PreHab for ACL Tear

Dr. Catherine Logan

Catherine Logan

Physical Therapy and Rehabilitation


All rehab programming should be performed under the supervision of your physician and a licensed physical therapist.

The importance of “prehab” prior to ACL reconstruction is simply to optimize your ultimate post-operative outcome. The better your motion and strength before surgery, the smoother the recovery process will go!

After sustaining an ACL tear, you will likely experience swelling, decreased motion and quad inhibition (decreased activation of the quadriceps muscle).

The single most important item to conquer is achieving full knee extension/straightening before going to the OR. Formal prehab with a sports medicine physical therapist will also work on controlling joint swelling, regaining knee flexion and normalizing gait.

The use of a brace and crutches when out and about in the community will reduce fall risk; as a fall could result in further injury to the meniscus and cartilage. An emphasis on each of these things will better set you up for success following ACL reconstruction, and help you achieve your long-term fitness and sport goals.

Range of Motion

  1. Stationary Bike: Daily, no resistance is necessary
  2. Heel Slides: heel slides with strap
    • Use your hamstring and/or a strap to pull your heel towards your buttocks while lying on your back. 10 reps of 5 second holds, 3-5 times per day.
  3. Prone Hangs:
    • Lie on your stomach and let your foot hang off the edge of a bed or table.
    • Hold this position for 5 minutes.
    • You can use the opposite foot to add gentle downward pressure, as needed.


  1. Quad Sets:
    • Lying on your back with your knee straight, attempt to contract your quad muscles (muscles on front of your thigh) for 5 seconds as strongly as possible. 
    • When contracting your quad muscles, your knee should press down towards the ground.
    • Repeat 10 times, 3-5 times per day.
  2. 4-Way Straight Leg Raise:
    • 10 reps in all four directions = 1 set; do 3-5 sets per day
  3. Duck Walks:
    • Side to side steps with band: 2-4 minutes per day