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ACL Recovery: When to Start Training After Surgery
One of the most common questions we hear from parents and athletes recovering from an ACL injury is:
“When can I start training again?”
It’s a fair question—and an important one. But before diving into timelines, it’s crucial to understand that full recovery from ACL surgery is a long, non-linear process. Progress can be frustrating at times. There may be setbacks, plateaus, and moments of doubt. That’s completely normal. The good news? With consistent, high-quality training and guidance, recovery is not only possible—it can often lead to a stronger, more resilient athlete.
ACL Surgery: A Second Injury
Athletes who undergo ACL surgery must understand that they’re essentially experiencing a second injury—one from the initial ligament tear and another from the surgical repair. This naturally extends the timeline for recovery. However, it also sets the stage for better long-term outcomes.
The human body is an incredibly adaptable organism. It often “remembers” the high levels of coordination, mobility, and athleticism it once had. With the correct inputs, the body regains those capabilities.
Early-Stage Rehab: The Role of Physical Therapy
In the first few weeks post-surgery, care is typically directed by a physical therapist. Their main goals during this phase are to:
● Reduce pain and swelling
● Restore normal knee range of motion (flexion and extension)
● Re-establish proper gait (learning to walk normally again)
This initial recovery window is vital. But contrary to common belief, the return-to-play protocol doesn’t have to wait for months. In fact, one of the keys to successful rehabilitation is to begin training before surgery and return to training as early as safely possible afterward.
When Can You Start Training?
Simple rule:
Once you can walk without crutches and bear weight evenly on both legs, you’re ready. There are safe training methods that you can perform to stay fit and accelerate the recovery process.
Here’s how:
Safe Training Options After ACL Surgery
1. Static Lower Body Strength Training w/ Restricted Range of Motion
Examples include exercises like RDLs, kettlebell swings, and high box squats. These exercises are safe because they are executed with both feet on the ground and within ranges of motion that safely load the muscle tissue without placing the injury site at risk. They also groove movement patterns that will be heavily loaded later in the rehab process.
2. Upper Body Weight Training
Since the lower body cannot be loaded heavily at this point, it is necessary to maintain a strength stimulus through upper body exercises. Strength training—even targeted upper body training—causes hormonal adaptations in the body, such as increased growth hormone and testosterone levels, which promote recovery, injury healing, and the maintenance of athletic qualities through neuromuscular stimulation. The exercise menu includes staple bodybuilding movements like overhead presses, bench presses, rows, pulldowns, and other arm and torso training. As a coach, it is necessary and important to lift from standing positions if tolerable, but ensure there is no risk of excessive weight bearing or falling onto the surgically repaired leg.
3. Plyometric Activities on the Healthy Leg
Jumping and plyometric exercises are fair game on the healthy leg. Early training and restoration of athletic qualities are necessary in the healthy leg to prevent detraining and to prime the nervous system for skill acquisition later in the rehab process, when both legs can be used equally. In our experience, some athletes perform so much targeted rehab and strength training on the injured leg that the healthy leg falls behind in strength and reactivity. As coaches, we must implement plyometrics early and often to keep the body primed for explosive activities. The same rules as upper body lifting apply—ensure the athlete can safely perform jumps and hops without accidentally falling or placing excessive force through the surgically repaired leg. Some example exercises include two legged vertical jumps and hop variations.
4. Assisted or Low-Intensity Plyometric Activities on the Surgically Repaired Leg
This is an incredibly important option and should be carefully applied under the watchful eye of an experienced coach. One of the overarching objectives and key milestones in ACL rehab is return to running. Running forms the basis for most sport-specific actions, and exercises like pogo jumps, assisted hops, and skipping are critical to restore the natural elastic qualities of the foot, ankle, knee, and hip in preparation for running. These movements are safe and necessary to deploy in a controlled environment as long as techniques and loads are monitored closely. Constant communication between the coach and athlete is vital to make adjustments if the athlete is responding well—or poorly. This element of the program is one of the most important, as static lifts and low-intensity physical therapy exercises are insufficient to mimic the forces and contraction speeds of sprinting, jumping, and changing direction that characterize sport.
