Let’s continue to stage 2 of ACL Rehab and discuss some of the general goals we set for the athlete through their rehab program. Stage 2 is usually where we see patients turn a corner for the better. They’ve regained most of their range of motion, their pain and swelling are gone (for the most part), they are walking more normally, and we can begin building up their strength again.
Here are the four key goals during stage 2 of ACL rehab:
1. Strength (including hips)
This stage is all about strength, strength, and more strength. We progress from double leg work, such as squats, to single leg work once appropriate. This is also where it is important to not only focus on the site of the injury but the entire athlete. Strengthening the quads and hamstrings is important, but so are the hips, the calves, and the core.
2. Active ROM
Range of motion work does not stop after stage I. Using active range of motion exercises helps the athlete to continue improving their motor control, strength, and usable range. These often include terminal knee extensions (TKEs) in many variations, hamstring curls, single leg squats, and 4-way hip strengthening.
3. Shock absorption
Strength allows the athlete to produce more force, but they also need to be trained to absorb that force, or else they are susceptible to re-injury. Hip strength plays a role here, as well as eccentric control. Once the athlete demonstrates good quad activation, nearly full range of motion, eccentric control (step downs, etc), and good balance, we can progress to shock absorption. This typically starts as one-to-one hops on flat ground, two-to-two 6-inch box jumps, two-to-one 6-inch box jumps, and one-to-one 6-inch box jumps. Once they have mastered the above and they have reached the 3-month mark, they can begin jogging.
4. SL stability
Single-leg exercises are critical to include throughout the rehabilitation process, as the majority of an athlete’s time is spent on one leg, and it is also when they are most vulnerable. There are many, many exercises to choose from here. Some of our favorites include SL straight-leg deadlifts, reverse lunges, split squats, Bulgarian split squats, step-ups, and step-downs. In this stage it is also important to perform all exercise on the uninjured leg, as well, to help prevent future injury.
If you missed our article on stage 1 ACL rehab goals, CLICK HERE.
Interested in the article on Stage 3 ACL rehab goals? CLICK HERE