How to Exercise After an ACL Injury


It’s every athlete’s worst nightmare: that awkward twist of the knee or the crushing impact of a lightning play that ends with the dreaded POP! If you’ve had an ACL injury (a tear of the anterior cruciate ligament in the knee), you know it’s a lifelong struggle that takes constant work and dedication. It’s one of the most common sports injuries that can be a potential career killer. While the most critical window for recovery comes immediately after the injury with surgery and intensive physical therapy, it’s important to have a workout routine that can help prevent recurring injuries. Enhancing mobility and strengthening muscles related to knee support can up your chances of getting back to, and maintaining, 100% knee fitness. 

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An ACL injury is not an end-all; with the right hands-on therapy and rehab techniques, it’s still possible to get your knee back into almost pristine condition. But for some—whether you just didn’t get the right rehab help or surgery didn’t go off as planned—the pain can linger. The most common symptoms of an ACL injury can be “a sudden popping sensation of the knee, swelling, and an inability to extend the knee to a full range of motion,” says Dr. Michael Camp, D.P.T. He adds that other signs involve tendinitis, buckling of the knee, deep throbbing pain, and unsteadiness when walking.

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Getting your blood circulating should always be your first step when working out with a weak ACL in mind. Light jogging, bike machines, and treadmill workouts are a great place to start. Camp also suggests warming up with dynamic exercises that emphasize balance, agility, and mobility, with a focus on your lower body and legs. Karaokes, in and outs, lateral drills, and incremental sprint drills can all help improve your overall lower-body strength and flexibility. “Light plyometric activity is another good way to start warming up your knees,” he adds.

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Glutes, quads, hamstrings, and calves: These four essential muscles are critical to the support of your knee. Try exercises that focus on resistance (take it slow and steady), pylometrics, and overall balance and mobility. The idea is to minimize the amount of work your ACL is doing, and maximize the support and flexibility it needs to stay strong.

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Glutes, the “powerhouse of the body,” according to Camp, should be a primary target in your workout routine. Try exercises like clamshells—lying on your side with your feet together and then pulling your knees apart with a resistance band wrapped around your upper thigh—to focus in on your glutes. Side stepping with a resistance band on your knees or squats will also help with your glutes and quad control. For hamstring workouts try Romanian deadlifts or glute-ham raises and calf raises to strengthen your calves. Biking is also another surefire way to hit all the key lower-body spots.   


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