Open kinetic chain exercises (eg. Knee extensions) in the ACL reconstruction patient tend to make all physios and orthopaedic surgeons nervous due to concerns over stretching the surgical graft. However consistent high quality evidence suggests that restricted range of movement knee extensions (as shown in this video) can be added into ACL reconstruction rehab as early as week 4, moving into full range of movement knee extensions by week 12 (van Melick et al, 2016, Perriman et al, 2018, Janssen

14 reactions · 3 comments | Open Kinetic Chain Knee Extension After ACL Reconstruction Should we perform open kinetic chain exercises after ACL reconstruction? Current research suggests we should. However, keep these things in mind. | Mike Reinold | Facebook

Do open chain exercises strain the ACL? Yes they do. Do closed chain exercises strain the ACL? Yes they do. Does performing a Lachman Test strain the ACL. Very much so. Open chain exercises such as knee extensions aren't "bad" for the knee and the recovering ACL reconstruction; particularly when done at the right time and through the right ROM. Current guidelines suggest limiting knee extension ROM between 45-90deg from weeks 4-12 post-op, then allowing full AROM knee extensions from 12 weeks on