An anterior cruciate ligament (ACL) injury can be a life-altering event, especially for athletes and other highly active individuals. The knee is one of the most complex joints in the body, and when an ACL is torn, it disrupts not only structural integrity but also daily movement, balance, and confidence.
While much of the focus is often placed on post-operative recovery, what you do before surgery plays an equally important role in your overall recovery outcomes. One of the most valuable tools during this phase is an ACL brace. More than just a support mechanism, this type of knee brace helps stabilize, protect, and prepare the knee joint for what’s ahead.
In this guide, we’ll cover why pre-surgery bracing matters, key goals for prehabilitation, and how a custom knee brace fits into a smart recovery plan.
Pre-Surgery ACL Rehabilitation
Pre-surgical rehabilitation, commonly referred to as “prehab,” is designed to optimize the knee joint prior to reconstruction. Whether you’re weeks away from your operation or have just received your diagnosis of an ACL tear, this period is critical for reducing pain, restoring function, and setting the stage for a smooth post-op recovery.
Pre-ACL Surgery Goals
A torn ACL isn’t just about ligament damage. There are often accompanying issues such as swelling, loss of motion, muscular inhibition, and instability. Each of these needs to be addressed before the surgeon intervenes.
Reducing Swelling and Pain
Following the initial injury, your knee will likely experience significant swelling due to inflammation and fluid buildup within the joint capsule. Reducing this swelling is crucial—not only to alleviate pain and discomfort, but also because a swollen knee can make it more difficult for the surgeon to perform a clean and accurate repair.
Restoring Full Range of Motion
You need to enter surgery with as close to a full range of motion as possible, particularly in extension. One of the most common post-surgical complications is loss of full straightening, which can impair gait, increase stress on surrounding tissues, and limit overall function.
Regaining Quadriceps Activation
After an ACL injury, your quadriceps—the large muscle group in the thigh—often shut down. This reflexive shutdown, known as arthrogenic muscle inhibition, results in weakness, impaired mobility, and muscle atrophy.
Your physiotherapist will likely prescribe neuromuscular exercises such as quad sets, straight-leg raises, and short arc quads. These low-load movements strengthen the quadriceps without placing excessive force on the knee joint.
Improving Proprioception and Balance
Proprioception is your body’s ability to sense joint position and movement. After an ACL tear, proprioception suffers, making you more prone to falls, re-injury, and inefficient movement.
Reintroducing balance exercises, such as single-leg stands with a brace, can help retrain neuromuscular pathways, and bracing can enhance proprioceptive feedback by providing tactile input.
Using an ACL Brace Before Surgery
Now let’s address what should be the centerpiece of your pre-op strategy: the knee brace.
When dealing with a torn ACL, the knee joint becomes unstable, especially during rotation or sudden deceleration. Movements that were once effortless—walking downhill, stepping off a curb, pivoting—probably now cause a feeling of uncertainty or even sharp pain. This is where a brace becomes invaluable.
A knee brace can help you:
- Stabilize the joint during walking and low-intensity daily activities
- Minimize abnormal translation of the tibia relative to the femur
- Reduce fear of movement and encourage safe mobility
- Lower the risk of re-injury or aggravating the meniscus
- Provide light compression to manage swelling
Some patients worry that bracing may create dependence or reduce muscle activity, but the right type of brace, especially when paired with targeted exercises, is a valuable tool for healing, not a crutch.
Custom Knee Braces
Off-the-shelf knee braces can offer some support, but they do not protect the ACL-deficient knee. A custom knee brace, on the other hand, is molded specifically for your leg’s dimensions, ensuring a snug fit that won’t slip or create pressure points and protects against any further injury.
A high-quality custom brace allows controlled flexion and extension, ensures consistent positioning, and delivers maximal function with minimal bulk. This is especially important for patients with additional damage to the meniscus, cartilage, or collateral ligaments.
