At this stage of your recovery, it is likely that you are feeling close to normal. Your knee should be as strong as the other side (and you should have tested this with your physio), it should feel stable and you shouldn’t be having any problems with pain or swelling. Given all these factors, it is quite easy to be fooled into thinking the hard work is over. Not quite! It is important that you complete your rehabilitation, this will ensure that going back to your chosen sport/s and hobbies is safe and will reduce your risk of re-rupture.
Completion of ACL rehabilitation means undertaking another 3-6 months of hard, plyometric and sport specific training. These exercises will give you a ……. to work from. It is of the utmost importance that you have been cleared to start this training by your physiotherapist and/or surgeon. You need to ensure that you have completed double and single leg strength and jumping/landing mechanics before beginning this last stage.
This training will work best if you are fatigued (tired) by the time you get to the jumping and landing exercises. The way the exercises are ordered will allow for fatigue to set in.
This programme will provide the most benefit if you complete it 2/3 x weekly.
Warm Up
Cycling
4 minutes of light to moderate resistance. 6 mins of hill
sprints (ie high resistance, standing on pedals for 1 min,
moderate resistance, seated pedalling for 1 min – repeat).
Running
3 minutes jog at natural pace. 3 minutes moderate-fast
pace, 4 minutes 30 sec sprint, 30 sec rest on sides (repeat).
Skipping
2 x 5 minutes / mix up fast, double, alternating legs, high
knees, etc.
Section 1: Strengthening
- Pick 3 exercises
These exercises should all be performed with 3-4 sets of an 8 Rep Max weight (RM). This means a weight that you are able to lift/push 8 times before failure/fatigue.
Single Leg Press
Sit in the leg press machine, with your back well supported. Place 1 leg on the plate and push out into full extension of the knee and then return to the start position with good control.
3 x 8 both sides
Single Leg Knee Extension
In sitting, place one leg only behind the bar. With smooth control, extend your knee fully and then slowly return to the start position.
3 x 8 both sides
Single Leg Hamstring Curls
Lay on the bench with 1 leg only behind the bar. With smooth control, pull the heel towards your butt and then slowly return to the start position.
3 x 8 both sides
Bulgarian Lunge
Holding onto your weights, place the back foot onto bench/box, keeping your weight over the front foot. Now perform a lunge onto the front leg, ensuring that your knee tracks forward and that the pelvis stays level. Extend through the hip and knee to return to the start position.
3 x 8 both sides
Single Leg Squat
With weights in hand, stand on one leg. Now perform a single leg dip, ensuring that your knee tracks straight forwards and the pelvis stays level. Extend through the hip and knee to return to the start position.
3 x 8 both sides
Deadlift
With feet hip width apart and bar in hand, softly bend the knees and bow forwards from the hip, lowering the bar to the ground and then return to the start position. Ensure your back remains in neutral throughout.
3 x 8 both sides
Single Leg Deadlift
Holding onto 2 Dumbbells, place one foot up on a box/step. Take the load through the lead leg and step up onto the box/step and drive the opposite knee up towards the chest. Now slowly return to the start position. Ensure your knee tracks straight throughout.
Weighted Step Up
Holding 2 Dumbbells, place on foot up on box/step. Take the load through the lead leg and step up onto the box/step and drive the opposite knee up towards the chest. Now slowly return to the start position. Ensure your knee tracks straight throughout.
Section 2: Plyometric and Stability Training
- Pick 4 Plyometric and 2 Running Exercises
Diagonal Hold Step Drill
Hop onto your right leg from your left, on a slight diagonal. Catch the position and hold for 2-3 seconds. Then hop off your left leg onto your right.
2 x 20
Double Leg Pogo Jump – sideways
Keeping the feet together, jump side to side, thinking of jumping from your ankles and toes. Keep your knees fairly straight. Do not allow your heels to hit the ground.
Repeat 4 x 30 seconds
Single Leg Figure 8/+ Hop and Hold
Standing on one leg, hop forward as far as you can. ‘Catch’ the landing and hold for 5 seconds. Leap forward again on the same leg and hold.
4 x 6
Single Leg Leap and Hold
Standing on one leg, hop forward as far as you can. ‘Catch’ the landing and hold for 5 seconds. Leap forward again on the same leg and hold.
Repeat x 4. Then switch sides.
Box Jump with single leg landing
Stand in front of a step on both feet.
Explode up and jump onto the box landing on one leg in a small squat. Ensure you control the landing.
4 x 4
Twice over Box Jump
Jump up onto a box. then off the other side, explode up again after you land onto another box/step or the blue side of a bosu ball.
4 x 6
Single Leg hop for Distance
Start standing on one leg. Hop forward as far as you can, complete 6 in a row (you will need approximately 30m of space). Complete on both legs.
