Why Prehab Before ACL Surgery Can Help Your Recovery

A little work before ACL reconstruction may help make recovery smoother, easier, and safer.

What we focus on in prehab

• Reduce swelling & stiffness – gentle hands-on therapy and movement can assist in calming the knee so surgery (and post-op rehab) may go smoother.

• Restore full knee range of motion (ROM) – regaining extension and flexion before surgery can reduce the chance of ongoing stiffness afterwards.

• Clean up your movement (gait mechanics) – prehab can support better walking mechanics, so you’re not reinforcing habits that may slow recovery.

• Keep your quads firing – early quad weakness is common after ACL injury; strengthening before surgery may help protect your knee function afterwards.

• Balance & neuromuscular control – balance training can improve movement control and reduce compensations during rehab.

What prehab usually looks like

• Assessment: swelling, ROM, gait, strength, balance.

• Hands-on care: to help manage swelling/stiffness and prepare the joint to move.

• Targeted exercise: ROM drills, quad activation/strength, simple balance work.

• Movement coaching: walking mechanics, stairs, sit-to-stand, daily tasks.

• Home plan: manageable strategies you can continue between sessions.

What the research suggests

Even a few weeks of focused prehab may help improve recovery after surgery. Research indicates that stronger quadriceps before ACL reconstruction are associated with better return to activity afterwards (Carter et al., 2023).

Take-home message

Going into surgery with less swelling, fuller ROM, active quads, and better control can give you a head start. Prehab isn’t a guarantee, but it can build a strong foundation that supports safer, more confident rehabilitation.

Reference:

Carter, H. M., Lewis, G. N., & Smith, B. E. (2023). Preoperative predictors for return to physical activity following anterior cruciate ligament reconstruction (ACLR): A systematic review. BMC Musculoskeletal Disorders, 24, 471. https://doi.org/10.1186/s12891-023-06489-5