Q: I underwent ACL surgery. I had lot of stiffness in the knee and I lost hyperextension of knee. What should I do?
Postoperatively, you should begin with range of motion exercises to avoid stiffness. These are the following exercises you can do at home:
Range of motion
1. Knee straightening stretch (sitting knee extension)
Sit on a sturdy chair with your lower leg on an equal height chair or solid surface in front of you. Relax your muscles to let your knee straighten. You should feel a gentle stretch on the back of your knee. You can do thigh squeezes to increase the stretch. Do this stretch for 5 to 10 minutes. You can also do this stretch lying on your bed with a rolled up blanket or towel under your ankle.
2. Knee bending stretch (sitting knee flexion)
Step 1: Sit toward the front of a sturdy chair. Bend your knee by slowly sliding your foot back-and-forth, resting briefly as needed. Try to move your foot back farther each time as you are able. You can use your hands to help. Do this for a few minutes as a warm up. You may want to use a plastic bag under your foot to help it slide easier.
Step 2: Slowly bend your knee back until you feel a gentle stretch. Scoot your body forward on the chair to increase the stretch as you are able. Your heel may lift from the floor but do not lift your hip. Hold for 20 to 30 seconds. Return to the starting position and relax. Repeat 3 times.
The stretching should be slower and more gentle than fast and forceful. Try to keep your muscle relaxed throughout the exercises
Apart from range of motion exercises, strengthening exercises are vital to faster recovery and resumption to daily activities. Here are some exercises you may do:
1. Ankle pumps and circles
Pump your feet up and down by pulling your feet up toward you, then pushing your feet down away from you. Next, rotate your feet clockwise and counterclockwise.
2. Thigh squeezes (quadriceps sets)
Tighten the muscles on the top of your thigh by pushing the back of your knee down into the bed. Hold for 5 seconds and relax.
3. Heel slides
Bend your surgical knee by sliding your heel up toward your buttocks while keeping your heel on the bed. Slide your heel back down to the starting position and relax. Keep your kneecap pointed up toward the ceiling during the exercise. You may want to use a plastic bag under your heel to help it slide easier.
4. Leg slides (abduction/adduction)
Slide your surgical leg out to the side, keeping your kneecap pointed up toward the ceiling. Slide your leg back to the starting position. You may want to use a plastic bag under your heel to help it slide easier.
5. Lying kicks (short arc quadriceps)
Lie on your back with a rolled-up blanket or towel (at least 6 inches in diameter) under the knee of your surgical leg. Straighten your surgical leg. Work up to holding for 5 seconds. Slowly lower your leg down and relax. The back of your knee should stay in contact with the blanket or towel during the exercise.
6. Straight leg raises (SLR)
Bend your non-surgical leg with your foot flat on the bed. Tighten the muscles on the top of your thigh, stiffening your knee. Raise your surgical leg up (about 12 inches), keeping your knee straight. Work up to holding for 5 seconds. Slowly lower your leg down and relax.
7. Sitting kicks (long arc quadriceps)
Sit on a sturdy chair or on the side of your bed. Straighten your knee. Work up to holding for 5 seconds. Slowly lower your leg down and relax.