ACL Reconstruction


Maximizing recovery after ACL reconstruction requires protection of the healing graft while promoting a gradual return of range of motion and strength, resolving the swelling and restoring functional abilities. This program must be initiated immediately after surgery, as directed by your orthopaedist or therapist. A physical therapist from the hospital may also review these with you; however, it is best to have thoroughly reviewed and practiced this program prior to your surgery. It is very important that you complete the following program with perseverance and consistency to optimize your recovery. If you have any questions about the post-operative protocol, please call University Sports Medicine at (585) 341-9150.


Your pain should gradually decrease during your recovery, along with increased range of motion and muscle control. Rest for 1 to 2 hours if pain worsens. Once the pain lessens resume your exercises with reduced intensity and for less time or fewer repetitions. Contact your therapist if the pain does not decrease. You should contact the physician’s office if you are having any side effects, such as stomach upset, from the medications you were given, if you are unable to control your pain with the elevation/ice/medications prescribed, or if you are running a fever.
IMPORTANT: Some discomfort is to be expected after having surgery and beginning to exercise. Progress will be greatly reduced by failing to complete the exercise program.

Brace Guidelines

Your post-operative immobilizer brace serves two primary purposes: to protect your knee from unexpected or undesirable motions and to maintain full extension (straightening).

You must keep the brace locked in extension at 0° (knee straight) throughout the day, with the exception of unlocking it for doing bending exercises, getting into/out of a car or school desk, or using the bathroom.

You may need to adjust your knee brace in order to perform the necessary exercises.

  Activity Duration Frequency
Ranging Flexion (bending) 5…10…15 minutes 4 times per day
Extension (straightening) 5…10…15 minutes Every hour
Kneecap mobilizations 4 directions
30 second hold
3 times
Every hour
Ankle pumping 30 times Every hour
Muscle exercise Hamstring heel digs 6 second
1 second rest 10…30 times
Every hour
Quadriceps setting…quad set plus leg raise 6 second
1 second rest
10…30 times
Every hour
Swelling control Elevation – keep leg higher than hips Throughout day Throughout day
Ice – with plastic barrier (keep dressing dry!) 20 minutes Every 2 hours

Our exercise tracking sheet will help you chart your progress.

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