anterior cruciate ligament

How to Maintain Strength Levels with An ACL Injury

Anterior Cruciate Ligament tears are among the most common knee injuries, mostly because of the inordinate amount of stress that sudden leg movements place on this one muscle. The ACL, with just a little help from the posterior cruciate ligament, controls almost all the knee’s back and forth motion. About 80 percent of these injuries result from the rapid directional change, sudden stops, and other such non-contact movements.

Among weightlifters with ACL injuries, squats are a major concern. No mobility in the knee means that it is basically impossible to squat. So, the faster the recovery, the faster you can get back to this important weightlifting exercise.

First Aid

There can be several days between injury and medical evaluation, especially if you hurt your knee in a weekend pickup game or some other unsupervised activity. This is the period that first aid is critical, because until that evaluation occurs and you make some decisions, recovery cannot begin in earnest. Fortunately, the R.I.C.E. method prevents the damage from getting any worse, so sprains don’t become tears. Moreover, a good first aid regimen sets the table for expedited recovery.

  • Rest: It’s easy to stay off the injured knee when it’s completely immobile, but that sensation may only last a few hours. Afterward, your knee will probably begin to feel better, but that does not mean that it is better. Never put any weight on an injured knee until medically cleared to do so, it will also stress more on your ankle which later could lead to strain.

  • Ice: In the first 72 hours, regular cold therapy (about 20 minutes every hour and a half) will decrease swelling, so the doctor can have a good look at the injured area. Ice will also decrease pain, and analgesic pain relief is almost always a good thing.

  • Compression: Since the knee must remain immobile, an unhinged compression sleeve, or even tightly-wrapped tape, will probably do the trick. A hinged orthotic aid for ACL injury might be necessary later, so bookmark the site.

  • Elevation: To decrease swelling even more, and also to prevent fluid from building up in the knee, keep it elevated above your heart as much as possible.

Stay away from pain pills even though the wound is incredibly painful, because opioids simply mask the injury.

Squats and ACL Injuries

Although medical science has leaped forward in almost every way, ACL recovery time is still about the same as it was in the 1980s. Yes, NFL running back Adrian Peterson was back in the starting lineup, and back to his All-Pro form, just nine months after ACL surgery. But he is a world-class athlete who devoted 24 hours a day to recovery. Most people with ACL injuries don’t have those luxuries.


It may take eighteen to twenty-four months to fully complete recovery and return to heavy squats. But since the knee will not improve very much without strength exercises, eighteen months of inactivity is not really an option. Instead, try a regimen like this:

  • Passive ROM: These range of motion exercises can begin about a week after surgery. Extend the injured knee as much as the uninjured one, and that even includes a little bit of hyperextension.

  • Patellar Mobilization: Shift the weight in the kneecap to different positions without flexing the quads. The speed is immaterial; what counts is a smooth, consistent rhythm. Your doctor should give you a recovery plan that tells you when to start these exercises, which should be performed three or four times a day for about ten minutes at a time.

  • Isometrics: These exercises focus on the muscles around the knee as opposed to the knee itself. They include hamstring curls, calf raises, quad extensions, leg press, short squats, and standing knee extensions.

  • Jumping: With range of motion partially restored and the muscles stronger than they were earlier, it’s time to move to the next phase. Try a combination of 2-legged jumps, 1-legged jumps, standing broad jumps, sideways jumps, box steps, 180-degree jump spins, and box jumps.

  • Gait Training: After a long period of forced inactivity, it’s important to reset walking motion, or else an improper gait may lead to re-injury.

Once range of motion is partially restored, it’s probably okay to return to low-intensity squats, and then work up from there with your doctor’s or therapist’s approval. After all this time, your new knee will be stronger than your old one, which is a very good thing.

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