A torn anterior cruciate ligament or ACL is one of the most devastating injuries you can sustain. The ACL is a ligament that stabilizes the knee joint and connects the thigh and shin bones. Rehabilitation exercises and continued strengthening of the leg muscles around the knee are important to prevent reinjury to repaired ACLs.
Hamstring Strengthening
Hamstring strengthening exercises are a key part of most ACL injury rehab and prevention programs. The hamstrings, which run the entire length of the back of the leg, are often neglected and overlooked in training. Exercises that work the hamstrings include isolation moves like leg curls and compound exercises such as deadlifts, lunges and squats. Peak Performance, an online educational resource for athletes and coaches, recommends performing lunges in all directions to strengthen the hamstrings on all planes because hamstring muscles are a big assist to the ACL. Perform these by stepping out as far as you can forward, and lunging down until your back knee touches the ground and your forward knee is parallel to the ground. Then repeat the lunge in all directions: left, right and behind with both legs.
Quadriceps Strengthening
Strengthening the quadriceps muscles on the front of the thigh can help to support a repaired ACL, as the quads are the largest muscle group around the knee. Gym exercises for the quads include leg extensions, squats, lunges and the leg press machine. Squats are one of the best compound exercises for the quadriceps and are easy to perform by holding weights and squatting down until your thighs are parallel to the floor. It is important in squats to keep your back straight in order to protect your back from injury.
Lower Leg Strengthening
Muscles around the knee must be restored to full strength, coordination and functional ability in order for ACL rehab to be successful. The often forgotten muscles around the knee are the lower-leg muscles. The muscles of the calves and shin are smaller and more difficult to train than the larger, upper-leg muscles. Calf raises and reverse raises work the lower-leg muscles well and can be performed with or without weighted resistance. Calf raises, which focus on the calf muscles, should be performed while standing on a step or raised surface. Place your toes on the step and let your heels hang off, then raise up as high as you can on your toes, holding the peak position for a second before lowering to the starting position. Reverse raises work the shins and the anterior tibialis muscle and are simply the opposite of calf raises. Start with your heels on the step and let your toes hang off, then raise your toes up toward your leg as high as you can. Reverse raises are more difficult than calf raises and your sets will have to be adjusted accordingly.
Flexibility and Balance Exercises
Improving balance is one of the main goals of an ACL injury prevention program. Balance is important in landing and the goal is to prevent another injury in the future. Peak Performance suggests incorporating one-legged versions of exercises to train for balance. Try the one-leg squat and lateral hop that involve you doing a bodyweight squat with one leg and at the bottom of the squat hopping up and laterally 6 to 8 inches before landing and going immediately into another squat. Flexibility exercises allow the muscles to have a greater range of motion, use their strength more efficiently and better protect the knee. Strength training will help flexibility, but you must stretch to reap the full benefits. Stretches that focus on the legs and pelvis area are the most effective in aiding a repaired ACL.
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