Acl Injury Solutions

SPORTS INJURY INFO
ACL Injury Solutions
© 2009 Sports Injury Info

http://www.sports-injury-info.com
All Rights Reserved.

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This electronic book is intended for educational purposes only, and should not be used as a substitute for proper medical care. Only
your physician can diagnose your medical condition. Medical questions should be discussed directly with your health care provider.
Consult with your physician before starting any type of rehabilitation or exercise program.
A C L I N J U R Y S O L U T I O N S
INTRODUCTION ________________________________________________________________ 3
MOBILITY AND STRETCHING EXERCISES __________________________________ 8
STRENGTHENING EXERCISES _______________________________________________ 13
BALANCING EXERCISES ______________________________________________________ 29
JUMP TRAINING _______________________________________________________________ 33
CONTROLLED JUMPING ______________________________________________________ 40
EXERCISE PROGRESSION ____________________________________________________ 47
KEYS TO SUCCESS _____________________________________________________________ 49
MAINTENANCE PHASE _______________________________________________________ 50
CONGRATULATIONS! _________________________________________________________ 51
OTHER PRODUCTS FROM SPORTS INJURY INFO _________________________ 52
2
Introduction
ACL injury has become an epidemic among athletes both young and old alike. Just
take a look at any competitive girls sports team – you will, unfortunately, find one, two,
or even 3 or more young ladies who have suffered an ACL tear. Some have even had
multiple tears – all at ages as young as 14 or 15.
No matter the sport, the age level, or the area of the world, ACL injury has become a
way of life for many of our young athletes. And even worse than a single ACL injury is
the recurring ACL tear.
All too often I have visitors to Sports Injury Info tell their story of multiple ACL tears.
They share their experience of injury, surgery, rehab, return to sports, and then the
crushing second tear. And although their primary fear is whether they will be able to
return to sports again, what they cannot yet see is the major life changes that will occur
because of their knee injury.
These are young athletes who have the world before them, only to have their futures
changed in the blink of an eye. Early arthritic changes, impaired quality of life, and
eventually an early knee reconstruction are what await those who suffer from multiple
ACL tears.
This epidemic is not completely understood. Research into the contributing factors for
ACL injury is still unknown. There are theories regarding biomechanics, strength
imbalances, sports mechanics, playing frequency, and many other factors. The research
is increasing, but not quickly enough. As we wait for the scientists to gain more
knowledge, our young athletes are suffering.
While the research is not yet there, there are obvious areas that must be addressed
when it comes to treating and preventing ACL injuries. The primary areas are strength
and stability of the lower extremity and core, and the proper neuromuscular training
necessary to protect the ACL. These areas are readily treated, and are the focus of this
book.
While there is no way to completely prevent an injury, the programs outlined in this
ebook are designed to give your knee the best chance possible to avoid ACL injury,
and to keep you off the sidelines.
3
Who This Book Is For
You can email ACL Injury Solutions has been written with prevention in mind. The exercises you
me anytime at
will find throughout this e-book are designed to get your body into the best shape
possible to protect you from ACL injury. Prevention truly is the key.
barton@sports-
injury-info.com if
Whether you have been fortunate enough to have avoided an ACL tear up to this
you have
point, or if you are rehabilitating after ACL reconstruction, your ultimate goal is to
questions about
avoid injury, or re-injury. This book is meant for anyone who wants to avoid a
the material in first, or second, torn ACL.
this book
Retraining the Body

While all of the contributing factors of ACL injury are not known, there are many
ACL Injury
thoughts that one of the primary factors relate to your body’s ability to adequately
Solutions is
adapt to the stresses of sports. When talking about preventing ACL injury, this
designed with
means having the strength and the control to be able to avoid injury.
for those who
wish to prevent ACL Injury Solutions is broken down into two different types of exercises –
ACL injury, or exercises for strengthening and mobility, and exercises designed to improve
those recovering neuromuscular control. The first phase works to address any major imbalances
from ACL that your body may have, improving mobility and strength first. The second phase
reconstruction, focuses on retraining your body to improve control. Together, the two phases
at least 5 help create a much stronger and more stable knee.
months out from
surgery.
Hardware vs. Software
Be sure to clear
the exercises
with your doctor If you have read any of my other e-books, or the material on Sports Injury Info,
if you have had you know that I am a big proponent of rehabilitation. It is an essential part of
an ACL
both recovering from injury and preventing re-injury. Any type of exercise
program has to address both “hardware” and “software” problems in the body.
reconstruction
Let me explain.
Hardware is the actual physical qualities of your body – how strong your muscles
are, how mobile your joints are, and the mechanics of your feet and lower body.
Hardware problems are fixed through strengthening, stretching, and mobility
exercises.
Software is how your body runs the hardware. How efficient your body uses the
muscles and joints. Software is about how well your muscles work, rather than
4
how strong they are. Are the right muscles working at the right times? “Software”
also focuses on balance, control, and quality of movements.
In your computer, when the software doesn’t work correctly, then it doesn’t
matter how fancy or advanced your hardware is. The same is true about your body
– it doesn’t matter how strong you are if your muscles aren’t working in the most
efficient manner and doing their jobs correctly.
This is very true with ACL injury prevention. You can be as strong as possible and
yet still be susceptible to an ACL tear if your body isn’t working in an efficient
manner and if you can’t control your movements. Throughout this e-book I will
refer to both software and hardware problems, and how to correct them through
exercises.
Strength vs. Control

There is a significant difference between strength and control in the body.
Strength is necessary – having it means the muscles are able to do their jobs. But
without control, your strength is wasted. Many of the following exercises focus on
improving your muscle control – to make sure you are using the right muscles at
the right time. Think of strengthening as correcting the “hardware” and control as
improving the “software”.
Over time your body will create compensations to make life easier – these
compensations often lead to irregular muscle contraction patterns and eventually
cause problems. Exercises focusing on control help to get rid of these patterns
and to restore normal, efficient function.
Many ACL tears occur without any type of contact. How many times have you
seen or heard about someone who landed wrong or was cutting and tore their
ACL? There wasn’t any contact, the knee just gave out. Part of that is related to
control (a software problem). If the muscles are not able to control the knee, it
gets into positions that put the ACL at risk. A perfect example is control when
landing. ACL Injury Solutions will teach you how to control your landing and
keep your ACL safe.
5
Engaging the Core

Throughout this e-book, I will refer to engaging the core – this means that you are
going to be trying to make your body as stable as possible. The core is not just the
abdominal muscles. The core is everything in the center of your body – your hips,
abs, back, chest, and shoulders.
Your body is like a house. Your core is the stable, rock solid foundation that you
build upon. Every movement of your body must start with core stability, which
allows for a stable base to build the movements of your arms and legs on.
The more stable the foundation is, the stronger the rest of the house – the body is
the same. The more control you have in your core, the easier it is for your muscles
to move your arms and legs – leading to more efficient movements and more
stability.
Quality vs. Quantity

