ACL Prehab Exercise Protocol #1
The first program was highlighted in an article by the Journal of Orthopedic & Sports Physical Therapy, which can be found here.
I recommend reading the entire paper – it’s really informative. If you’re looking only for the exercises, you can scroll all the way to the bottom to the appendices (page 14). The article also includes images that are helpful to understand the recommendedexercises. For further detail, I’d recommend simply looking up the exercises on YouTube.
Here’s a quick overview of the program used – they recommend performing this workout 2-4x/week for 5 weeks:
*Note that when you see “(+2)”, it means that you should try to perform as many reps as possible on the last set. If you can perform 2 more than the recommended reps, you should increase the weight for the next workout.
- 10-15 minute continuous warm-up on a stationary bike, treadmill, or elliptical
- Single Leg Squat – 3×8
- Step-up – 2×10
- Squat on BOSU ball – 2×20
- Single leg leg press – 3×6 (+2)
- Single leg knee extension – 4×6 (+2)
- Squats to 90 degrees – 3×8 (+2)
- Leg curl – 3×8 (+2)
- Hamstring on physioball – 3×6
- Single-leg hop – 1×15
- Sideways single-leg hop – 3×15
- Skater lunges – 2×20
If you have access to trained supervision and a rocker board, you might also try the perturbation training described in appendix B of the paper.
ACL Prehab Exercise Protocol #2
Another study, published in the American Journal Of Sports Medicine, found that the following exercise routine helped participants to perform better on the single leg hop test, improved self reported knee function scores, improved quadriceps and hamstring strength, and even showed a positive trend for return to sport after surgery
Per the study:
“The program consists of 4 exercise periods per week: 2 supervised gym sessions interspersed with 2 supervised home sessions… Patients were allowed 1 repetition of their maximal effort to determine the starting weights at the gym. Each gym activity had 3 sets of 12 repetitions, and the weights were increased weekly by 10% to 15%. During the last gym session, the weights were reduced to the previous week’s value to prevent fatigability preoperatively and to favor the muscular response to endurance and gaining mass. Home exercise consisted of the same program as the gym, but with the use of a TheraBand instead of weights. Patients used a DonJoy knee brace locked at 20 degrees of extension to reduce the risk of further straining the ACL pre- or postoperatively during open kinetic chain (OKC) exercise. The brace also functions as a confidence factor during OKC exercise. Proprioception training was done on a wobble cushion.”
The exercise routine, highlighted in the appendix of the study, consists of the
following. While the full text of the study is not available for free, you can access the appendix here by clicking “Supplemental Material” in the left column.
Exercise Group 1 – All Exercises 3×12
- Leg press
- Leg curl
- Leg extension
Exercise Group 2 – All Exercises 3×12
- Half lunge
- 45 degree squat
- Calf raises
Exercise Group 3- All Exercises 3×12
- Hip Abduction
- Hip Adduction
- Hip Flexion
Balancing/Proprioception – 3×30 seconds – Use a wobble cushion
- Phase 1: Stand on one leg with
eyes open - Phase 2: Stand on one leg with
eyes closed - Phase 3: Stand on one leg with
eyes closed, head facing upwards
Stretching – All Stretches 3×30 seconds
- Quadriceps
- Hamstring
- Calf
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