What is Knee Extension?

Knee extension is your knee’s ability to straighten. Straightening the knee is important for walking properly without a limp. It also promotes strengthening in your quadriceps. After an ACL Reconstruction gaining full knee extension is incredibly important. If you struggle with regaining this range of motion you will have difficulty with strengthening, walking and swelling.  

Effect of Lacking Knee Extension

If a client struggles with getting knee extension range of motion back it can alter how they walk. You may walk with a bent knee and limp which can hinder progress. Walking with a bent knee can also continue the inflammatory cycle which will lead to continued swelling. This increase in swelling may heighten the sensation of pain/discomfort in the knee which can make you reluctant to move it for exercises. Finally, all of these factors will make strengthening the knee more difficult and therefore make it more challenging to progress.

How Do We Get Knee Extension Back?

The best way to get knee extension back is through the principle of low load long duration holds. This basically means keeping the knee straight for an extended period of time with a low amount of weight. There have been studies done that have demonstrated this to be an effective way of slowly regaining knee range of motion. It sounds easy, right? What research has found is that you need to be in this position for roughly 45 minutes a day to improve your range. This can be difficult to achieve and this position can be very uncomfortable for clients. We utilize different exercises related to improving one’s ability to understand where the knee is in space as an adjunct to low load stretching.

The MANA Difference

If your PT is not educating you on the importance of regaining knee extension  after an ACL reconstruction then you need to speak with an expert. If your PT does educate you on the importance of knee extension but you are in pain when performing your exercises, then you need to speak with an expert. What we do differently at MANA is we have the time to create an individualized plan of care for a client to fit their needs. We utilize a combination of manual therapy techniques and dosing strategies related to home exercise  to create a successful outcome.  Check out a few ways we aim to get back knee extension below.


The time after ACL reconstruction can be an overwhelming, uncomfortable experience. It is important to have a PT who understands you as a person and can educate you on the most important things. Knee extension after surgery is an essential component to a successful outcome. Being able to straighten the knee will reduce swelling, improve how you walk and allow for strengthening in the knee to occur. The main way of achieving this range of motion is with low load long duration stretching. This should be dosed appropriately based on an individual’s needs. Regaining knee extension should be at the top of the list for priorities after an ACL reconstruction.