One last thing before we get started with the exercises – In order to train your
muscles to provide good control of your knee, you have to focus on the quality of
your movements.
A perfectly performed exercise is worth 100 poorly performed exercises. Make

sure that you are focused on your form for every single repetition that you
perform. It may mean you can only do three or four repetitions, but that will get
better as your control improves.
It takes time to retrain the body to function at its highest level. Improving your
strength, mobility, and most importantly, your control will take time. Be patient
and consider how much you have at stake when it comes to suffering an ACL
injury or re-injury.
NOW FOR THE EXERCISES.
6
At A Glance
ACL Injury Solutions is a comprehensive strengthening, balance, and mobility
program designed to create a strong, mobile, and well functioning body. The
program is divided into two primary phases, one addressing hardware problems
like mobility, flexibility, and strength, and the other addressing software problems
like balance, control, and muscle firing patterns.
In order to be effective, it is important that you work through the program in

order. You have to correct major hardware problems (like tight muscles or
mobility restrictions in your hips and core) before you can effectively improve
your control.
Phase I focus is on strengthening and balance. Phase II focuses on improving

muscle control and jump training. You must build a good foundation of strength
and balance before you progress to the jump training. In the exercise progression
you will find exercises listed as optional or recommended. Feel free to pick and
choose the exercises that you feel help you the most to achieve your goals.
Read through the exercises to get an idea of what you are doing. Then refer to the
exercise program to see which specific exercises to do, and when to do them.
Once you work through the 8 week program, then you can move to the
“Maintenance” phase which is a shorter version of the program designed to help
keep you in the best shape possible.
ACL Injury Solutions is designed for end phase rehabilitation after ACL
reconstruction and for prevention of ACL injuries. You should be at least 5
months out from your surgery before going through this program. And, be sure to
talk to your physician about the exercises to make sure you have been cleared to
perform them.
7
Mobility and
Stretching Exercises
Mobility and flexibility are important for athletes. With good mobility and
flexibility, your body is able to work the way it is supposed to. Your muscles can
move your joints, and you can control the position your knee is in. Good mobility
will also help to prevent other injuries like Patella Femoral Syndrome and
tendonitis.
I cannot stress enough how important good mobility is. If your joints don’t move
the way they are supposed to, then your body must compensate and create extra
movements at other joints. This means that it isn’t working the way it is meant to,
and can lead to the potential for injury. It also means that your muscles cannot
effectively control your knee, and that is our primary goal.
8
Active Hamstring Stretch

The active hamstring stretch is likely much different from the hamstring stretching
you are used to. I started using it with patients about 2 years ago, and I have seen
amazing results with it compared to traditional hamstring stretches.
Not only does it stretch your hamstrings, but it also helps to improve the mobility
of your hips (hardware) and the way your body moves (software).
This exercise has two versions, and requires some type of lift for the toes and
heels. A 2X4 board works well. If you don’t have a lift, you can perform these
exercises with your feet flat on the floor.
STEP 1: Place your heels on the board,

This position
feet together, and with a small diameter
may be
foam roll, or a rolled up bath towel
awkward, but try
between your knees.
to keep your feet
together when
STEP 2: Reach over your head with both hands – reach as high as you can, and
you are reaching try to feel a small stretch in your abdominals.
up
STEP 3: Bend over and
Remember to place your palms flat on the
keep your palms floor in front of your feet.
flat and your Bend your knees as much as
chest and thighs you need to in order to get
close together your palms flat. Your chest
and thighs should be very
close together.
STEP 4: Keep your palms

flat and lift your hips,
straightening out your knees.
You do not have to get your
knees straight. Just lift until
you feel a stretch. Hold for 2-
3 seconds.
STEP 5: Stand back up and reach over your head to start the stretch again
Do 5 repetitions with your heels up, then 5 repetitions with your toes up on the
board. You should feel a stretch in your hamstrings, calves, and glutes, and muscle
contraction in your quads.
9
Cross Over Stretch

The cross over stretch is designed to improve mobility in your upper and lower
back, as well as your hips. You may be surprised at how tight you are when you
perform this exercise – don’t worry, a few exercise sessions and you will improve.
STEP 1: Lay on your left side with your

knees bent to 90 degrees and your arms out
in front of you.
Make sure that STEP 2: Keeping your knees together and

you keep your touching the floor, reach your right arm
knees in contact back across your body, trying to touch your
with the ground right shoulder to the floor.
and are not
shrugging your STEP 3: Return to the starting position
shoulder as you
reach Repeat 6 times on each side.
You should feel a stretch in your upper back and torso
Expert Tips
If you find you have a hard time keeping your knees together and on the
ground when you perform this stretch, try rolling up a bath towel and
squeezing it between your knees.
10
Kneeling
K g Hip Flexor
F Sttretch
Balance
B betwween muscles is importantt. Many times the hip flexxors become very
tiight and this can lead to both
b softwarre and hardw ware problem ms in the bodyy. Think
about
a how much
m time youu spend eachh day sitting – with your hip
h flexors inna
shortened
s po
osition. As yo
our hip flexorrs become tigghter, this caauses the pelvvis to
tiilt, and leads to a shut do
own of the hiip muscles thhat help conttrol the femuur (a
MAJOR
M softw
ware problemm).
Use a The
T kneeling hip flexor sttretch helps to
t improve your
y flexibilitty – pay atten
ntion to
broomstic ck or the position of
o your pelvis during this exercise – itt should stay neutral and notn
small diam
meter rotate
r when you
y stretch.
PVC pipe to
t hold
onto for ba
alance.
STEP
S 1: Kneel on your right
r knee wiith your rightt foot up on the toes. Place your
leeft foot in lin
ne or just a liittle to the rigght of your riight knee.
You may have

h to
do this in front
f of
STEP
S 2: Keeeping your lo
ow back and hips inline, lean
l forward until you feeel a
a mirror thhe first
stretch
s in the front of youur right hip and
a leg.
few time es to
Hold
H the streetch for 2-3 seconds,
s relaax, and repeaat. Do 5 repettitions of 2-33
monitor your
seconds
s on eaach leg.
alignment.
You
Y should feel
f a stretch in the front of your hip.
11
© 2009 Sports
S Injury Inffo
Knee Wiggle
I know this exercise sounds funny, but it really works to improve your hip mobility and
control. Part of the problem with knee control is that most people aren’t aware of how
their hips are supposed to move.
The muscles that normally stabilize the hips have long since shut down. Before
Pay close
you can strengthen them you have to wake them up.
attention to how
much your hips
STEP 1: Step out on
move – squeeze
your right foot in a
your glutes and
slightly staggered
abdominals as stance. Place most of
you perform this your body weight on
exercise to keep your front leg.
everything
stable. STEP 2: Keeping
your hips square and
stable, push your knee
as far in to the left as
you can – don’t let
your knee go too far
forward over your
toes.
STEP 3: Wiggle your knee back and forth as far as you can right and left without
letting your hips move side to side.
Repeat 20 wiggles each direction on each leg.
You should feel contraction in your glutes and outside hip.
12
Strengthening Exercises
Strengthening of the muscles of the hips and core are the key focus for improving
your function and getting your body ready to work on improving your control.
The following exercises emphasize improving the strength and control of the
muscles that stabilize the femur and the knee
The majority of the exercises can be performed without any equipment at all. A
few of the exercises require the use of an elastic band or a stability ball. These
items can be found at most sporting good stores, or even at your local Walmart.
The exercises listed are not the only ones you can do to help keep your lower
body strong, just the ones that I have found to be most successful in improving
strength for preventing ACL injuries. Feel free to add in other exercises that you
enjoy to the program.
The strengthening exercises are the primary exercises for phase I of the program.
13
Trunk Rotations
The first exercise I am going to show you will help to get you to engage your core.
Proper form is
It will also help to improve mobility in your lower torso, shoulders, and hips. You
essential when
could call it a combination strengthening / mobility exercise.
performing the
trunk rotations.
STEP 1: Lie on your back with your arms out to your side, palms up, and your
You may only be
knees and hips bent to 90 degrees.
able to do a few
to start out with,
so make sure
that you are
keeping good
form and stop
when you can’t
maintain the
proper position.
STEP 2: Keeping
As you rotate
both shoulders flat
your knees
on the floor, rotate
toward the floor, your left palm down
push your hand and then let your
into the floor to knees rotate as far to
give your self the left as you can.
stability.
STEP 3: Continue to keep your shoulders flat and then pull your knees back to the
starting position. As you return, rotate your palm up again.
STEP 4: Repeat on the right side, remembering to rotate your hands and keep
your shoulders flat.
Repeat 10 repetitions on each side.
14
Core Engaged Leg Lifts (CELL)

