Playing The Field by Ashleigh Nelson

Road to Rehab – Part 2


ACL Rehab Program – Weeks 1 – 5


Ashleigh Nelson

Ashleigh Nelson

The most common question when another person learns of your ACL tear is:  “What does the rehabilitation process involve?” In order to appease many of those interested or individuals going through the same rehabilitation process, here is a brief description of what I have gone through and exercises involved from weeks 1-5.

Please Note…

  • This is a basic description of what I am doing but hopefully gives you a reasonable idea of how I have progressed.
  • This program has been compiled and overseen by medical professionals specific to my ACL repair.
  • Only use this as a reference point and obtain professional services for your own ACL rehabilitation.
  • All ACL recoveries are different so it is essential to listen to your body.
  • If your body is not ready to engage in the below exercises then do NOT do it.


  • Injury: April 27, 2016
  • Surgery: April 29, 2016 (overnight stay). Hamstring graft right knee.

Week 1: (May 2, 2016)

Aim: Maintain activation in quadriceps and VMO (inner quad/thigh) through isometric contractions. Reduce swelling after surgery. Attempt to get leg slowly into full extension (note: flexion comes with time, extension is a priority).

Mobility: Partial weight bearing with crutches and brace (can take on and off – however, majority of time in brace). Out of bed, mobile and partial weight bearing on the morning following surgery.

Medication: Regular use of pain medication – slow and rapid release.

Exercises: VMO and quad co-contraction

  • Pain especially on transfers (in and out of car, off couch and toilet, in and out of bed).
  • During the first few weeks consider hiring a “game ready” machine to assist with swelling reduction.
  • Difficulty getting dressed due to an inability to stretch hamstring.
  • Limited sleep – unable to get comfortable while sleeping on my back. Would often move onto the couch midway through the night.
  • Quite emotionally volatile – still dealing with knee injury, feeling tired and in pain isn’t a good mixture.
  • Feeling unwell and tired on pain medication.
  • Lost of appetite.

Week 2: (May 9)

Aims: Continue to reduce swelling compression, elevation and ice. Continue activation exercises. Continue leg extension. Post stitches being removed start with scar management (massage scar with bio oil)

Mobility: Time in and out of brace (use as required). Partial weight bearing with crutches.

Medication: Reduced use of rapid release medication. Still using slow release to manage pain.

Rehab exercises (non weight bearing): Rehab – co-contractions, straight leg raise, hami curls

Fitness exercise: Upper body conditioning 5 x per week. 1 leg (unaffected leg) airdyne can be used for conditioning purposes.
Example session: UB – 10 punches (seated) , 10 pushups , 10x 1 leg squats (unaffected) , 10 DB row, 10 situps. 20 punches, 9 PU, 9 SL squats, 9DB row, 9 situps. Continue to 100 punches and 1 pushup etc.

May 13 – 1st physiotherapy appointment
May 12 – reviewed by surgeon and stitches removed
Approved for swimming with pool buoy as wound has healed
Leg close to full extension
Some lag on straight leg raise – continue trying to get full leg extension and quad/VMO activation.
Week 3 (May 16, 2016)

Aim: Partial weight bearing – taking some steps without crutches. Continue with gaining and maintaining fell leg extension. Scar and swelling management – gentle massage over scars. Start flexion no more than 45 degrees – due to meniscus repair. Double leg airdyne introduction

Pain: Some pain with flexion behind the back of the knee. Pinching at lateral meniscus site. Poor sensation around scar sites.

Mobility: Partial weight bearing graduating into full weight bearing without crutches. Reduced use of brace – sometimes used if knee was sore and required extra support.

Driving: Resumed driving automatic car over small distances.

Medication: No medication used.

Rehab exercises:
(Everyday, unweighted) Rehab – co-contractions, straight leg raise, hamstring curls, seated co-contractions, prone reverse extensions

Introduction and trial of lower body exercises completed 1 x per week:
3 x 1min wall sit
3 x 6 squats to 45
3 x 6/leg lunge to 45
3 x 10sec straddle hold
3 x 6/leg running man

Fitness exercises: 5 x per week
DL airdyne introduced: Note seat height placed at an elevated level to reduce flexion of knee.

Example 1:
Upper body -16 mins. Tabata (20 secs on, 10 secs off – 4mins total). Airdyne x2 & ball slams. Airdyne x 2 russian twists

Example 2:
UB conditioning – 2min airdyne. 30 SL rope, 10 v-sit, 30 sec hang (25mins total)

Week 4: (May 23, 2016)

Aim: Stop loss of muscle loss in right leg (atrophy). Scar & swelling management. Commence gait re-education. Continue with gentle flexion exercises and maintaining full extension. Introduction of stationary bike riding (with high bike seat)

Mobility: Limited use of crutches, unless going for distance. No longer using brace at all.

Pain: Primary pain comes with flexion due to meniscus damage behind the back of the knee. Some pain negotiating stairs.

Rehab exercises:
Daily rehab exercises as per week 3.

Low body rehab exercises x 6 times per week
3 x 1min SL wall sit
3 x 6 squats to 45 (no weight until week 5) (See video)
3 x 6/leg lunge to 45 (See video)
3 x 10sec straddle hold
SL catch and throw – balancing activities (See video)

Calf bounces 
10min bike with a high seat


Fitness exercises:
1 x swim session – 1.5km -2 km with pool buoy (no kicking)
4 x fitness workouts per week see two examples below

Example 1:
2min AD
12 push ups, bentover row, press, slasher 
2min AD
10 push ups, bentover row, press, slasher
cont to 2 push ups, bentover row, press, slasher
Continue to 1 rep of each exercise

Example 2:
1min of each exercise 
AD, rope, DB thruster (unaffected leg to chair, Russian twist, ball slam, rest)
5 rounds total

Week 5: (May 30, 2016)

Aim: Stop loss of muscle loss in right leg (atrophy). Scar & swelling management
Continue gait re-education. Continue with gentle flexion exercises and maintaining full extension. Introduction of SL rehab exercises. Introduction of cross trainer

Mobility: No use of crutches, slight limp with walking. Difficulty getting full extension with stride.

Pain: Pain behind back of the knee has reduced. Some awareness during initial stages of bike riding and airdyne.

Rehab exercises:
Daily rehab exercises as per week 4.

Low body rehab exercises x 6 times per week: (Single leg intro)
3 x 1min SL wall sit
3 x 6 squats to 45 + weight
3 x 6/leg lunge to 45+ weight
3 x 10sec straddle hold
3 x6/leg Box step downs
SL catch and throw
 Calf bounces

Fitness exercises:
1 x swim session – with pool buoy (no kicking)
4 x fitness workouts per week see examples below

Example 1:
10min crosstrainer
2 min airdyne between sets
 Slasher to halo
 Bentover row
 Ball slams

Example 2:
15min cross trainer

 Partner 1 
Straddle stretch x 10 
Straddle holds -fwd,bkw,up/down, hold
 Wall angles

Partner 2 (See video)
 Tabata something (bike or airdyne for length of time partner one takes to complete above set)


In my next blog I will update my progression from week 6 – 12. If you have any questions or would like a rehab exercise recorded and explained please leave a comment below.


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