Key features to look for in a custom knee brace include:
- Hinges for controlled movement
- Adjustable straps for individualized load distribution
- Lightweight frames to reduce fatigue during wear
- Comfortable padding for prolonged use
Most importantly, our rehab and brace specialist, Dr Kottoor, can prescribe the exact settings and limits based on your unique injury, body type, and activity goals.
Complementary Prehabilitation
Beyond wearing a knee brace, a well-rounded prehabilitation plan includes supportive tools and practices that protect the knee joint, manage swelling, and improve mobility and muscle function before surgery. These elements help patients perform better during post-operative rehab and reduce long-term complications.
Mobility and Strength Exercises
Preserving mobility and function through low-load exercises is another key component of prehabilitation. These movements strengthen the quadriceps, hamstrings, calves, and glutes while avoiding undue force on the knee joint.
Effective pre-surgery exercises include:
- Quad sets: Activate the front of the thigh without joint motion.
- Straight-leg raises: Improve hip and thigh strength while maintaining a safe position.
- Heel slides: Promote gentle flexion and extension of the knee.
- Bridges: Target glutes and hamstrings with minimal stress to the knee.
During these movements, a brace can offer additional support, especially if the joint feels unstable or painful. Always follow your physiotherapist’s instructions to ensure proper form and progression.
How We Can Help
At Leaside Sports Medicine in Toronto, our practitioners are highly experienced in helping athletes return to sport as safely and quickly as possible through the use of supportive braces and other complementary therapies.
Our knee health, custom knee bracing, and prescription exercise programs are designed to provide:
- Comprehensive ACL recovery assessments to determine your ideal bracing requirements
- Custom-fitted knee braces designed for your specific anatomy and activity goals
- Personalized rehabilitation programs that integrate optimal bracing strategies
- Regular progress evaluations to adjust your brace as you advance through the recovery stages
Take the next step in your ACL recovery journey. Reach out to our specialized ACL rehabilitation team today at (647) 368-6280 or contact us online in just a few clicks. Dr Kottoor, our clinic director, has been doing ACL custom bracing for over 20 years.
Frequently Asked Questions
Can an ACL brace prevent the need for surgery?
In some cases, especially among older or less active patients, using a knee brace, especially a custom knee brace, can be part of a non-surgical management strategy.
However, for full ACL tears, especially in younger or more active individuals, surgery is typically the best path to restoring full knee stability and long-term function.
Will prehab make my ACL recovery faster?
Yes—studies consistently show that patients who complete a prehabilitation program experience better post-op results. They typically regain range of motion, quadriceps strength, and knee function more quickly. This leads to faster return to daily activities, sport, and a reduced risk of long-term instability.
Prehab also improves patient confidence and understanding of how to perform exercises correctly after surgery.
How to reduce swelling before ACL surgery?
Here are some effective ways to reduce swelling before ACL reconstruction surgery:
- Use a compression knee brace
- Apply ice 2–3 times daily
- Elevate your foot above the level of your thigh whenever possible
- Rest the knee from demanding physical activity
- Avoid standing or walking for extended periods
These steps will improve motion, reduce pain, and enhance the effectiveness of your surgery and post-op rehabilitation.
Final Thoughts
Preparing for ACL surgery isn’t just about waiting—it’s about taking deliberate action to protect and improve your joint before the reconstructive procedure. Based on our clinical experience, we have found that wearing an ACL brace before surgery is one of the most effective ways to maintain knee stability, reduce swelling, and promote safe and confident movement during this phase of recovery.
A custom knee brace, in particular, will ensure a snug, precise fit that maximizes support without compromising mobility. When paired with a structured rehabilitation plan—including proper exercises, the RICE method, and potentially crutches—you set yourself up for the best possible post-op outcome.
At Leaside Sports Medicine in Toronto, we support patients throughout every phase of their ACL recovery journey, from prehabilitation to full recovery. Dr. Kottoor will fit you with the right brace, guide you through appropriate exercises, and create a personalized program to reduce pain, restore function, and protect your knee.
If you’ve recently suffered an ACL tear or are preparing for surgery, please contact us today. Our experts are here to help you move forward—stronger, safer, and more confident than ever.
