Pre-Surgery Preparation Exercises

Pre-ACL surgery preparation exercises, (often called prehab), are crucial for athletes and individuals who want to strengthen their knees and reduce the risk of anterior cruciate ligament (ACL) injuries. These exercises focus on improving muscle strength, flexibility, balance, and coordination, which are essential for stabilizing the knee joint during physical activities.

You’ll want to talk to your orthopedist about a pre-surgery rehab protocol. What you’ll want to do will likely vary depending on injury type, severity, any additional injuries and so on. When an injury involves “just” the ACL, that may be one protocol, but often there’s also damage to surrounding areas, (like the meniscus), and in extreme cases, there may be multiple fractures or complex issues that will require careful thought and planning regarding what you may be able to do.

One of the primary goals of pre-ACL preparation is to strengthen the muscles around the knee, especially the quadriceps, hamstrings, and calves. Strong muscles help absorb the forces exerted on the knee, reducing strain on the ACL. Exercises such as squats, lunges, and leg presses are commonly recommended to build lower body strength. It is important to perform these exercises with proper form to avoid injury and maximize benefits.

In addition to strength training, balance and proprioception exercises play a key role in pre-ACL preparation. These exercises improve the body’s ability to sense joint position and movement, which helps prevent awkward landings or sudden twists that could damage the ACL. Activities like single-leg stands, balance board exercises, and agility drills enhance neuromuscular control and coordination.

Flexibility exercises also contribute to ACL injury prevention by ensuring that the muscles and tendons around the knee maintain an optimal range of motion. Stretching the hamstrings, quadriceps, and calf muscles regularly can help reduce muscle tightness and improve overall mobility.

Incorporating a comprehensive pre-ACL exercise program into regular training routines can significantly decrease the likelihood of ACL injuries. Athletes should consult with a physical therapist or trainer to design a personalized plan that addresses their specific needs and sport demands. Consistency and proper technique are key factors in achieving effective pre-ACL preparation.

Some patients may feel, “Why bother with prehab? I’m just going to have to do it all over again after surgery.” While that reaction is completely understandable, it’s based on a false assumption that prehab doesn’t matter. In reality, the stronger and healthier you are going into surgery, the better your recovery is likely to be. Prehab won’t eliminate the long rehab journey ahead, but it can significantly ease the first few days and weeks, reducing pain and helping you regain mobility more quickly.