5. Isometrics
Isometrics are exercises that require intense muscular contractions without producing movement. Because the knee (or leg in general) will not be moving through a range of motion, these exercises are relatively safe. Isometric exercises like split squat, calf raise, and hamstring bridges build tissue tolerance through longer duration holds in specific positions that help prepare the athlete’s body for more intense stressors later in the program. They are also effective for training co-contractions, which integrate the foot, calf, quad, and hamstring musculature in patterns that apply directly to walking, running, and sprinting. Lastly, isometrics build tendon strength and resilience—just as important as muscular strength—and may reduce the risk of developing Achilles or patellar tendon pain as a result of increased training demands.
Final Thoughts
Recovery from ACL surgery is long and tough—but it’s also an opportunity to overcome adversity. The early stage of ACL reconditioning is about restoring function to get back to intense training. The middle and late stages of ACL recovery are about training intelligently at intensities that prepare you to sprint, jump, land, and change direction. Ultimately, what we are able to do in training is what we will be able to do in competition. With a strategic approach that targets speed, plyometrics, strength and movement quality, athletes can continuously progress performance and build momentum for the next phase of their comeback.
Struggling to navigate the early stages of ACL?
Need Guidance on how to get back to the field fitter and stronger than before?
Our ACL Reconditioning Program is the answer.
The 5 Best Weight Room Exercises After ACL Surgery
Recovering from an ACL injury is a long arduous journey, physically and psychologically. We recommend introducing weight room exercises after ACL surgery as soon as athletes are able to walk without crutches, swelling and pain are under control, and knee extension is restored in the surgically repaired knee. Weight room exposure is crucial for rebuilding strength, coordination, and confidence. A well-designed strength training program can help you return to your sport stronger and more resilient than before.
Listed below are the five best weight room exercises for athletes recovering from an ACL injury. Each of these movements will restore knee stability, rebuild quad and other important leg musculature, and improve sports performance via improvements in coordination and total body strength. They can also be considered important tools for reducing ACL injury risk for healthy athletes. It is important to note that we implement proper progressions into most of these advanced movements. Ultimately, the goal is to get our ACL reconditioning athletes performing these exercises confidently, aggressively, and most importantly, pain free.
1. Depth Jumps
Video Example: Watch here
Why It’s Great for ACL Injury Recovery: Depth jumps are one of the most intensive exercises implemented within the weight room. When recovering from an ACL injury, the goal is to progress an athlete to eventually perform this exercise. Our philosophy is that we want our athletes to touch intensities that will prepare them for the demands of sports. Depth jumps do that by exposing the knee joint to forces that are comparable to cutting and stopping in soccer.
How to Implement Depth Jumps:
With Plyometric exercise, especially very intensive one such as depth jumps, the volume should remain relatively low
15-30 reps total
2. Snatch
Video Example: Watch Here
Why It’s Great for ACL Injury Recovery: The snatch is a powerful Olympic Weightlifting exercise that improves explosiveness and coordination capabilities. It has the potential to be one of the more intense exercises we can perform in the weight room. At TKO, you will progress to performing a full snatch, which may take 3-6 months. Regressions and variations of the movement are implemented so that we can eventually get our ACL reconditioning athletes to perform a full snatch.
How to Program the Snatch: Due to the snatch being an intense and technically challenging movement, the volume stays relatively low.
Sets: 2-6
Repetitions 1-5
Typical progression model:
Muscle Snatch, Above Knee Hang Snatch, Below Knee Hang Snatch, Power Snatch and Full Snatch.
Catch positions: Power Position (quarter- half squat) and Full Catch (full squat)
3. Full Squat
Video Example: Watch Here
Why It’s Great for ACL Injury Recovery: Full squats are a foundational weight room exercise and are a staple within the TKO ACL Reconditioning protocol. Progressing athletes to perform full squats, meaning hamstrings smashing calves all with an upright torso, is ultimately the goal. This exercise has the highest loading potential relative to knee bending (flexion and extension). This is important because being able to move heavy loads with full knee bend is required for a healthy knee joint.