The CORE ENGAGED LEG LIFT (CELL) is not an exercise to strengthen your
quads – the primary reason you are doing this is to get your core to engage while
the leg is moving. This is vital during activities. Regular leg lifts often fail to
adequately engage the core, so you end up training the quads to contract without
proper core stabilization – which compromises your control.
This exercise will change that – forcing your core to engage and creating the basis
for a stable foundation.
Expert Tips
You will be using the elastic band for several exercises, and you can find
them online or at your local sporting goods store – they are inexpensive
and a great tool for functional exercise.
To perform a CELL, the first thing you need is a elastic band – you can use a
piece of elastic tubing or an elastic band, or you can purchase an exercise cord
with handles.
For the CELL,
you need a band STEP 1: Lie on your back with your head toward the door, with each end of the
that is about 8 band in your hands.
feet long – tie a
knot in the STEP 2: Lock both of your legs out completely straight, pushing your knees flat
middle of the into the ground.
band or tube,
and then shut it
tightly in the top
of a door in your
home (give it a
good tug to
make sure it is
secure).
15
STEP 3: With your arms extended over your head and keeping your elbows
straight, pull the band down until your hands are touching the floor (don’t hook
them on your hips – that is CHEATING).
The CELL is a STEP 4: Keep both knees locked out straight, and then slowly lift one leg as far as
fantastic you can – stop lifting as soon as you feel either knee start to bend, or you feel your
exercise for
down leg start to rotate.
improving
You may lift 6 inches, or you may be able to lift all the way up to 90 degrees –
muscle control,
how high you lift does not matter – the key to this exercise is keeping your knees
core strength
locked out.
and stability, and
building quad
STEP 5: Lower your leg back
strength while
down and then let your hands go
stretching the
back up overhead.
hamstrings
actively. That is one repetition – now
repeat on the opposite leg. Repeat
2 sets of 6 on each leg.
Expert Tips
After this exercise, if you are doing it correctly you should feel like your
quads were working, as well as your core and lower abdominal muscles –
you may also have a stretched out sensation in your hamstrings – and
your arms may be tired as well – how’s that for a total body exercise!.
16
Side Lying Leg Lifts (SL3)

This exercise is not as functional or total body as the CELL, but it does help to
If your hip build gross strength in the hip abductors. I don’t use this one as much as others,
rotates and your but I think it is a good exercise to include.
toes point up,
you end up using
your hip flexor STEP 1: Lay on your
muscles instead side making sure that
of the abductors your hips are straight
– this is a up and down and your
compensation body is not curved.
and is
CHEATING!
STEP 2: Lift your top

leg about 8 inches off of
your lower leg. As you
lift, make sure that your
hip doesn’t rotate –
watch your toes and try
to keep them pointing
either straight out to the
side (parallel to the
floor).
STEP 3: Hold for 10 seconds, relax and repeat 1 set of 8 repetitions, holding each
repetition for 10 seconds.
Repeat on the other side.
Expert Tips
You can add ankle weights to this exercise to make it more challenging –
just make sure that you don’t rotate your leg. You should feel the muscle
burn in your glutes and outside hip, not in your hip flexor
17
Resisted Knee Wiggles

In the mobility warm up, you worked on waking up the hip muscles by doing knee
wiggles. Now you are going to add some resistance and start strengthening those
muscles
This exercise STEP 1: Place an elastic band around your legs, just below your knees.
relies heavily on
good form, so try STEP 2: Stand with your feet a little wider than your shoulders, and squat down as
it in front of a much as is comfortable. Keep your back flat and place your hands on your hips.
mirror to start
out with.
STEP 3: Let the elastic band pull your right knee in toward the middle of your
body and then push your knee back out to return to your starting position.
STEP 4: Alternate back and forth between right and left knees, keeping your hips
square and stable.
Repeat 10 repetitions on each side.
Expert Tips
This exercise should be done only after you master the Knee Wiggles.
Remember, you first have to wake the muscles up and get your hips and
knee moving correctly before you can start to strengthen them.
18
Elastic Band Walks

The next exercises are a great way to improve your hip strength and control – they
are one of my favorite exercises to use with patients – I do them myself in my
own workouts. However, the elastic band walks are probably the least favorite
exercises of most of my patients – they create a great muscle burn and are tiring –
but they work very very well. So, push on and do them – your knees will thank
you.
Make sure that Sideways Elastic Band Walk

you don’t bring
your feet too The first direction you will be going is sideways. Tie an elastic band into a circle,
close together. about two feet in diameter.
You should
maintain tension STEP 1: Place the band around your legs just below the knees and then step out to
on the band at the side so the band becomes taut.
all times.
STEP 2: Keeping your knees slightly bent, take a step to the side, and then step
with your trail leg.
Take 10 steps sideways, rest for 30 seconds, and then take 10 steps in the other
direction, leading with the opposite leg.
19
Expert Tips
As you get stronger, you can bend your knees more and squat down as
you are stepping sideways. At higher levels, this exercise should look very
much like a defensive slide in basketball (except that you are stepping and
not sliding, which is CHEATING).
As you work through the elastic band walks, make sure to pay attention to your
knees. Your patellas should always be pointing straight forward, or even a little bit
toward the outside. They should never, ever, be pointed in toward each other –
this is the position you want to avoid.
Forward Elastic Band Walk
The forward
elastic band
walk is similar to
the sideways STEP 1: Place the elastic band around your legs just
walk, just a below your knees and then spread your feet out a
different little wider than your shoulders to make the band
direction.
tight.
STEP 2: Keep the band tight, knees slightly bent, and

