ACL (Anterior cruciate ligament) Reconstruction is a common orthopaedic procedure with primary goal of bringing you back into the game. The surgery has exceptional results inexpert hands with a minimal complication rate. Post-surgical rehabilitation remains as important as a good surgery. The pain and swelling occurring postoperatively inhibits the patient to exercise and start rehabilitation from day.

This is the most important reason of having supervised physiotherapy.Full extension from 1post-operative day is our first goal. To add on gradual knee bending up to 90 degrees and isometric quadriceps exercises are started. These continue for about 4 weeks till the ROM reaches from full extension to 120 degrees of flexion. 5th week onwards, gradual muscle training and strength gaining exercises are started.All the previous exercises are added up each time you come up for a session to learn next set of exercises. 

The primary goal post 2 months of surgery is strength training with control of balance and muscle co-ordination. These are done using wall squats, standing on operated leg, SLR with ankle weights, side SLR with ankle weights, stationary cycling, side walking, backward walking, calf strengthening. 

Development of joint sense or proprioception comes after adequate coordination and control is regained. This is made possible by wobble board exercises, mini tramp board, ball tossing, multi directional balance board, cross trainer after 4 months of surgery.By the 5th month patient is asked to start skipping, alternate leg jumps, on spot jumps, box jumps to depth and sides, hurdle crossing, controlled running, cone running and core exercises.
By usual protocol, most patients are able to do all activities of daily living by 6 weeks and start playing sports by 6 months after consulting their Orthopaedic. Follow up after every four weeks is essential and helps the doctor keep a track of improvement and address any fresh complaints. All patients do not have same progress post-operatively. 

Some may also require assisted or supervised rehabilitation. The post-operative prognosis is also governed by cartilage and meniscal pathologies associated with the Ligament tears. In patients with additional procedures to ACL Reconstruction, the protocol of rehabilitation differs with longer time to recovery and return to sports.

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