How to Program Full Squats: the objective is to work up to heavy loads with low to moderate volume. We are trying to maximize the loading potential on the legs and the body as a whole.
Sets: 2-6, Repetitions: 1-8
4. Barbell Romanian Deadlift (RDL)
Video Example: Watch Here
Why It’s Great for ACL Injury Recovery: The barbell RDL strengthens the hamstrings in a lengthened position. Developing strong and resilient hamstrings provides the knee with stability and helps athletes become more resilient to knee injuries. Heavy RDL’s are a must in any training program, including a return to play (RTP) program because an athlete will experience reduced range of motion and knee instability after an ACL tear.
How to program the Barbell RDL:
Start with two leg RDL’s with a comfortable load and pain free range of motion. After proper tolerance has been built, start accessing more range of motion by standing on a plate. Range of motion (ROM) and load are equally valuable for this exercise. Once adequate ROM is achieved progress to heavier loads. Build a stable foundation of strength bilaterally then progress to unilateral loading with the Single Leg RDL.
Sets 2-4, Repetitions 3-8
5. Heavy Unilateral Exercises (e.g., Reverse Lunge)
Video Example: Watch Here
Why It’s Great for ACL Injury Recovery: Heavy unilateral exercises, like the Reverse Lunge or Bulgarian split squat, target each leg independently, addressing muscle imbalances and improving single-leg strength—critical for developing confidence and function in the injured leg. Single leg exercises also provide extra stress to the groin, glutes, and spinal stabilizers. Once an athlete is loading heavy unilaterally they are in a great spot in terms of progressing to other more dynamic and intense exercises.
How to program Unilateral Exercises:
Unilateral exercises should be implemented in the strength program as soon as possible, alongside traditional squats and RDLs. Examples include split squats, lunges, Bulgarian split squats, and high box step-ups. The split squat and the lunge are going to be the exercises with the most loading potential.
Sets: 2-4
Repetitions: 3-8 per leg
Regain Your Strength & Function…
Strength training is a valuable contributor to a comprehensive rehab plan for recovering from an ACL injury. It helps athletes rebuild strength and coordination, improve functional mobility, regain lost muscle mass, and target neglected muscle groups that may help reduce the risk of reinjury. These five exercises—depth jumps, snatches, full squats, barbell RDLs, and heavy unilateral exercises—are the bedrocks for athletes looking to return to the field fitter and more resilient.
If you’re in San Diego and recovering from a torn ACL or ACL reconstruction, we offer free ACL consultations to help design a program tailored to your specific needs. Whether your goal is to enhance sports performance, or simply regain confidence in your knee, TKO’s approach is the solution you are looking for!
Book your free ACL Consultation here!
The Eight (8) Characteristics of Successful ACL Rehabs for Soccer Players
Finding the best coach, facility, or clinic to do your ACL rehabilitation can be confusing and frustrating. Here are eight (8) characteristics that every successful rehab program includes. If you are an athlete, parent, or coach, use this list to vet out your choice of rehab program or ensure that you get the best care in your current situation.
Principle-Based
There must be training philosophies and methods in place that are grounded in current research, fundamental human biology, and strength and conditioning best practice. For example: At the beginning of the rehab process, minimizing swelling, restoring pain-free range of motion, and reestablishing the ability to walk are principles that all practitioners can get behind. In the later stages of rehab, learning how to sprint, jump, change direction, and execute soccer skills under fatigue are advanced principles that coaches should value as fundamental. Operating under a principles-based approach will ensure that every aspect of the program is lean and targeted towards the objectives and benchmarks established at the beginning of the process. It will also ensure that the coaches and athletes don’t grasp at “shiny objects” when the process becomes difficult or slow.