Try to keep your take a step forward with one foot, then the other.
hips square so Make sure to push your knees out as you step.
you are walking
forward rather
than waddling.
STEP 3: Take 20 steps total, 10 with each leg.
As with the sideways elastic band walks, you can

progressively bend your knees more and squat down.
Imagine the defensive basketball position as you work
through these exercises.
20
Lunges
Lunges are a great exercise that works on lots of muscles, both strengthening and
control. One caution about lunges – they can cause knee pain if you don’t perform
them correctly. I am going to show you the basic lunge in several directions. These
may not be the same lunges you remember from P.E. class – but they work
similarly.
Expert Tips
As you perform the lunges, make sure you concentrate on the position of
the knee. It should always be either directly over the toes, or slightly
toward the outside.
If you find the lunges to cause knee pain, try going a little less deep, or
concentrating on pushing your knee toward the outside as you lunge. Also,
pushing off from the heel rather than the toe may also help decrease your pain.
Anterior (Forward) Lunges
The anterior lunge is a forward step, and then a return to the starting position.
Try to keep your
You should only step out as far as you feel comfortable.
stance leg (the
one you are not
STEP 1: Step out with one leg, keeping your
stepping with) toes pointed forward.
straight. This
will force your STEP 2: Try to get your knee out over your
hip and quad toes, placing as much weight as you feel
muscles to work comfortable through your leg. Also, keep
harder to your body upright and don’t lean forward at
stabilize and the waist.
control your
knee. STEP 3: Push off with your heel and return
to the staring position
Perform 2 sets of 8.
21
Lateral (sideways) Lunges
The lateral lunge is sideways step, and then a return to the starting position. You
should only step out as far as you feel comfortable.
STEP 1: Step out to the side with one leg,

keeping your toes pointed forward.
STEP 2: Try to get your knee out over your

toes, placing as much weight as you feel
comfortable through your leg.
STEP 3: Push off with your heel and return

to the staring position
Rotation Lunges
Don’t Forget
The rotational lunge is a forwar lunge with a rotation of your upper body and
Your Form!
torso. You can do this with our without weight.
STEP 1: Step out with one leg, pointing your

toes in the same direction you are lunging.
All of the lunges STEP 2: Try to get your knee out over your
should be done toes, placing as much weight as you feel
without pain, or comfortable through your leg.
only very minor
discomfort. If STEP 3: As you reach the end of your lunge,
you do have rotate your body as far as you can over your
pain, try taking a lunge leg. Maintain upright posture.
shorter step, or
pushing your STEP 4: Push off with your heel and return
knee toward the to the starting position
outside.
The anterior lunges should be the easiest. The lateral lunges will place different
stresses on your knee. The rotation lunges will work different muscles in your hips
and core.
22
Squats
Body weight squats will strengthen your quads, hamstrings, hips, and core if done
correctly. Squats can also be one of the more difficult exercises to perform
correctly, especially if you have hip weakness. Being able to perform a squat
correctly will be very important once we get into the jump and landing training
later on in the program. So, focus on getting the squat right.
For this exercise we are going to be using an elastic band to improve the control
Doing squats in of the hip muscles. You may find that doing squats with the elastic band
front of a mirror significantly increases your stability almost immediately – this is not uncommon
so you can see and is a great example of how important the hip muscles are in keeping your knee
yourself from the stable.
side is a great
way to make
sure you
maintain good
form. Since I am STEP 1: Take the same elastic band you
not there to help used for the resisted knee wiggles and place
you, use a mirror it around your legs, positioning it just
until you get the below your knee.
feel for what a
good form squat
feels like.
STEP 2: Place your feet about shoulder
width apart and extend your arms out.
STEP 3: Pushing your knees out against

the band so that it becomes tight, slowly
lower your hips and squat down as far as
you can without pain.
STEP 4: Return to the starting position,

slow and controlled.
Repeat 2 sets of 8.
You should feel your quads working

during this exercise, but you should also
feel your outside hip muscles working, and
maybe even a little burn in the glutes
23
I cannot
Expert Tips
overstress the
importance of As you squat, try to keep your chest up high and your back flat. Your
good form with chest, knees, and toes should all be in a straight line above each other.
the squat. It is Don’t let your back curve, or bend over too far at the hips.
the basis for a
lot of athletic
activity, and it is
a core exercise .
that every single If you feel off balance with this activity, try pushing
patient I see harder against the band. As you get stronger and
goes through. gain better muscle control, you should be able to go
Once you get the lower and feel more balanced.
squat right,
everything else
If you feel like you cannot squat down without
falls into place.
feeling like you are going to fall over, try placing a
2X4 under your heels – this will change your center
of gravity and allow you to engage the core better,
and squat deeper.
As you get stronger and your hips start to

wake up, you will be able to squat without
using the elastic band. Once you can squat
without the band and still keep your knees in
a wide position over your toes, you have
mastered the squat and are ready to move on
to Rotation Squats.
24
Rotation Squats
So you mastered the squat, and you can do a deep squat without falling over.
Now it is time to add a little more challenge to the hips. Adding rotational
activities will challenge the hip muscles to maintain good stability and control of
the core and knee.
Try holding onto Squats with rotations are just like regular squats, except now you are going to
a small ball or rotate your upper body right and left as you squat. When you rotate your arms and
rolled up towel trunk, you force the hip muscles to engage to maintain balance and keep your
when you do the body stable. You also produce hip rotation, since everything is connected.
rotations.
Notice how the

knee stays in the
proper position
over the toes,
rather than
collapsing in
toward the
Squat down to about parallel (thighs parallel to the floor), and as you approach the
middle of the
bottom of your squat, rotate your arms as far as you can to the right.
body.
As you return to standing, rotate back to the center, then repeat the squat with
rotation to the left. This should be a fluid movement, timing the rotation and the
squat so that you are fully rotated at the bottom, and then return to center at the
top. Rotate right and then left – that is one repetition.
Repeat 2 sets of 8 repetitions.
Expert Tips
Pay attention to your hips – they should remain square and facing
forward as you rotate your arms and trunk. Also, make sure that your
knees remain over your toes or slightly toward the outside (the same
position you were working on with the elastic band squats).
25
Step Overs
Step overs are Step overs are a good exercise to work on hip control. They are much more a
difficult at first
control exercise than a strengthening exercise. The best way to perform step overs
is in front of a mirror. You need to be able to see what your hips are doing as you
because your
perform this exercise. The visual feedback will help you tune into the muscles –
hips are not
and since I am not there to help, a mirror works best.
used to working
in such a precise
way.
Sideways Step Over
STEP 1: Stand in front of a mirror and place a

