Strengthening for ACL Injuries

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Strengthening exercises which may form part of an Anterior Cruciate Ligament Injury rehab program.

The following is for information purposes only. Always seek professional advice before starting any rehabilitation programme.

Static quads seated

  • Contract the quadriceps muscles and hold for 5 to 10 seconds.
  • Relax for about 3 seconds and repeat 10 to 20 times.
  • Place the fingers on the muscle towards the inside of the leg above the knee (vastus medialis oblique (VMO) muscle).
  • It is important that this muscle is developed and this one should be felt contracting whilst performing the exercises.

Static quads standing

  • As above but performed in the standing position.
  • This exercise is performed from phase 3 onwards of the post surgery rehabilitation programme.
  • These exercises should be performed on a daily basis.

Static hamstring holds

  • Lie on front or stand upright.
  • Bend the knee to about halfway up.
  • Hold in that position for 10 to 20 seconds.
  • Repeat 1 to 3 times daily.
  • Progress by increasing duration of hold and number of repetitions or using an ankle weight.

Calf raises

  • Simply raising up and down on the toes, keeping the legs straight.

  • Aim for 3 sets of 10 to 20 repetitions daily.
  • This exercise can be progressed later in the rehabilitation process by doing single leg calf raises and then single leg calf raises without leaning against a wall or holding onto anything.

Hip flexor strengthening

  • Raise the knee up as high as comfortable, bending the knee and lower.
  • Aim for 3 sets of 10 to 20 repetitions daily.
  • This is developed in the later stages by increasing the speed of movement on the upwards stage as well as the number of repetitions.

Hamstring curls

  • An exercise for later in the rehabilitation process.
  • These can be done using rehabilitation band or with a special weights machine.
  • Curl up against resistance and back again in one smooth movement.
  • Aim for 3 sets of 10 to 20 repetitions.
  • As strength increases and more weight / resistance is added then more recovery time may be required between sessions.

Quarter squats

  • Squat down to about a quarter of the way down and return to the starting position.
  • Aim for 3 sets of 10 to 20 repetitions.
  • Progress this by going down to half way (Phase 3 of rehabilitation) and then full squats (to horizontal) in the sports specific stages.
  • Increase the intensity by adding weight.
  • Ensure stomach muscles are kept firm when performing squats.

Lunge

  • Standing one leg in front of the other as shown.
  • Bend the front leg to lean forwards and return to standing.
  • Aim for 3 sets of 10 to 20 repetitions.
  • Increase intensity by adding weight.
  • Ensure stomach muscles are kept firm when performing this exercise.

Proprioception exercises

  • Proprioception is similar to balance but means the awareness of where your body (or body part) is in space.
  • These kind of exercises help in controlling the movement of the limb and preventing re-injury.
  • Start by just trying to balance on the injured leg for 30 seconds.
  • Once this is easy, try closing your eyes!
  • To progress further you can use a wobble board or cushion, which increases the difficulty by adding an unstable surface.

Hip Adduction/Abduction

  • Use a section of resistance tubing, attach to something stable and around the ankle.
  • For adduction pull the leg across the body, keeping the knee straight as shown.
  • For abduction, turn around (keeping the tubing on the same leg) and take the leg away from the body against resistance, again keeping the knee straight.

Heel drops

  • Standing on a step or similar of up to 6 inches in height, bend one leg so the heel of the other almost touches the floor and return to starting position.
  • Repeat until the muscles feel tired.
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