What does prehab involve before ACL surgery?

Can doing a course of physical therapy before ACL surgery improve your recovery after surgery? If so, what does that prehab involve? In this week’s Ask Dr. Geier video, I answer that question from a reader who suffered an ACL and MCL injury.

Chrissy asks:

I tore my ACL and MCL five days ago in a soccer collision. My ACL is completely torn, and my MCL is almost completely torn from the tibial attachment. On day 5, I am back to almost normal gait and full extension. My flexion is not terrible but not great. I’m going to do prehab, but the earliest physical therapy appointment I could get was a week from now. I’m trying to at least safely work on range of motion and gait from home, but most of the information regarding prehab exclusively discusses the ACL. Does an accompanying MCL injury have any impact on prehab or the pre-surgery healing timeline?

Prehabilitation is the process of “preparing an individual to withstand a stressful event through enhancement of functional capacity.” In terms of outcomes after ACL reconstruction, we usually refer to work with a physical therapist before surgery to improve quadriceps strength and lower extremity function as prehab.

Also read:
“Prehab” before ACL reconstruction and other elective surgeries

Prehab can help patients decrease swelling, restore knee range of motion and neuromuscular control of the quads prior to surgery. Doing so can help the patients get back to normal after surgery faster.

Over the years, I’ve seen many patients struggle to set up physical therapy after surgery. Working with one before surgery can ensure that postoperative appointments are in place so they can start four or five days after the procedure. Plus the physical therapist can advise the patient about postoperative instructions and common mistakes other patients make.

In this video, I explain the key components of prehab and its role in MCL and ACL surgery.

Also read:
Can “prehab” improve outcomes after ACL surgery?

Physical therapist working on knee motion after injury