ACL Surgery PREhab

May 23, 2025

ACL Surgery PREhab: Why Preparing Before Surgery Matters

When it comes to ACL (anterior cruciate ligament) reconstruction, recovery doesn’t begin in the operating room. It starts well before. “Prehab,” or pre-surgical rehabilitation, plays a critical role in setting the stage for a successful surgery and smoother recovery.

Why Prehab Matters

In the days or weeks following an ACL tear, the knee is typically swollen, painful, and unstable. Jumping straight into surgery without addressing these issues can compromise both short- and long-term outcomes. Prehab is designed to improve your knee’s condition beforehand, reducing inflammation, restoring motion, and strengthening key muscles. Surgeons will typically not even considering operating until a patient’s knee is somewhat stable, or considered, “calmed down.”

Goals of ACL Prehab

Restore Full Range of Motion
Regaining full extension (straightening the knee) is especially important. Lack of extension before surgery increases the risk of post-op stiffness and complications like arthrofibrosis. (Of course, this just might not be possible.)
Reduce Swelling
Managing inflammation helps improve joint mobility and tissue quality, allowing for better surgical access and healing.
Strengthen the Quadriceps
Strong quads stabilize the knee and are essential for walking, stair climbing, and post-op recovery. Quad activation can be impaired after an ACL tear, so early focus is key.
Improve Gait and Function
Walking without a limp and with good biomechanics helps “reset” the body before surgery, avoiding compensatory patterns that are hard to break later.
Mental Preparation
Prehab offers patients a chance to learn exercises, understand the rehab process, and build confidence—reducing anxiety and improving post-op adherence.

A Typical Prehab Program Includes:

Heel slides, quad sets, and straight leg raises
Stationary cycling for mobility and circulation
Balance and neuromuscular control drills
Education on bracing, crutch use, and surgical expectations

The Takeaway

Patients who undergo prehab tend to recover faster, regain motion more easily, and return to sport with fewer setbacks. In short, the stronger and more mobile your knee is going into surgery, the better your chances of a smooth and successful recovery afterward. Don’t wait until after the operation to start healing—start now.