Patient question
What exercises should I do to get my knee ready for ACL surgery?
Dr. Pablo GelberOrthopaedic Knee Surgeon
Quick answer
Before ACL reconstruction, the aims are a calm knee with little swelling, full straightening, good bending, an active quadriceps and walking without a limp. Reaching these usually makes recovery after surgery smoother, explains Dr. Pablo Gelber, knee surgeon at Aman Hospital in Doha, so prehab is time well spent.
Goals before the operation
- A knee that is no longer hot or puffy after daily activity
- Full extension, matching the other knee when you lie with both legs straight
- Bending to at least around 120 degrees, enough to sit back comfortably
- Being able to do a straight leg raise without the knee bending
- Walking normally without crutches or a limp
- Feeling mentally ready and understanding the rehabilitation ahead
Exercises, step by step
- 1. Heel prop for extension: sit with the heel on a rolled towel or stool and nothing under the knee for five to ten minutes, several times a day
- 2. Quad sets: tighten the thigh and press the knee down, hold five seconds, ten times
- 3. Heel slides: slide the heel towards your bottom and back, ten to fifteen times
- 4. Straight leg raises: ten to fifteen, three sets
- 5. Bridges and side-lying leg lifts for the hip and buttock, ten each
- 6. Stationary bike with light resistance for 10 to 20 minutes once the knee bends enough
- 7. Single-leg balance on the injured leg, holding support, up to 30 seconds
- 8. Mini squats and step-ups, only if they do not cause the knee to shift or swell
What to avoid while you wait
Without a functioning ACL, the knee may give way with twisting, cutting, jumping or sudden stops. Avoid football, padel, basketball and similar sports until after reconstruction and rehabilitation. Each giving-way episode risks further damage to the meniscus or cartilage. Straight-line cycling, swimming with a gentle flutter kick and controlled gym strengthening are usually fine.
When surgery should not wait for prehab
Prehab is helpful but not always the priority. If the knee is locked and cannot straighten, often from a displaced bucket-handle meniscus tear, or there are other significant ligament injuries, your surgeon may advise earlier surgery. If the knee keeps giving way despite prehab, let your surgeon know. At Aman Hospital in Doha, the timing is decided after examination and MRI review.
Frequently asked questions
How long does ACL prehab take?
Often two to six weeks after the injury, depending on how quickly the swelling settles and movement returns. Some patients are ready sooner.
Should I see a physiotherapist before ACL surgery?
Yes, if possible. A physiotherapist can guide your prehab and teach you the first exercises and crutch use you will need after the operation.
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