As you lift and large book up on its end directly to the left of
step, watch your your body.
hips in the mirror
– they should
remain level the STEP 2: Put your hands on your hips and then
entire time. bend your knees slightly.
They should also
stay in the same STEP 3: Keeping your back flat, lift your left leg and step over the book, then lift
plane as you your right leg up and over, completing the step over.
step over –
meaning you
shouldn’t see
them move up
and down, and
they shouldn’t
tilt as you
perform the
exercise.
STEP 4: Lift your right leg and step back over, followed by your left – this
completes one repetition – repeat 8 times.
You should feel this exercise in your hips and quads.
26
Bridging
Bridging is a great exercise to work on improving your glutes and core stability.
There are several different bridging exercises in this section – the first focus on
waking up your glutes and getting your core stable – then you will progress to
bridging on a stability ball, and finally bridging with a hamstring curl.
Basic Bridging
You can place STEP 1: Lie flat on your

an elastic band back with your knees bent
around your
to 90 degrees, feet flat on
knees to
the floor. Arms are out to
your sides, palms up.
increase your
hip muscle
activity.
STEP 2: Squeeze your

glutes and lift your hips to
make a straight line
between your shoulders
and knees.
STEP 3: Hold for 10

seconds, pushing your
knees out against the
resistance of the band.
Repeat 2 sets of 8
27
Stability Ball Bridging
Your hands STEP 1: Lie on your back and

should remain by place your feet on top of a
your side, but stability ball. Your ankles and
you can use lower calves should be on the
them for balance ball.
when you first
start out.
STEP 2: Squeeze your glutes and

lift your hips to create a straight
line between your shoulders and
feet.
STEP 3: Hold for 10 seconds,

keeping your hips level and
maintaining your balance on the
ball
Perform 2 sets of 8
Expert Tips
You may have trouble staying balanced on the ball during your first few
tries. To increase your stability, move your feet so that the lower part of
your leg is also on top of the ball. As you get more stable, you can try
putting less of your legs on the ball.
Once you master the ball bridging, you can

add a hamstring curl to the exercise. Simply
bridge up and then pull your feet toward you,
letting the ball roll. Make sure to keep your
hips high and squeeze your glutes.
This is an advanced exercise that you should

only do once you can easily bridge and
maintain balance the full 10 seconds.
28
Balancing Exercises
Balance exercises are a great way to improve muscle control. They are often
overlooked when it comes to prevention programs. I believe they are an essential
part of any rehabilitation or prevention program – and if done correctly, they can
produce great results in improving your hip and core muscle control.
Start off with a simple single leg stance
Single Leg Stance
Keep your knee STEP 1: Stand next to a chair or table so that you
slightly bent as
can hold on if you need to. Place all of your weight
you balance.
on one leg, and then lift your opposite foot off of
the ground.
STEP 2: Maintain your balance, moving your arms as

much as you need to. Try to balance for 30 seconds
to start.
Perform 5 repetitions, balancing for 30 seconds

each.
29
Once you master the single leg stance, it is time to look at what your hips are
doing as you balance. So, back in front of the mirror – this time you are going to
try to maintain a level hip position.
Place your hands on your hips so you have a reference point for your hip level.
Place all of your weight on one leg, lifting the opposite foot off of the ground
about 3-4 inches – (don’t touch the lifted foot to your other leg – that is
CHEATING)
Notice in the
pictures how the Watch yourself in the
right hip is mirror and try to keep
higher than level your hips level as you
on the left and balance.
lower than level
on the right. You will see your body
fighting to maintain
your balance, and your
hips will tilt side to side.
The more you can

control your hips, the
more stable your knee is
going to be.
Expert Tips
Balance exercises are meant to challenge the communication between the

muscles and the joints. In order to get the most out of these exercises,
you should try to really fight to keep your balance. Don’t just put your
foot down and then start again. Move your arms, legs, body, etc to try to
fight from losing your balance. The more you fight it, the more your
muscles will work, and the better your balance will get.
30
Single Leg Stance – Backward Reach

Next come movements with your balance. The first is a reach with the opposite
leg. My patients called this the “Ballerina” I call it a single leg stance with posterior
reach – no matter what you call it, it helps improve your muscle control in your
hips, hamstrings, and core.
STEP 1: Start off by placing all of your weight on one leg, with your knee slightly
bent.
Focus your eyes

STEP 2: Keeping your back flat
and your head up slowly bend
on an object
forward at the waist and lift your
across the room
opposite leg out behind you.
to help keep
your head up and
Try to lift as far as you can,
maintain keeping your trunk and leg in
balance. line.
STEP 3: Return to the starting

position, but try not to touch
your foot down.
Repeat 6 repetitions, then switch

to the opposite leg. Repeat 2 sets total on each side.
Expert Tips
Stop lifting when you feel like you are not in alignment anymore, or when
you feel like you are losing your balance. You may want to try this one in
front of a mirror to monitor your form. You can also hold onto a chair
for balance in the beginning.
31
Single Leg Stance – Sideways Reach

My favorite balance activity is the next exercise. I think it is the best way to
improve hip control, and it is very challenging exercise. It is easy to cheat on this
one, so make sure you follow the instructions closely.
It is helpful to have a line on the floor for this exercise. You can use a seam in the
tile, a long piece of tape, or a string laid out on the floor.
Bend your knees STEP 1: Place both heels on the

as you reach, line, with the line extending to your
and use your right and left. Lift your left foot off
arms and upper of the ground and balance on your
body to counter right
balance.
STEP 2: Reach out as far as you can
to your right along the line, crossing
behind your stance leg and rotating
your hips.
STEP 3: Once you get as far out as

you can, try to get your foot within
1 inch of the floor, but don’t actually
touch the floor.
Return to the starting position,

repeat 8 times.
Switch to the other side and do 6

repetitions, then repeat 2 sets total
on each side.
You should feel this exercise in your

quads and in your hips and glutes.
Expert Tips
If you have trouble keeping your balance with this activity, try reaching a
shorter distance, or pushing your knee toward the outside of your body
as you reach. As your control and strength get better, you will be able to
reach farther and farther.
32
Jump Training
Remember, Up to this point, some of the exercises are probably familiar. Maybe a bit different
strength of the than the ones you have seen before in rehab or in your sports strength training
muscles is only programs. If you work through all of the exercises listed so far, you likely have
part of the ACL significantly improved your lower body mobility, flexibility, and strength.
injury prevention
key – the rest is
Now that we have a stable foundation to work from, with hips and core muscles
that are doing their job, we can work on improving all of the remaining software
making sure that
problems and teach your body how to protect your knee and ACL.
your muscles
use that
strength
The following exercises are designed to improve your ability to control your body
correctly.
as you jump and land. By creating good muscle firing patterns, and improving
your reaction time and position sense, you will have more control of your knee.
The Jump Training portion of the ACL Injury Solutions program focuses on
quality of movement: Two things to keep in mind as you move through this
phase.
1) Always try to land as soft as possible. The best way to achieve this is to
make sure that you are bending your knees as you land, and that you are
landing on your toes and then your heels. Never land flat footed!
2) Pay attention to the position of your knees. Just like with the lunges and
squats, it is important to keep your knees in a good position. This means
directly over your feet, not letting them cave in toward the middle of your
body. Remember that squat position – that is what you want to achieve
when you land – knees bent, back flat, chest and toes inline.
Expert Tips
If you are rehabbing from an ACL reconstruction, make sure that you
have been cleared by your physician and rehab clinician to start jumping
before you move into jump training. Different physicians have different
timelines that they use to determine when jumping is appropriate after
ACL reconstruction. Follow their timelines and their guidelines!
33
Functional Warm Up
Be sure that you Returning to running can be challenging after an ACL reconstruction. One way
are cleared by
you can improve this is to start with a Functional Warm Up program before you
start running. The Functional Warm Up exercises are designed to improve your
your physician to
coordination and to work on movement patterns that may be awkward.
start any type of
running/jogging
If you are ACL injury free and are working on preventing injury, the Functional
activities. Follow
Warm Up is a great warm up activity, and can help to improve form and balance.
the timelines Remember, the key is improving control and coordination.
they set for your
recovery!
Skips
Think back to elementary school and PE class. Skipping is
light and fun. And that is how you should approach it. Just
skip down the sidewalk, the court, etc. Land soft and try to
make as little noise when you land as possible. Try 3 sets of
20 skips.
High Skips
This is just like a regular skip, but you try to get your knees
as high as you can when you go up. Remember to try to land
as soft as you can. Try 3 sets of 20 high skips.
Walking Lunges
This is an anterior, or forward lunge repeated on the right
and left sides, one right after the other. Make sure to keep
good form, with your knee over your toe, back flat and
chest tall. Try 2 sets of 5 lunges on each side.
34
Lateral Slides
Keep your knees bent and your hips level, and then slide your feet side to side.
Think of this like a basketball defensive drill. Don’t bring your feet close together.
Do 3 sets of 20 slides each direction.
Carioca
This is a grapevine or lateral step over drill. Start by crossing
your right foot over in front of your body, and then stepping
with your left foot. Repeat the crossover as you move down
the floor. Focus on swiveling your hips as you cross over.
Try 3 sets of about 120 feet.
Walking Rotation Lunges

