ACL Recovery Exercises 9 to 12 Months Post Op

by Rashida Bealin ACL and Meniscus Surgery, monthly updateson Posted on

In this article, I will share a few of my ACL recovery exercises for 9 to 12 months and beyond. I still do many of them today. To see the exercises I did for 4-6 months, head to my previous blog. Please keep these things in mind before reading:

  • I had ACL reconstruction and meniscus repair in April 2018, a partial meniscectomy in May 2019, and a partial meniscectomy in September 2022.
  • I am NOT a professional of any type (not a doctor, PT, strength coach, etc.) This information is based on MY recovery.
  • Every rehab is different. You may be on a different timeline or receive different instructions than I did.
  • This list does NOT include every single exercise I did. I continued several exercises shown in the blogs and videos from previous months.
  • I did very similar exercises for my meniscus trims, just on a much quicker timeline. They may work well for rehab from several different types of knee injuries.

My ACL Rehab Videos

SL Leg Press (regular and Isometric)

Leg press was a staple throughout many stages of my recovery, including this last part. I used the leg press machine to complete regular repetitions, but also for isometric and eccentric work. By this part of rehab, I often focused on single-leg leg press.

  • Requirements: adequate strength on the affected leg
  • Purpose: strength
  • Muscles Targeted: quads, glutes
  • Timeline in recovery: 3 months+
  • Approximate reps/sets: 3-10 depending on the style and weight used
  • How to add difficulty: Add weight, hold in the bent position, add eccentric movement

SL Step Up Isometric Hold

To help strengthen my quad without irritating my knee as much, I implemented many isometric movements. For this one, I put a very heavy weight on the bar, so heavy that I could not actually move it. Then, I planted on leg on a box and pushed with all my force as if I was stepping up a stair. In reality, I would not move the weight, but I would emit a lot of force trying to.

  • Requirements: adequate strength in legs and core
  • Purpose: strength
  • Muscles Targeted: quad, glutes, calves
  • Timeline in recovery: 6 months+
  • Approximate reps/sets: hold for 5-10 seconds and do 1-2 reps each leg. Repeat 3-4 times.
  • How to add difficulty: Hold the isometric portion for longer, add more sets

Eccentric Pistol Squat

Pistol squats were incredibly helpful strengthening and SL control exercises. Sometimes, I sat on a box or bench to do them. However, to strengthen in a greater range of motion, and work on eccentric strength, I often used this variation. I attached a large workout band to the squat rack/pullup bar. I held the band while slowly doing down into a pistol squat. Then, I exploded up as fast as possible.

  • Requirements: SL strength and balance
  • Purpose: eccentric strength, SL control
  • Muscles Targeted: quads, glutes, hamstrings
  • Timeline in recovery: 8+ months
  • Approximate reps/sets: Go down for 3-7 seconds, repeat for 6-10 reps, repeat for 3 sets.
  • How to add difficulty: Smaller assistance band, slower eccentric movement, add weight.

BB Pistol Squat

Another pistol squat variation I described. I would perform a single-leg pistol squat onto a bench or box. Again, I would control my movement down and then try to push up quickly. Adding a barbell helped challenge my core and increase leg strength with this exercise.

  • Requirements: SL strength and balance
  • Purpose: eccentric strength, SL control
  • Muscles Targeted: quads, glutes, hamstrings
  • Timeline in recovery: 8+ months
  • Approximate reps/sets: Go down for 3-7 seconds, repeat for 6-10 reps, and repeat for 3 sets.
  • How to add difficulty: Add more weight, increase reps, go down slower

Pistol Squat Jump

To add power to the pistol movement, I added a jump. This helped work on explosiveness/power, but also some landing mechanics on the way down. Repeating it several times can also induce some cardio work and muscle stamina. Essentially, I would perform a pistol squat onto a box. When standing back up, I would push up into a single-leg jump. As I landed, I would eccentrically start to go down again into the next rep. I often held a small weight or medicine ball while doing this.

  • Requirements: SL strength and balance, sufficient power, ability to jump and land on one leg
  • Purpose: power, explosiveness, landing mechanics, eccentric strength
  • Muscles Targeted: quads, glutes, hamstrings
  • Timeline in recovery: 9 months+
  • Approximate reps/sets: 6-10 reps, 3 sets
  • How to add difficulty: jump higher, use heavier weight, pause on the landing, more reps

BB Split Squat

Barbell split squats were essential throughout my entire recovery. I continued doing these at this stage, often with heavier weights or other variations to make them harder. For this, I would place a barbell on my back. Then, I’d unrack the weight and move my feet into a split squat position. From there, I’d go down into a single-leg squat, and then back up.

