Prehab is often prescribed before ACL surgery as we aim to have nearly full range of motion and minimal swelling before surgery. However, most patients have a limited number of physical therapy visits and therefore was try to “save” visits for after surgery when most patients go to PT for 6-9 months.
This study showed that “Preoperative quadriceps muscle strength deficit had a significant negative relationship with postoperative function at 1 year following ACL reconstruction.”
I typically use electrical stim after surgery to try to get the quad working as quickly as possible. In some cases, we start the stim before surgery and this may be the direction we are heading in as data accumulates to show that the stronger you are before surgery the better off you are after.
This doesn’t mean that surgery should be delayed, however, as waiting on ACL surgery has been shown to increase the risk of meniscal injury, especially in adolescent patients.
Read this article in Nature to learn more about how muscle strength deficit severity predicts knee function after ACL reconstruction.