Why Getting Your Knee Straight Early After ACL Surgery Matters (and How Massage Helps)

Regaining full knee extension in the first 4 weeks after ACL surgery is critical for long-term recovery. Learn why and how massage and exercises can help.

👋 Introduction

Recovering from an ACL reconstruction isn’t just about walking again—it’s about regaining full function.

And that starts with getting your knee straight (full extension) in the first 0 to 4 weeks post-surgery.

At Body Fit Physiotherapy, we’ve worked with hundreds of ACL patients and consistently seen this golden rule:

If you don’t get your knee straight early, everything else becomes harder later.

In this blog, we explain:

• Why full knee extension is essential post-ACL

• How massage and targeted exercises can speed this up

• What can go wrong if you delay

• Plus, videos from our team showing techniques you can do at home

❗ Why Knee Extension Matters After ACL Surgery

One of the first goals after ACL reconstruction is to restore full passive and active knee extension (the ability to fully straighten your leg).

✅ Why it's important:

• Prevents arthrofibrosis (joint scarring and stiffness)

• Improves gait pattern (so you don’t limp or overcompensate)

• Allows for normal quad activation (which is inhibited when the knee is bent)

• Sets the foundation for squats, running, and jumping later

🧠 A 2008 study in The American Journal of Sports Medicine showed that patients who didn’t regain full extension in the first 4 weeks had worse long-term outcomes and higher risk of revision surgery.

🎥 Video: Post-ACL Massage Techniques

Watch our video:▶️ Post-ACL Massage Techniques for Swelling & Extension

💡 How massage helps:

• Loosens tight tissues restricting extension

• Reduces fluid build-up that limits movement

• Makes it easier to activate the quadriceps

• Helps relieve post-op discomfort so you can move more confidently

🦵 Essential Early ACL Rehab Exercises

It’s not just about massage—exercise is crucial.

▶️ Watch: ACL Recovery Week 0-4 | Best Exercises

🔁 How Often Should You Do These?

• Massage: 1–2x daily for 10–15 minutes

• Extension-focused exercises: 5–6x per day (short and frequent is key)

• Monitoring: Constantly reassess to make sure you are making progress. If you are strugling we recommend seeing your physio

📏 Target: Your surgical leg should be able to lie flat on the ground by week 4

⚠️ What If You Don’t Get It Straight?

Delays in extension can lead to:

• Long-term stiffness

• Difficulty activating the quads (especially VMO)

• Poor walking mechanics

• Delays in return to running or sport

• Secondary compensations in hip, back, or opposite leg

Don’t wait—early action prevents long-term setbacks.

🧑‍⚕️ Our Approach at Body Fit Physiotherapy

At Body Fit, we offer:

• 1:1 post-op physiotherapy tailored to ACL protocols

• Hands-on massage and joint mobilisation

• Structured home exercise programs

• Ongoing progress tracking to ensure milestones are hit

We also use video education (like the ones above) to empower you with knowledge and confidence in your recovery journey.

📍 Final Takeaways

• Getting your knee straight in the first 0–4 weeks is non-negotiable

• Combine daily massage + targeted exercises for best results

• Watch our videos for guided techniques you can follow at home

• If you’re not seeing progress, seek help early—we can help unlock your extension safely and quickly

📞 Book your ACL post-op rehab session at Body Fit Physiotherapy North Adelaide

🌐 Visit www.bodyfit.life