2. Emphasis on Return to Performance
The components of training must produce physical adaptations that prepare the athlete to play their sport. Ultimately, the objective is to help the athlete safely and thoroughly prepare for an inevitable return to playing soccer. The training must emulate the physical demands of sport while (theoretically) reducing the risk of re-injury. This does not mean training must LOOK like sport. Rather, the training must reproduce the forces, velocities, biomechanics, and energy systems of soccer. For example, soccer is known as a repeated sprint ability sport. Therefore, rehabilitation must include well-executed sprinting and conditioning methods that target the aerobic energy system. These two components will ensure that the athlete can sprint frequently and aggressively without experiencing debilitating fatigue.
3. Individualization
The course and rate of rehabilitation will be determined by the athlete’s response to training. There is no magical timeline that indicates an athlete’s readiness to return to the field and operate at the same level as they did before the injury. One of the many myths of ACL injuries, that has been debunked in recent research, is that an individual can complete a successful rehabilitation in 6-9 months. Every athlete will progress through rehabilitation at a unique pace. The athlete should understand this is a long and arduous journey. The coach should honor this variability by challenging the athlete appropriately and gently pushing boundaries in training, being mindful not to overwhelm them with the pace and urgency of the process.
4. Criterion-Based & Objective-Driven
Successful rehab includes assessments, pre-tests and post-tests to establish baseline data. The data collected in these assessments can be referenced against benchmarks to ensure progression. Strength coaches and physical therapists should collect important metrics like quad strength, symmetry between legs, and jumping outputs. These data points indicate when an athlete has cleared an important criteria for progression and is ready for the next stage of rehab. Other examples of valid assessments for ACL rehabilitation include knee range of motion, triple hop tests, change of direction deficit, and flying sprints.
5. Load Management
Successful rehab requires the intelligent integration of technical training (aka soccer practice) and the proper management of external load. Injury risk, or the possibility of re-injury, increases dramatically after periods of detraining. Athletes are often haphazardly thrown back into heavy practice loads and introduced to open soccer environments far too aggressively. At best, this habit leads to fatigue and poor performance. At worst, muscle strains and re-injury, oftentimes in the other knee. Loads should be gradually introduced and tracked diligently, and coaches should ensure that high intensities are achieved in a safe, structured training environment BEFORE being introduced in open, soccer environments.
6. Audibles
Good coaches have a plan when the plan goes wrong. Progressions, regressions, and audibles are critical in the rehab process, especially as an athlete gets closer to returning to practice. Coaches should be able to answer the following questions: What do you do when an athlete isn’t responding well to an exercise? What if an athlete has pain or swelling that prohibits movement? Conversely, what if they are responding well, feel great, and need more challenging tasks? Athletes often progress quickly through early stages of rehabilitation because their ability to progress is accelerated when training variables are tightly controlled and rehab is their sole focus. However, the more variables (like soccer practice) are introduced, the more difficult it is to ensure recovery. Changes may need to be made to the training program to accommodate pain, soreness, and fatigue from heavy workloads.
7. Collaborative Care
In reality, it takes major cooperation between the athlete and several specialists to rehab an ACL. The strength coach needs to communicate with the PT. The PT must communicate with the doctor/surgeon. They all communicate with the athlete and the sport coach. There are several opinions and expectations that need to be considered. The consideration that matters the most is the health, safety, and longevity of the person who was injured. All decisions should be made with this in mind. Communication amongst all major players in the rehab process will prevent gaps or overlapping roles and facilitate better outcomes long term.
8. Environment
Patience is an absolute necessity because setbacks are likely. No athlete will return to the field on a perfect timeline. Two steps forward and one step back is an expectation in some rehabs. Remember that when an athlete suffers an ACL tear (and subsequent surgery), they have been physically and psychologically injured. There will be fear, hesitation, and doubt. Coaches should create a challenging, but not overwhelming, environment for the athlete to rebuild their physical resilience and confidence. My golden rule for the psychological game is to make the player execute drills and skills in training so intense that there will be no doubt in their mind about their readiness when asked to step back on the soccer field. This takes time, trust, and safe, intelligent programming.
Have questions or want to know more?
TKO Athletic Performance specializes in early, middle, and late-stage ACL reconditioning programs.
Click here to book your free ACL consultation!
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