities.
Phase 5: Prevent Re-injury:
- a. Exercises: Continued strength training with added resistance, agility drills, plyometrics, and functional training.
- b. Importance: Maintaining strength and conditioning helps prevent future injuries by ensuring that muscles are well-prepared for physical demands.
Want to know more about ACL?
For further reading on ACL rehabilitation, consider exploring these articles:
Understanding the specific exercises involved in each phase of ACL rehabilitation is crucial for effective recovery. By following a structured program tailored to individual needs, patients can regain strength, stability, and confidence in their knee function while minimising the risk of re-injury. Always consult with a healthcare provider or physical therapist before starting any new rehabilitation program to ensure it aligns with your specific condition.
What is Low Back Pain?
Low back pain (LBP) is a common ailment that affects individuals of all ages and lifestyles. It can arise from various factors, including muscle strain, poor posture, and sedentary behaviour. LBP can significantly impact daily activities, work performance, and overall quality of life. Fortunately, simple stretches can provide relief by improving flexibility, reducing tension, and promoting better spinal alignment.
How is it caused?
The lower back consists of several structures, including vertebrae, intervertebral discs, muscles, ligaments, and nerves. Poor posture or prolonged sitting can lead to muscle tightness and imbalances, which in turn can cause pain and discomfort. When muscles are tight or weak, they may not support the spine effectively, leading to increased stress on spinal structures. This can result in inflammation and pain in the lower back.
What can be done?
Here are several effective stretches that can help relieve low back pain:
1. Knee-to-Chest Stretch: Lie on your back with your knees bent. Pull one knee toward your chest while keeping the other foot flat on the floor.
2. Hamstring Stretch: While seated or lying down, extend one leg straight and reach toward your toes to stretch the back of your thigh.
3. Cat-Cow Stretch: On all fours, alternate between arching your back (cat) and dipping it down (cow) to mobilize the spine.
4. Pelvic Tilt: Lie on your back with your knees bent and feet flat; gently tilt your pelvis upward while tightening your abdominal muscles.
5. Piriformis Stretch: Lie on your back with knees bent; cross one ankle over the opposite knee and gently pull the uncrossed knee toward your chest.
How does it work?
– Knee-to-Chest Stretch: This stretch helps relax the lower back muscles and increases flexibility in the lumbar region, relieving tension.
– Hamstring Stretch: Tight hamstrings can contribute to lower back pain; stretching them helps alleviate strain on the lower back.
– Cat-Cow Stretch: This dynamic movement promotes spinal flexibility and helps release tension in the back muscles.
– Pelvic Tilt: This exercise strengthens abdominal muscles while providing a gentle stretch to the lower back, improving stability.
– Piriformis Stretch: By targeting the piriformis muscle, this stretch helps reduce tightness that may contribute to sciatic nerve pain.
For more information on stretches for low back pain relief, check out these articles: Incorporating these simple stretches into your daily routine can help manage low back pain effectively, promoting better mobility and comfort. Always consult with a healthcare provider before starting any new exercise program, especially if you have chronic pain or underlying health conditions.
