For a brief overview of knee anatomy, physiology, and biomechanics, please click here.

Please note that these resources address not only ligament reconstructions, but also other types of knee surgeries as well. Some exercises will be suitable for all types of knee surgeries. Note that these exercises and protocols should only be pursued and followed on the advice of a knee-experienced physiotherapist.

Note: Chapters from the superbly detailed and highly readable book Knee Ligament Rehabilitation, edited by Todd Ellenbecker and published by Churchill Livingstone in 2000, can be found under Textbook Chapters, Conference Proceedings, and Other Resources. This book, destined to become a classic, provides a very comprehensive yet wonderfully understandable discussion of all facets of knee-ligament rehabilitation.

Summary of ACL Reconstruction Rehabilitation Protocol (delayed version), Cincinnati Sports Medicine and Orthopedic Center. This protocol is primarily used in complex cases, or where post-operative complications are deemed more likely to occur. Meanwhile, the Accelerated Rehabilitation Version of this protocol can be used in cases deemed less likely to engender complications. Sincere thanks to Sue Barber-Westin, Director of Research at Cincinnati Sports Medicine and Orthopedic Center, for providing these documents. These documents are provided as Adobe PDF documents, and have been formatted for simplex or duplex printing. Adobe Acrobat Reader can be freely downloaded for all operating systems, including Microsoft Windows, Apple Macintosh, and all flavours of Unix/Linux, here.

Other rehabilitation protocols from Cincinnati Sports Medicine are also available:

Updated Meniscus Repair Protocol (July 2011), also used for combined ACL reconstruction and meniscus repair (including complex meniscus repairs)

Meniscus Repair Rehabilitation Protocol (Original document)

Meniscus Transplant Rehabilitation Protocol

Posterolateral (includes LCL) Reconstruction Rehabilitation Protocol

OAT - Osteochondral Autograft and Autologous Chondrocyte Implantation Rehabilitation Protocol

Lateral Release Rehabilitation Protocol

MCL (medial collateral ligament) Rehabilitation Protocol

High Tibial Osteotomy (HTO) Rehabilitation Protocol

PCL Rehabilitation Protocol

Proximal Distal Rehabilitation Protocol

Total Knee Replacement/Arthroplasty (TKR/TKA) Rehabilitation Protocol

Chapter 24: Plyometrics in Rehabilitation. Donald Chu, from Knee Ligament Rehabilitation, edited by Todd Ellenbecker, Churchill Livingstone, 2000. Comments: This superb and richly detailed article is full of helpful suggestions for plyometric (ballistic jumping) training. The concern of fatigue vis-à-vis knee injuries is noted, as is the concern of injury if plyometrics are not correctly performed. Plyometric training is helpful both in terms of knee-injury rehabilitation and improving athletic performance. It should always be done under the direction or supervision of a knee-experienced physiotherapist or trainer. For people recovering from knee-ligament injuries and surgeries, these exercises should only be pursued with the permission of a knee-experienced orthopedist.

VHI Closed Kinetic Chain Exercise Cards. Comments: This is the closed-kinetic-chain subset of the VHI physiotherapy cards, directly scanned in. These cards are typically used by physiotherapists: the cards are inserted into a holder (maximum 6 per page), and can then be photocopied and given to the patient, along with various instructions and annotations. Of course, the proffering of these cards would be accompanied by all the hands-on aspects of physiotherapy, including passive manual manipulation, supervised exercises, stretching/range of motion, and numerous other modalities and therapies...and therefore the cards would in any case merely illustrate the "homework" the patient must do between formal physiotherapy sessions. Physiotherapy is a complex science in itself, and is the domain of highly trained, licensed physiotherapists. These cards are provided here merely for illustrative and convenience purposes, not as a substitute for the services of a knee-experienced physiotherapist. (Depending on the nature of your particular knee injury or injuries, some of these exercises may be unsafe and therefore would be contraindicated. For this reason, especially the initial phases of post-surgery rehabilitation should not be considered a "do-it-yourself" pursuit. Again, there is no substitute for a seasoned physiotherapist.) The 74 cards in this set are specifically closed-kinetic-chain exercises; nearly all pertain to the knee or lower body in general, albeit there are some upper-body ones as well.