This is similar to the walking lunges, although now you are
going to add a rotation, just like with the rotation lunges in
the strengthening exercise section. Make sure to time your
rotation so that you are fully rotated at the end of the lunge,
then alternate back and forth between right and left. Try 2
sets of 5 lunges on each side.
35
Back Pedal
Back pedaling is like running backwards. When you perform this exercise, try to
reach out as far as you can with your feet, touching your toes down first. Try 3
sets of about 120 feet.
Expert Tips
The Functional Warm Up can be awkward at first but the more you
perform these exercises the easier they get. Resist the urge to just start
back into running. After a week or two of doing the Warm Up exercises,
running will be much easier.
36
Jump Rope
Jump rope is one of the best exercises to begin to train your body to improve
muscle control. After an ACL reconstruction, it helps to condition your body to
begin to accept ballistic movements. For prevention, it helps to improve control,
coordination, and muscle firing patterns. I use jump rope as an early activity with
patients long before I begin them on actual jumping or hopping activities.
Expert Tips
The jump rope exercises are listed in order of difficulty. You should try
to do each one, and then increase the number of sets and time for each
exercise
Singles
Remember, land
Singles refer to how many times the rope passes as you jump. For each turn of the
rope, you will jump once.
soft and stay on
your toes!
STEP 1: Keep your weight even between both feet. You should spend most of
your time on your toes.
STEP 2: Swing the rope, and jump once every time the rope goes around
STEP 3: Try to get as many consecutive jumps in as you can for 1 minute. Don’t
worry if you mess up, just start again until the minute is over.
Repeat 2 sets
37
Doubles
Most people can
either do singles
Doubles refer to how many jumps you do each time the rope goes around.
or doubles very
well, but not
STEP 1: Keep your weight even between both feet. You should spend most of
both– changing
your time on your toes.
the timing will
help to improve
STEP 2: Swing the rope, and jump twice every time the rope goes around. One
your jump should be over the rope, and the second should be slightly smaller, keeping
coordination. time as the rope comes around again. You will swing the rope slightly slower than
with the singles.
STEP 3: Go for 1 minute. Don’t worry if you mess up, just start again until the
minute is over.
Repeat 2 sets
Alternating
Alternating feet is the hardest jump rope exercise to perform. It takes some
concentration to get the timing right. But, once you master it, it will make a huge
difference in your overall muscle control.
STEP1: You will be jumping on each foot separately with alternating jumps. Start
with one foot on the ground, the other lifted off the floor. You should spend
most of your time on your toes.
STEP 2: Each time the rope swings around, jump from one foot to the other. This
closely resembles running in place.
STEP 3: Go for 1 minute. Don’t worry if you mess up, just start again until the
minute is over.
Repeat 2 sets
38
Quick Feet with Elastic Band

This exercise is another great way to improve your coordination and condition
your body to start to accept ballistic activities. It is also a great hip strengthening
activity.
STEP 1: Get into a good squat position with

a light resistance elastic band tied in a circle
around your ankles. Remember, knees bent,
back flat, feet facing forward.
STEP 2: Maintaining a good squat position,

chop your feet up and down as fast as you
can. Try staying on your toes and keeping
the rest of your body still.
STEP 3: Continue chopping for 20 seconds,

then rest
Repeat 3 sets.
39
Controlled Jumping
Jumping is one of the hardest things to return to after an ACL reconstruction.
And for those who haven’t had an ACL injury, it is often one of the biggest areas
of risk. With this in mind, we are going to go through some pre-jumping exercises
to help train your body’s coordination and to improve your jumping technique.
Line Jumps
Line jumps are done for speed and quickness. The idea is to move as fast as you
can, maintaining accuracy and a soft landing. They should be done primarily on
your toes.
Don’t try to jump Forward Line Jumps

high. Focus on
speed and soft STEP 1: Place a piece of tape about 12 inches long on the floor. Stand with your
landings on your feet together with your toes at the edge of the tape.
toes!
STEP 2: Jump forward and then back over the line as quickly as you can,
continuing for 20 seconds.
Repeat 2 sets
Sideways Line Jumps
STEP 1: Place a piece of tape about

12 inches long on the floor. Stand
with your feet together with your right
foot along the tape.
STEP 2: Jump sideways over the line

and then back as quickly as you can,
Repeat 2 sets.
40
Line Hops
Hops are more Line hops are also done for speed and quickness. This is the next step in the pre-
demanding, so
jumping exercises, transitioning to just one foot. Make sure to perform on both
make sure that
sides.
you can
successfully Forward Line Hops
perform the line
jumps before you STEP 1: Place a piece of tape about 12 inches long on the floor. Stand on one foot
go to the hops. with your toes at the edge of the tape.
STEP 2: Hop forward and then back over the line as quickly as you can,
Repeat 2 sets
Sideways Line Hops
STEP 1: Place a piece of tape

about 12 inches long on the floor.
Stand on one foot with the outside
of your foot along the tape.
STEP 2: Hop sideways over the

line and then back as quickly as
you can, continuing for 20
seconds.
Repeat 2 sets
Expert Tips
As you perform the line jumps and hops, try to keep the rest of your
body stable. You shouldn’t have a lot of motion at the hips or flailing
your arms as you jump or hop. If you do, you likely need to work on the
strengthening exercises some more to improve your core stability.
41
Jumping For Accuracy

One of the problems with jumping and landing that can result in injury is a lack of
control of the body. By practicing jumping for accuracy, you can train the body to
control itself and absorb the stress of landing.
Dot Drills
Try to land as STEP 1: Space four pieces of tape out on the floor in
soft as you can the shape of a square, about 24-36 inches apart. Place
when you one additional piece in the center.
perform the
jumping STEP 2: Stand on any corner dot with both feet
exercises facing forward and follow the arrow, jumping to the
next dot. Try to land exactly on the dot with your
toes
STEP 3: Continue following the arrows, jumping to

each dot until you go through the pattern 2 times
Expert Tips
The key to jumping exercises is to make sure that you are bending your
knees both before you jump and when you land. By loading and
unloading the leg you are teaching your muscles to control your
movements, making you more stable.
Follow the arrows in the patterns below for your jumping drills. Go through each
pattern 2 times
ALWAYS FACE THE SAME WAY SO THAT YOU ARE JUMPING IN DIFFERENT
DIRECTIONS FOR EACH PATTERN.
42
Box Jumps
It is important that you teach your body to absorb the stress of landing, and the
best way to do that is to bend your knees. But trying to think about bending your
knees is sometimes hard. So instead, try to land as soft as possible. This will force
your body to absorb the stress and to bend your knees.
Make sure that STEP 1: Stand on top of a box (9-12 inches) or a step
you try to land
with your feet together
as soft as you
can, bending
STEP 2: Bend your knees and then jump forward off of
the box onto the floor
your knees to
absorb the
STEP 3: Land as softly as you can, bending your knees to
stress
absorb the stress
Repeat 2 sets of 8 repetitions
Box Jumps (Up)

