Can You Safely Perform Squats After ACL Surgery? Expert Insights

Can deep squats be performed after posterior cruciate ligament surgery?

Hello Doctor: I am currently 34 years old.
When I was 20, I participated in an amateur taekwondo competition, which resulted in a rupture of my left knee's posterior cruciate ligament.
About a year later, I underwent surgery to replace it with an artificial ligament.
Since then, I have been living normally (as an office worker, not an athlete) without any significant adverse reactions, except for mild pain in my left knee when hiking.
After the surgery, my attending physician advised that I could live normally and recommended low-impact exercises such as swimming and cycling, while suggesting that I avoid high-impact activities like hiking, climbing stairs, and taekwondo.
Approximately two years ago, I had a follow-up appointment, and the doctor indicated that my condition was normal and advised me to return in five years.
I would like to ask: given the aforementioned circumstances, can I perform squats as part of my fitness routine? I have found various opinions online, so I would appreciate your guidance.
Thank you for taking the time to respond.

Miles Huang, 30~39 year old female. Ask Date: 2018/03/19

Dr. Shi Guozheng reply Orthopedics

If you are currently experiencing discomfort, it is advisable to return to your primary physician for an evaluation.
You should be able to perform squatting movements, but engaging in overly strenuous activities still carries a risk of re-injury.

Reply Date: 2018/03/19

More Info

After undergoing ACL reconstruction surgery, many patients are eager to return to their regular activities, including exercises like squats. The question of whether it is safe to perform squats after ACL surgery is multifaceted and depends on several factors, including the individual’s recovery progress, the type of surgery performed, and the guidance of healthcare professionals.

Understanding ACL Surgery and Recovery
ACL (anterior cruciate ligament) reconstruction is a common procedure aimed at restoring stability to the knee joint after a tear. Post-surgery, the recovery process typically involves a structured rehabilitation program that focuses on regaining range of motion, strength, and functional stability. The timeline for returning to activities varies, but most patients can expect to gradually resume normal activities within 6 to 12 months, depending on their specific circumstances.

When Can You Start Squatting?
1. Initial Recovery Phase: In the first few weeks post-surgery, the focus is primarily on reducing swelling, regaining range of motion, and beginning gentle strengthening exercises. During this phase, high-impact activities, including squats, are generally discouraged.

2. Rehabilitation Phase: As you progress through rehabilitation, typically around 6 to 12 weeks post-surgery, you may begin to incorporate more functional exercises. However, it is crucial to ensure that your knee is stable and that you have regained sufficient strength in the surrounding muscles, particularly the quadriceps and hamstrings.

3. Return to Squats: Once you have achieved adequate strength and range of motion, and your physical therapist or surgeon has cleared you, you can start incorporating squats into your routine. It is advisable to begin with bodyweight squats and gradually increase the intensity as tolerated. Pay attention to your body’s signals; if you experience pain or discomfort, it may be a sign to modify your approach.

Expert Recommendations
- Consult Your Surgeon or Physical Therapist: Before starting any new exercise, including squats, it is essential to consult with your healthcare provider. They can assess your knee's stability, strength, and overall readiness for more demanding activities.

- Focus on Form: Proper squat technique is crucial to avoid undue stress on the knee. Ensure that your knees do not extend beyond your toes, maintain a neutral spine, and engage your core throughout the movement.

- Progress Gradually: Start with bodyweight squats and progress to weighted squats only when you feel confident in your strength and stability. Consider using resistance bands or light weights initially.

- Listen to Your Body: If you experience pain, swelling, or instability during or after squatting, it is essential to stop and consult your healthcare provider. Pain is a signal that something may not be right.

Conclusion
In summary, while it is generally possible to safely perform squats after ACL surgery, the timing and approach should be individualized based on your recovery progress and the advice of your healthcare team. Gradual progression, proper form, and listening to your body are key components of a successful return to exercise. Always prioritize your knee's health and stability to ensure a safe and effective rehabilitation journey.

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