VHI Hip and Knee Exercise Cards. Comments: This is the hip-and-knee subset of the VHI physiotherapy cards, directly scanned in. These cards are typically used by physiotherapists: the cards are inserted into a holder (maximum 6 per page), and can then be photocopied and given to the patient, along with various instructions and annotations. Of course, the proffering of these cards would be accompanied by all the hands-on aspects of physiotherapy, including passive manual manipulation, supervised exercises, stretching/range of motion, and numerous other modalities and therapies...and therefore the cards would in any case merely illustrate the "homework" the patient must do between formal physiotherapy sessions. Physiotherapy is a complex science in itself, and is the domain of highly trained, licensed physiotherapists. These cards are provided here merely for illustrative and convenience purposes, not as a substitute for the services of a knee-experienced physiotherapist. (Depending on the nature of your particular knee injury or injuries, some of these exercises may be unsafe and therefore would be contraindicated. For this reason, especially the initial phases of post-surgery rehabilitation should not be considered a "do-it-yourself" pursuit. Again, there is no substitute for a seasoned physiotherapist.) There are 64 cards in this set.

VHI Ankle and Foot Exercise Cards. Comments: This is the ankle-and-foot subset of the VHI physiotherapy cards, directly scanned in. These cards are typically used by physiotherapists: the cards are inserted into a holder (maximum 6 per page), and can then be photocopied and given to the patient, along with various instructions and annotations. Of course, the proffering of these cards would be accompanied by all the hands-on aspects of physiotherapy, including passive manual manipulation, supervised exercises, stretching/range of motion, and numerous other modalities and therapies...and therefore the cards would in any case merely illustrate the "homework" the patient must do between formal physiotherapy sessions. Physiotherapy is a complex science in itself, and is the domain of highly trained, licensed physiotherapists. These cards are provided here merely for illustrative and convenience purposes, not as a substitute for the services of a knee-experienced physiotherapist. (Depending on the nature of your particular knee injury or injuries, some of these exercises may be unsafe and therefore would be contraindicated. For this reason, especially the initial phases of post-surgery rehabilitation should not be considered a "do-it-yourself" pursuit. Again, there is no substitute for a seasoned physiotherapist.) There are 38 cards in this set.

VHI Back (Spine) Exercise Cards. Comments: This is the back (spine) subset of the VHI physiotherapy cards, directly scanned in. These cards are typically used by physiotherapists: the cards are inserted into a holder (maximum 6 per page), and can then be photocopied and given to the patient, along with various instructions and annotations. Of course, the proffering of these cards would be accompanied by all the hands-on aspects of physiotherapy, including passive manual manipulation, supervised exercises, stretching/range of motion, and numerous other modalities and therapies...and therefore the cards would in any case merely illustrate the "homework" the patient must do between formal physiotherapy sessions. Physiotherapy is a complex science in itself, and is the domain of highly trained, licensed physiotherapists. These cards are provided here merely for illustrative and convenience purposes, not as a substitute for the services of a knee-experienced physiotherapist. (Depending on the nature of your particular knee injury or injuries, some of these exercises may be unsafe and therefore would be contraindicated. For this reason, especially the initial phases of post-surgery rehabilitation should not be considered a "do-it-yourself" pursuit. Again, there is no substitute for a seasoned physiotherapist.) There are 54 cards in this set, but cards 1 and 25 were missing from the set at the time of scanning.

VHI Shoulder Exercise Cards. Comments: This is the shoulder subset of the VHI physiotherapy cards, directly scanned in. They were added by request, since a good number of people with knee injuries also have shoulder problems. (A Shoulder Library, similar to the Knee Library, is in the process of being developed.)

Sahrmann Muscle Imbalance Exercises. Comments: These classic exercises were devised and compiled by Shirley Sahrmann, a renowned physiotherapist who extensively studied (and still studies) movement disorders and muscle imbalances (Movement System Balance). She has written a number of highly regarded books in the field, and continues to be active today. Although newer versions of her exercise compilations are available, this classic set remains valuable in its own right.

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