STEP 1: Stand in front of a box (9-12 inches) or step with
your feet together
STEP 2: Bend your knees and jump up onto the box or

step
STEP 3: Land as soft as you can, bending your knees to

absorb the stress
Repeat 2 sets of 8 repetitions
Expert Tips
You can use a box, or a step to do these exercises. Start off with a low
box or step and then progress to higher boxes – the box in the pictures is
12 inches high – I start my patients with a 6 inch box and then progress
from there.
43
Hopping
Hopping is performed on one leg only. Hopping for accuracy and speed are two
ways you can improve your ankle function. Hops should only be performed once
you are able to do all of the jumping exercises.
Hops for Accuracy
Focus on landing STEP 1: Using the same dots from the jumping drills
directly on the above, stand on one foot on a corner dot.
dots with your
toes. STEP 2: Follow the arrow, hopping on one foot to
the next dot.
STEP 3: Continue following the arrows, hopping to

each dot until you go through the pattern 2 times
Hops for speed

should be
performed after
you can
accurately hop
through all of the
dot patterns.
The exercise is
the same but
now you are Expert Tips
focusing on
moving from dot Hopping for accuracy is a great way to improve coordination as well as
to dot as fast as your leg strength and endurance. Don’t worry about how fast or high you
you can, still can hop, just try to land directly on the dots with your toes.
maintaining your
accuracy.
Hops For Speed
Once you master the hops for accuracy, you can progress to hops for speed. The
exercise is identical, moving through the patterns just as you did before, although
this time you are trying to go as fast as you can with good form and accuracy.
44
Leg Circuit
The leg circuit is a set of four exercises that are done one right after the other.
They focus on improving strength, control, landing and jumping technique, as well
as endurance. They are not easy. In fact, you may struggle to get through one full
circuit. Don’t worry through – work your way up to being able to do three perfect
circuits and you will be doing great.
Squats
Make sure to STEP 1: Stand with your feet about

maintain good
shoulder width apart, arms extended in
knee position
front of you, or with your hands behind
your head
with your squats
STEP 2: Squat down, maintaining good

form (see squat exercise)
STEP 3: Return to the starting position

and repeat 10 repetitions as quickly as
possible keeping perfect form.
Go immediately into
Jump Lunges
Try not to stop STEP 1: Start in a lunge position, with one foot in front of the other, front knee
as you land – slightly bent, back flat and chest upright.
make a smooth
transition,
STEP 2: Lower your body into the lunge and then jump up, switching your feet so
loading your legs
you now have the other foot forward.
as you land and
STEP 3: As you land, drop down into the lunge and then jump up, switching
again.
then explode up.
Repeat 20
repetitions, 10 on
each leg as quickly
as possible keeping
perfect form.
Go immediately
into
45
Step Up Jumps
If you cannot STEP 1: Start with one foot on top of a 6-9 inch step, the other foot on the floor.
maintain good
form throughout STEP 2: Lower your body on your down leg and push off to jump up and switch
the circuit, your feet, placing your other foot on the step.
reduce the
number of STEP 3: As you land, lower yourself onto your down leg and then jump up,
repetitions for
switching again.
Repeat 20 times, 10 times each leg, as quickly as possible keeping perfect form.
each exercise
Go immediately into
Squat Jumps
STEP 1: Start with your feet shoulder

width apart, arms out in front or
overhead.
STEP 2: Squat down to parallel,

keeping good form.
STEP 3: Explode out of the squat,

jumping straight up with your arms overhead
STEP 4: Land softly, bending your knees and squatting down to prepare for the
next jump.
Repeat 10 times
That is one circuit. As your strength, balance, and endurance improves, try to do 2
and then 3 circuits, resting for 1 minute in between each.
46
Exercise Progression
The exercises listed so far in ACL Injury Solutions have focused on improving
If you have had
strength, mobility, and muscle control in the lower body, hips, and core. They are
an ACL
the same exercises that I have used with dozens of ACL reconstruction patients,
reconstruction,
and dozens of patients who are working to prevent ACL injury.
make sure you
follow your The exercise program for ACL Injury Solutions is broken down into two phases –
physician’s a strengthening and balance phase, and a muscle control phase. Each phase should
guidelines and be done in order, and you should only progress to phase II once you are
timelines for comfortable with the phase I exercises. For most people, phase I should take
your recovery. about 4 weeks to complete and successfully master all of the exercises.
The total 8 week program is designed to give your body the best chance to
prevent ACL injury – whether you are returning from an ACL reconstruction, or
are working to prevent ACL injury. The timelines are only a guide – it may take
you longer to get through each phase, or you may go through faster. They key is
to listen to your body and let it tell you when you are ready to progress. You
should do at least 10 sessions of exercises within each phase – if you are going 2-3
times a week, this averages out to about 4 weeks per phase.
Remember, the majority of ACL injuries occur because the body is unable to
control the position of the knee during activity – and that is usually because of
strength imbalances and lack of muscular control. This program is specifically
designed to help fix those problems.
The following page lists the exercises within each phase of the program. Follow
the recommended sets and reps as listed in the exercise descriptions. Both phase I
and Phase II exercises should be performed 2-3 times a week. If you have
soreness or pain, you may be doing too much, so take a couple days of rest and
then resume.
Expert Tips
Exercises are listed as recommended or optional on the following page in

the exercise program. I have tried to put together a program that not only
addresses all of the needed areas, but that also doesn’t take too long to
perform. Some exercises are listed as optional during phase I or II – feel
free to perform them if you have time, but they are not absolutely
necessary.
47
X=recommended O=Optional
Notice there are Mobility Exercises Phase I Phase II
not a lot of Active Hamstring Stretch X X
“strengthening”
Cross Over Stretch X X
exercises that
carry over to Kneeling Hip Flexor Stretch X X
phase II. This is Knee Wiggle X O
because the Strengthening Exercises Phase I Phase II
jump training
Side Lying Leg Lifts (SL3) X O
activities are
Core Engaged Leg Lifts (CELL) X O
great
strengthening Trunk Rotations X O
exercises. Step Overs X O
Resisted Knee Wiggles X O
Basic Bridging X O
Anterior Lunges X O
Squats X O
Lateral Elastic Band Walks X X
Rotation Lunge X
Forward Elastic Band Walks X
Ball Bridging O
Rotation Squats O
Balancing Exercises Phase I Phase II

Single Leg Stance X O
Single Leg Stance In Mirror X O
Single Leg Stance – Backward Reach X
Single Leg Stance – Sideways Reach X
Jump Training Phase I Phase II

