What can I do to get my flexion back after ACL surgery? What are the best exercises for knee flexion after ACL surgery?
This is are questions that I frequently asked my PT and doctor as I heavily struggled with my range of motion following my ACL and medial and lateral meniscus surgery in 2018.
Today, I’ll share the top exercises I used to get my flexion back after ACL surgery.
Exercises for Knee Flexion After ACL Surgery
Wall Slides
Wall slides are one of the first exercises I was able to do for flexion. Lay on your back perpendicular to the wall. Raise your leg up so your heel is on the wall. Slide your foot down toward your butt and hold for a few seconds before straightening again. Repeat 15-20 times for 3 rounds. The closer your butt is to the wall, the harder it will be, so as you progress, try to lay right up against the wall.
NuStep Machine
My gym had a “NuStep” machine which typically elderly people used for exercise. Sit on the seat, and keep the resistance down and first. Keep your feet on the footrest areas, and alternate your feet so your legs bend and straighten. Use the machine for 10-20 minutes.
As your flexion improves, you can move the seat closer and turn up the resistance.
Biking
Biking is one of the most common flexion exercises. There are several types of bikes to choose from, so pick the one you are comfortable with. Again, keep the resistance down. Pedal as far as possible. At first, you may only be able to do half-circles, but overtime your flexion will improve and you should be able to do full circles.
As you improve, increase resistance and lower the seat until it’s in your normal position.
Leg Press Machine (No weight)
Use the leg press machine without weight or with very little weight. This helps you bend your knee far more than you could if you were squatting. Eventually, you can use the leg press for strength, but early on it’s more about just the motion of bending your leg, and you won’t want to put on weight that you cannot handle.
Focus on going down slowly as far as you can. Hold for a second before returning up. Do not lock your knees out straight. Do 10-15 reps for 3 sets.
Roll Forward on a Ball or Chair
Choose either a chair with wheels or a large exercise (yoga) ball. Sit on the ball or chair, and slowly roll forward so that your knees flex more. Repeat the motion of rolling back and forth, trying to push yourself into deeper flexion.
Assisted Heel Slides
for assisted heel slides, first, sit on the ground. Loop a band or ACE wrap around your heel, grabbing one end in each hand. Slide your heel back so you are bending your knee. As you do this, pull the ends of the band to help pull your heel back more and push you into deeper flexion. Repeat 10-15 times for 3 rounds.
Prone Knee Flexion Stretch
The prone knee flexion stretch was another one I did A LOT. Lay on your stomach on a flat surface. Use your other heel or a stretching strap to pull your heel to your butt as far as possible. Hold it there for a second, pulling as much as possible, before returning it down to a resting position.
As you progress, you can try to push your foot back against the resistance for a few seconds before relaxing the quad again and pulling your foot more. Repeat 15 times for 3 rounds.
4-Point Kneeling and Rocking
For 4-point kneeling and rocking, kneel on all fours. I recommend using a yoga mat and/or doing this on carpet. Push yourself back toward the position of sitting on your feet as far as you can and then rock back forward. Repeat the motion of rocking back and forth on all fours 15 times for 3 rounds. Make sure to kneel on a pad or something soft.
Tips for Improving Knee Flexion After Surgery
- Motion is lotion. This was a phrase I heard often for my PT. Flexion comes back most from motion, which is why all of the exercises involved motion, not stationary stretches. Keep your knee moving and focus on working on flexion through normal motions with exercises for knee flexion after ACL surgery.
- Push through the pain, but be smart. It hurts A LOT to work on flexion. You need to work through the pain to progress, but also listen to your body and do not overdo it.
- Work on both aspects of the range of motion, you can’t just neglect extension while you’re working on flexion.
- Work on ROM several times a day, especially at first. If you are struggling with it, you’ll need to do exercises 2-3 times a day.
Flexion After ACL Surgery FAQ
When did you get full range of motion after ACL surgery?
2 years after ACL and meniscus surgery, I do not have full flexion. The flexion is within a couple of degrees, and it is enough for every physical activity that I do. I do have full extension, and that took about 6 months total.
Does it hurt to work on flexion?
Yes. It’s very painful to work on flexion and extension. The pain was immense for me and it felt like a tightness as well as a sharp pain. Today, it still hurts when I try to push flexion. You need to battle through pain to progress with ROM, but if you are concerned about your pain you’ll need to consult a doctor.
How often do I need to work on flexion?
You’ll need to work on flexion and extension 2-3 times per day for the first few months after surgery, depending on your progress. After that, you may be able to go down to 1-2 times per day. You will need to work on it consistently to see results. For flexion, it’s best to work on it via motion, not long-duration stretches.
For more questions about my ACL and meniscus surgery, head to this FAQ.
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