6 x 5 hops consecutive
Single Leg Hop for Height (Pogo Hop)
Keeping the knee straight, gently hop up and down. Do not allow your heel to hit the ground. Perform on both legs.
4 x 20
Double Leg Jump with Single Leg Landing
Stand in neutral. Squat down to jump up. Land onto one leg with control. Do not let your knee or hip fall inwards.
4 x 8
Hop and Turn
Standing on one leg with approximately 10-20m of space in front of you. Hop forward and turn 90 degrees as you move so you land facing 90 degrees to the left (or right). Continue to hop forward and turn 90 degrees each time.
4 x 12
Box Jump
Stand in front of a step on both feet. Explode up and jump onto the box landing in a small squat. Ensure you control the landing and land evenly through both legs.
4 x 6
Single Leg Landing +/- with contact
Stand on a step on both feet, and engage the core gently. Step, or leap as you improve, off the step to land on one leg on the floor. Progress this by having a partner gently push you as you are ‘falling’ so that you have to react to the contact.
2 x 10
Jumping Lunge
Start in a lunge position. Jump up and switch your legs to land in the alternate lunge. Repeat.
3 x 20
Running Drills
T Drill
Set up 5 cones in a ‘T’ shape (10m x 10m). Start at the bottom of the T and sprint as fast as you can to the top middle cone. Sidestep to the left cone, then all the way to the far right cone. Sidestep back to the middle then back pedal to the start point.
x 5 (one way = 1)
M Drill
Set up cones in an M shape (10m x 10m). Start on one side at the base of the M. Sprint to the cone directly in front of you, then change direction to sprint down to the middle cone. Turn again to sprint up and then back down to the last cone. you can mix this one up and trial it with some back pedalling or side stepping.
x 6 (both ways = 1)
4 Corner Drill
Set up cones in a 5-10m square (you can mix up the distance). Start on the bottom left corner and sprint forward to the top left, side-step down to the bottom right corner, then sprint forward to the top right. Side-step back down to the start point.
x 6 (one round = 1)
Ladder Drills
x 12 (forward and back = 1)
Z Cone Drill (forwards, backwards and sidestep)
Set up 4 cones in a Z shape over a 5m x 15m space. Start at the bottom of the Z and run to each cone. Complete a mixture of forwards running, backwards running and sidestepping.
x 2 forward
x 2 backward
x 2 sidestep
Section 3: Balance
Single Leg Perturbation +/- distraction
Standing on a black side of the bosu. Have a partner slowly and gently tap the edge of the bosu to make it rock. Maintain your balance while they walk around you and tap at the edges at different angles. They can increase the force as you improve.
You can throw a ball at a wall or to another partner if this becomes easy.
6 x 30 seconds
Y Balance Reach +/-eyes closed
Standing on your right leg. Imagine you are standing in the middle of a Y shape. Reach your left leg forward as far as you can, then behind you and out to the left, then behind yourself to the left. Reach as far as you can and keep your balance.
2 x 10 each side
Arabesque with toe touching and knee raise +/- bosu
Standing on one leg, keep a small bend at your knee. Slowly shift your chest forward and reach your other leg straight out behind you. Hold this position for a count of 3 then slowly tilt back to standing, draw your knee into your chest without placing it on the ground. Return to the starting position.
2 x 10 each side
Curtsy Lunge
Shift on one leg, ensure your pelvis is aligned. Complete a single leg squat whilst maintaining your balance.
2 x 10 each side
Single Leg Squat on Foam/Bosu +/- eyes closed
Standing on one leg, ensure your pelvis is aligned, Complete a single leg squat whilst maintaining your balance.
2 X 10 each side
Section 4: Core
- Pick 2 exercises
Front Plank with Toe Tap
Start in a plank position, lift one foot and tap it out to the side, bring it back to start position and alternate.
2 x 45 seconds
Side Plank with Lifted Top Leg
In a side plank, on elbow or hand and feet. Brace through your core and slowly lift the top leg. Keep it straight and pelvis steady. Hold for 30 seconds then switch sides.
2 x 30 seconds each side
Swissball Pike (half or full)
In a plank position with your feet up on the swissball. Keeping core braced, slowly pull your knees toward your chest. Straighten out again and repeat.
For full puke – lift hips up and bring feet toward chest.
3 x 10
Swissball Leg Lowers
Lying on your back with a swissballl between your ankles (about half way up the ball). Squeeze the swissball and lift it toward the ceiling with your legs. your back and shoulder blades should stay on the floor.
2 x 20
Mountain Climbers
Start in a plank position on your hands and toes. Bring your left knee toward your right arm. Take it back to a plank position then alternate legs. Continue alternating.
2 x 30
