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Staying healthy and strong

During this phase you will work on building your strength back while allowing the ligament to heal into the bone tunnels in your femur and tibia. Most physical therapists prescribe closed chain kinetic exercises during this phase. In this type of exercise your foot is planted on the floor and it is not free to move about. Squats are an example of a closed chain kinetic exercise whereas quadriceps extension exercises on a weight training machine are an open chain exercise.

Most surgeons prefer to wait until at least three months have passed before allowing their patients to return to agility training exercises. When to return to competitive or recreational sports after an ACL reconstruction is a difficult decision. The timing of your return will depend upon how well you have done with your rehabilitation, how solid your knee feels to you, and what you and your surgeon decide is reasonable for you. Even after you return, it is important that you pay special attention to keeping your quadriceps and hamstrings in good shape, as this is considered an essential part of protecting the ACL.

Keeping your quads strong.

Two very good exercises for maintaining quadriceps strength are short arc squats and lunges. In the short arc squat, which is illustrated below, the feet are kept shoulder-width apart, the back is held straight, and the knees are bent to the point where this is still a comfortable exercise. The goal of this exercise is to strengthen your quadriceps muscle, and not to force your knee through a complete range of motion. Therefore, it is not wise to try to squat down as far as you can possibly go, but rather to perform the exercise to the point where you just start to feel pressure inside your knee. When first starting with a strength training program, it is a good idea to have a physical therapist give you instructions on how to perform each exercise.

ACL surgery rehabilitation - strength training
ACL surgery rehabilitation - strength training
ACL surgery rehabilitation - strength training
Lunges are also an excellent exercise for maintaining quadriceps and hamstring strength. In this exercise, start with both feet shoulder-width apart, and then step forward with one foot. Allow yourself to dip down to the point where you just start to feel pressure inside your knee, and then come smoothly back up to the starting position. As your quadriceps get stronger, you can increase the amount of weight and repetitions that you perform.
ACL surgery rehabilitation - strength training
ACL surgery rehabilitation - strength training

Agility Exercises

Agility exercises are designed to improve the power and strength in the muscles that move your knee after the ACL graft has healed. These exercises are often called plyometrics, and they are an important part of agility exercises and retraining. In this first box jump exercise, stand to the side of the box and hop up onto the box, landing with both feet. Then hop off the box down to the ground, again landing with both feet.

ACL surgery rehabilitation - agility training
ACL surgery rehabilitation - agility training
ACL surgery rehabilitation - agility training

As your strength and agility increases, you can progress to jumping completely over the box, landing with both feet together on the far side.

ACL surgery rehabilitation - agility training
ACL surgery rehabilitation - agility training
ACL surgery rehabilitation - agility training

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