Functional Warm Up O X
Jump Rope O X
Quick Feet with Elastic Band O X
Forward Line Jumps O X
Sideways Line Jumps O X
Jumps for Accuracy X
Forward Line Hops X
Sideways Line Hops X
Box Jumps X
Leg Circuit X
48
Keys To Success
There are a lot of different things that can contribute to possible ACL injury.
Unfortunately there is no way to completely prevent this injury. There are some
things that you can do to help maximize your success with this program and to
give your knee the best chance to avoid injury...
TAKE YOUR TIME

Working through each of the phases and really focusing on your form will help
ensure success. Don’t rush through the program – it takes time to improve your
muscle strength and control.
FOCUS ON FORM
Quality exercises and movement will always be better then quantity. So, for every
exercise, make sure your form is perfect. This is especially true with the jump
training exercises. You MUST focus on soft landings, and controlling your body.
That is the key to protecting your knee.
LISTEN TO YOUR BODY

The body is an amazing machine – and it knows when it is being overstressed. If
you have muscle soreness or pain, cut back on the frequency of your program, or
take a few extra days of rest.
LISTEN TO YOUR DOCTOR

If you are recovering from an ACL reconstruction, please make sure to clear your
activities with your Doctor before beginning anything new. This program is
designed for those athletes who have been cleared for most activities – it is
designed to help bridge the gap between supervised physical therapy and return to
play – generally occurring 5-6 months after surgery.
49
Maintenance Phase
The maintenance phase of ACL Injury Solutions is designed to provide continued
training once you have worked through the full 8 week program. It incorporates
just a few of the many exercises described in the book. It is a guideline, not an
absolute. Feel free to pick and choose among the exercises that you feel help you
the most.
The maintenance phase is also designed to not take up a lot of time. So, it consists
primarily of stretching and warm up activities, as well as a few great exercises. Use
it as a warm up or cool down program combined with your regular work outs.
X=recommended O=Optional
Maintenance Phase
Functional Warm Up X
Active Hamstring Stetch X
Kneeling Hip Flexor Stretch X
Jump Rope X
Leg Circuit X
Elastic Band Walks (forward and lateral) O
Quick Feet with Elastic Band O
Single Leg Stance - Sideways Reach O
Expert Tips
It is important to continue to train the body to maintain control and

strength. So, even once you work through the entire 8 week program,
make sure you continue with the maintenance exercises at least once a
week to maintain your strength, balance, and control.
50
Congratulations!
You made it through the entire program. Hopefully, you feel like you have a much
stronger, stable, and safer body. I wish you the best of luck with your continued
safe sports activities.
ACL tears have become an epidemic in the United States, especially with our
young athletes. While all of the possible factors of injury are not known, there are
things that you can do to make sure you are as safe as possible. This program is
one way to help protect your knee.
I have seen countless ACL injury patients in my 10 plus years of athletic training
practice. Each one was a unique case, and each one handled their injury
differently. All of them were able to return to their sports participation, and thus
far, I have never had a patient re-tear his or her ACL. Part of that is due to the
exercise program and one on one care they received. But part of that was also the
learning process that they went through with their injury.
If you or someone you care about has suffered an ACL injury, either currently or
in the past, I would strongly recommend you take the time to read
“WARRIOR GIRLS: PROTECTING OUR DAUGHTERS AGAINST THE INJURY

EPIDEMIC IN WOMEN’S SPORTS”.
BY MICHAEL SOKOLOVE
It is an eye opening, well researched documentary on the prevalence of ACL

injury among female athletes. It also gives some great insight into how to prevent
these devastating injuries, and what we can do as parents, coaches, and athletic
trainers to help protect our young athletes.
Reducing the risk of ACL injury is possible – you have taken a major step with
your completion of the ACL Injury Solutions program. I hope you continue to
enjoy safe sports.
Best,
51
Other Products From

Sports Injury Info
You can find a ton of great, free information on the website including articles on
anatomy, specific sports injuries, and rehabilitation techniques.
I also offer several e-books designed to provide you with more detailed
information for specific sports injuries. These e-books are your step by step guide
for treating your injury, and can help you stay on the right track for a full recovery.
Check out the products below for more information
The Athletic Trainer’s Corner

This free monthly newsletter keeps you up to date with the
latest sports injury information as well as updates to the
website. Subscribers receive discounted rates and early bird
access to all of the products offered by Sports Injury Info
Ankle Sprain Solutions

The complete guide to treating your ankle sprain. From injury
all the way to back on the field, this downloadable ebook will
teach you everything you need to know for a full recovery
from your sprain.
Patella Femoral Solutions

The key to successfully treating patella femoral solution and
knee pain is a good exercise program that focuses on hip and
core strengthening and control. This e-book will give you
exactly what you need to treat your knee pain in the comfort
of your home, without costly doctor or therapy visits. Isn’t it
time your knees stopped hurting?
For more information on Sports Injuries, visit Sports Injury Info
52

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ACL Injury Solutions

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Who This Book Is For

Retraining the Body

Strength vs. Control

Engaging the Core

Quality vs. Quantity

A perfectly performed exercise is worth 100 poorly performed exercises. Make

NOW FOR THE EXERCISES.

In order to be effective, it is important that you work through the program in

Phase I focus is on strengthening and balance. Phase II focuses on improving

Active Hamstring Stretch

STEP 1: Place your heels on the board,

STEP 4: Keep your palms

Cross Over Stretch

STEP 1: Lay on your left side with your

Make sure that STEP 2: Keeping your knees together and

You should feel a stretch in your upper back and torso

You may have

Repeat 20 wiggles each direction on each leg.

You should feel contraction in your glutes and outside hip.

Repeat 10 repetitions on each side.

Core Engaged Leg Lifts (CELL)

Side Lying Leg Lifts (SL3)

STEP 2: Lift your top

Repeat on the other side.

Resisted Knee Wiggles

Repeat 10 repetitions on each side.

Elastic Band Walks

Make sure that Sideways Elastic Band Walk

Forward Elastic Band Walk

STEP 2: Keep the band tight, knees slightly bent, and

As with the sideways elastic band walks, you can

Anterior (Forward) Lunges

Lateral (sideways) Lunges

STEP 1: Step out to the side with one leg,

STEP 2: Try to get your knee out over your

STEP 3: Push off with your heel and return

STEP 1: Step out with one leg, pointing your

STEP 3: Pushing your knees out against

STEP 4: Return to the starting position,

You should feel your quads working

As you get stronger and your hips start to

Notice how the

Repeat 2 sets of 8 repetitions.

STEP 1: Stand in front of a mirror and place a

You should feel this exercise in your hips and quads.

You can place STEP 1: Lie flat on your

STEP 2: Squeeze your

STEP 3: Hold for 10

Stability Ball Bridging

Your hands STEP 1: Lie on your back and

STEP 2: Squeeze your glutes and

STEP 3: Hold for 10 seconds,

Once you master the ball bridging, you can

This is an advanced exercise that you should

Start off with a simple single leg stance

Single Leg Stance

STEP 2: Maintain your balance, moving your arms as

Perform 5 repetitions, balancing for 30 seconds

The more you can

Balance exercises are meant to challenge the communication between the