Learn three essential exercises commonly used during the first week after ACL reconstruction to restore movement, activate muscles, and build a strong foundation for recovery.
3 Essential Exercises During the First Week After ACL Reconstruction
The first week after ACL reconstruction surgery plays an important role in your recovery. During this early stage, the focus isn't on returning to sport or performing advanced exercises—it's about reducing swelling, restoring movement, and reactivating muscles that often become inhibited after surgery.
One of the biggest challenges after ACL reconstruction is regaining full knee extension, activating the quadriceps, and preventing muscle loss. Building a strong foundation during the first week can help support long-term recovery and prepare you for the next stages of rehabilitation.
Every ACL reconstruction is different, so always follow the rehabilitation protocol provided by your surgeon or physiotherapist. These exercises should only be performed if they are appropriate for your specific procedure.
1. Heel Slides
Heel slides are one of the first exercises commonly introduced after ACL reconstruction. Their primary purpose is to gradually restore knee flexion, or bending, while encouraging gentle movement through the joint.
To perform this exercise, lie on your back with both legs straight. Slowly slide your heel toward your buttocks as far as feels comfortable. If needed, gently press your heel into the floor while sliding to help activate the hamstrings. Then slowly straighten the leg back to the starting position.
This exercise helps improve knee range of motion, reduce stiffness, promote circulation, and encourage safe movement during the early stages of recovery.
2. Side-Lying Hip Abduction
Although ACL surgery is performed on the knee, the hip muscles play a significant role in lower-limb stability. In particular, the gluteus medius helps control leg alignment during walking, climbing stairs, and many everyday activities.
To perform this exercise, lie on your side with the operated leg on top. Keeping the knee straight, lift the leg slightly behind your body in slight hip extension before slowly lowering it with control.
Strengthening the hip muscles early in rehabilitation helps improve hip stability, supports proper knee alignment during walking, and may reduce compensatory movement patterns as you recover.
3. Heel Raises
Following surgery, the calf muscles can weaken quickly due to reduced activity and changes in weight bearing. Heel raises help begin restoring strength throughout the lower leg while supporting normal walking mechanics.
Stand while holding onto a stable surface for support. Slowly rise onto your toes before lowering yourself back down with control. This exercise should only be performed if your surgeon or physiotherapist has cleared you for weight bearing.
Heel raises help strengthen the calf muscles, activate the posterior chain, improve ankle mobility, and assist with restoring a more natural walking pattern.
How Often Should You Perform These Exercises?
In many cases, these exercises can be performed two to three times per day, depending on your rehabilitation program.
Remember that quality is far more important than quantity. Slow, controlled movements are more effective than rushing through repetitions, especially during the early stages of healing.
Recovery Is a Marathon, Not a Sprint
The first week after ACL reconstruction lays the groundwork for everything that follows.
Early rehabilitation focuses on reducing swelling, restoring knee extension, gradually improving knee flexion, activating the quadriceps, maintaining hip and calf strength, and helping you return to safe walking mechanics.
While progress may seem slow at first, each milestone contributes to long-term recovery. Following a structured rehabilitation program and progressing at the appropriate pace can help you regain strength, confidence, and function over time.
Final Thoughts
Recovering from ACL reconstruction takes patience, consistency, and the right guidance.
Early rehabilitation isn't about doing the hardest exercises—it's about mastering the fundamentals. By restoring movement, activating key muscle groups, and building a strong foundation during the first week, you're setting yourself up for the next phases of recovery.
Every recovery journey is different, which is why rehabilitation should always be individualized to your surgery, goals, and stage of healing.
Need Help With Your ACL Recovery?
If you're recovering from ACL reconstruction, our physiotherapists can help guide you through every stage of rehabilitation with a personalized treatment plan designed to help you return safely to work, sport, and the activities you enjoy.
Pain Free Health Clinic proudly serves patients in:
📍 Richmond
📍 Ladner
📍 Surrey
📍 Langley
Watch the Exercises in Action
Want to see how these early rehabilitation exercises are performed?
Watch the video above for a demonstration of three essential exercises commonly used during the first week after ACL reconstruction, along with tips on proper technique and why each movement is important during the early stages of recovery.
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