After an ACL injury or surgery, most athletes have two primary goals:
- I want to get back on the field as soon as possible
- I want to ensure this never happens again
One of the most significant obstacles in achieving those goals is rebuilding the quadriceps muscle on the affected knee. Immediately after the ACL tears, the nervous system recognizes there has been significant trauma in the area and starts shutting down the muscles that move the knee through a range of motion. One of those muscles is the quadriceps.
In order to both return to the field as soon as possible AND minimize the risk of re-injury, we need to re-build the nervous system’s trust in fully activating the quadriceps. The quad is a major force absorber for the knee, meaning that if you plan to return to sport, we want it firing as optimally as possible to ensure THE MUSCLE absorbs forces and NOT the ligaments and other soft tissues in the knee.
If you’re reading this article, I’m sure you’ve already heard a lot of this material. You’ll probably also receive exercises from your PT or strength coach to help you build strength and avoid muscle atrophy in the quadriceps.
So, that’s not where this article is going to focus.
The truth is — all of the exercises provided by your PT/strength coach can probably help you to re-build quad strength…. IF they’re being performed properly.
And that can be a big IF.
That IF is where we will focus today.
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As I mentioned earlier, the nervous system will organize movement in every way possible to MINIMIZE use of the quad.
So, what’s it going to do when you set out to MAXIMIZE use of the quad with your exercises?
It will compensate… in every way possible.
For those of you unfamiliar with the term “compensate,” this means that the body will figure out a way to utilize OTHER muscles to move the body through the apparent range of motion and trick you into believing you’re executing the assigned exercise. In reality, other muscles are being strengthened, you may not be getting maximal benefit from the exercise, and it’s even possible that you’re reinforcing less efficient biomechanical patterns that ultimately lead to re-injury.
This is important. Make sure that no matter what exercise you are doing, you badger your PT or strength coach with questions as to what the movement looks like when it’s done properly AND all the different ways it can be performed improperly.
Today, I’ll share one cue that does wonders in terms of ensuring the quadriceps is being utilized appropriately and without compensation.
For any exercise that utilizes the standing position, imagine pushing straight down through your heels.
This might sound simple at first glance… ok, so just push down into the heels… “so what?”
However, keep in mind, it is not just pushing through the heels, but straight down.
And try to maintain the ability to do so throughout the entire range of motion of whatever exercise you are performing.
For instance, let’s take a look at a mini squat or squat. If you sit too far back into your heels, you will be loading the posterior chain too much and probably not getting enough quad activation. You may even be relying on the lower back somewhat. If you push the weight too far forward, you will start compensating with your plantar flexors (soleus and gastrocnemius), again decreasing the amount of quad activation you are actually getting with the exercise.
It’s only when you focus on pushing straight down through the heels that you will feel the activation of the quadriceps and supporting muscles in the pattern that we are looking to achieve. If you cannot maintain this ability and focus through the entire range of motion, work only in the range of motion that you can do it correctly.
When you activate the quadriceps optimally, you’ll set yourself up to build quad muscle and avoid muscle atrophy after ACL surgery. Using this simple cue in EVERY exercise that utilizes the standing position will allow you to do just that.
So, go ahead… give it a shot. And remember to maintain the focus throughout the entire range. I think you’ll find it to be harder than it sounds 🙂
Leave a comment below or email me, Zach, directly at email@example.com to let us know how it goes.
If you’re interested in working with me and my team to build quad strength quickly and avoid atrophy after ACL surgery, click the link below to find out if you qualify for a 2 day trial.
I had a total left knee done 14 weeks ago. I am 64 years old, avid golfer, former 20 year world long drive competitor. Is this program applicable for me ? I am in PT 2 times a week, also in the gym 4 days a week. I have full extension to zero degrees, and am currently around 135 degrees flexion. Please advise, thank you
Hi Brad, great question and congratulations on the 20 year long drive career! Depending on what your goals are, I think the program could be a great fit. I will follow-up with an email to learn a little more.
How much the cost?
Hi Robert, we offer a 2 day trial, which includes rental of one of our devices and 2 hours of virtual work with our trainers, for $99. If you’re interested, you can apply here: https://trial.accelerateacl.com.
I am 56 yrs old, humbly started, I am in really good shape and I tore my right ACL, Meniscus and ALL on June 4 of this year during opening day of summer league flag football :o(
I had surgery on July 28 and the doctor said it was a full success at time of surgery and in 3 visits to him since and I am now approx.17 weeks post surgery. My PT staff tell me I’m way ahead of schedule in my recovery and current abilities (complements of being so vigilant with my PT and working really hard every day and being in good shape) and I’d like to know will your program tailor to my needs based on the time since my surgery?
Please keep in mind that I do want to get back on the field for Summer or Fall 2023 Fall flag football seasons and I’ve been training to optimize my physical abilities to support this goal. I welcome your thoughts and maybe we can collectively evaluate if I’m a good candidate for the program and the same as to is the program is a good fit for me?
Hi Alex, thanks for the comment – it sounds like you are doing a great job with the recovery process so far. Congratulations on all of the hard work you’ve put in. Based on what you’ve told me, I definitely think it’s worth exploring further – do you have time for a call at 9am or 3pm on Thursday, 12/1?
I can do Thursday at 3pm and that’s EST ;o).
Should I call you or you call me?
I will be awaiting your call on Thursday at 3.
Hi Alex, looking forward to it! I might have missed it – can you send me your phone number? If you’d rather not post it here, you can send to firstname.lastname@example.org.