  • Requirements: SL strength and balance, sufficient core strength
  • Purpose: strength
  • Muscles Targeted: quads, hamstrings, glutes
  • Timeline in recovery: 6 months+
  • Approximate reps/sets: 3-10 reps, 3 sets
  • How to add difficulty: Add weight, go down slower, pause at the bottom, increase reps

Band Pull Through

The band pull-through exercise was a helpful strategy for improving hamstring strength and power. Tie a large exercise band to a secure object (squat rack, post, pole, etc). Stand facing away from the object, holding the band between your legs with a slight bend in your knees. As you stand up straight, push your hips forward and pull the band through as well.

  • Requirements: full weight bearing, adequate balance,
  • Purpose: hamstring activation, hamstring strength
  • Muscles Targeted: hamstring, glutes
  • Timeline in recovery: 6 months+
  • Approximate reps/sets: 10 reps, 3 sets
  • How to add difficulty: Thicker band, faster/more explosive movement, additional sets.

Landmine Squat

The landmine squat is a great variation for improving explosion. I placed a weight on a barbell and laid it against a squat rack. I held the barbell on the side with the weight, and the other side pushed against the sqaut rack. Facing the squat rack, held the end of the barbell at my chest. I went down into a squat, and then exploded up into a calf raise.

Pro tip: Push the barbell above your head as you stand up for a full-body movement!

  • Requirements: adequate strength and coordination
  • Purpose: strength, explosiveness
  • Muscles Targeted: quads, hamstring, glutes, calves
  • Timeline in recovery: 9 months+
  • Approximate reps/sets: 6-10 reps, 3 sets
  • How to add difficulty: Add more weight, incorporate arms with a press-up, add reps/sets

SL Landmine Squat

A variation to the landmine squat is the singe-leg landmine squat. For this, set up the bar the same way. Instead of facing perpendicular to the bar, stand parallel to it. Slightly lean into the bar as you lower down into a split squat with a slight curtsy. Push off the front leg to stand up with the weight.

  • Requirements: SL strength and balance, coordination
  • Purpose: strength
  • Muscles Targeted: quads
  • Timeline in recovery: 9 months+
  • Approximate reps/sets: 6-10 reps for 3 sets
  • How to add difficulty: heavier weight, hold at the bottom, go down slower, add reps

Shoulder Elevated Glute Bridge

Set up a deadlift bar with the weights of your choice. Lay the bar on the ground, parallel to a bench or soft box. Use a matt or bar pad and place it over your waist. Put the bar on top of your waist, and your shoulders on the bench. Push your hips up into a bride while your shoulders are elevated.

  • Requirements: hamstring strength, knee ROM
  • Purpose: hamstring and glute strength
  • Muscles Targeted: glutes and hamstrings
  • Timeline in recovery: 6 months+
  • Approximate reps/sets: 13-10 reps, 3 sets
  • How to add difficulty: heavier weight, single-leg variation, hold at the top, add eccentric movement

Butt Kicks

This was an exercise I did for hamstring speed and endurance. Set up a band that’s parallel to the ground. I used the safety bars on a squat rack. Then, lay down on your stomach with the band a little lower than your butt. Kick your feet to your butt as quickly as you can, with the band offering resistance.

Tip: An alternative is to have someone hold a yoga ball in place on your butt as you kick up into it.

  • Requirements: adequate flexion, hamstring control
  • Purpose: hamstring endurance and speed
  • Muscles Targeted: hamstrings
  • Timeline in recovery: 6 months+
  • Approximate reps/sets: 10-45 seconds, 3 sets
  • How to add difficulty: Thicker band, longer duration, more sets, add ankle weights

Hex Bar Jumps

Hex bar jumps were something I commonly did in college soccer before ever getting hurt, but they were definitely helpful in these later stages of my recovery. Perform squat jumps while holding a hex bar. Aim to jump as high as possible while still controlling your landing mechanics.

  • Requirements: clearance to jump, especially for height
  • Purpose: power, sport-specific movement
  • Muscles Targeted: quads, hamstrings, glutes, calves
  • Timeline in recovery: 8+ months
  • Approximate reps/sets: 4-6 reps for 3 sets
  • How to add difficulty: Add weight, jump higher

SL Eccentric RDL

Another deadlift variation that I used a lot. Position one leg slightly in front. Place the other leg behind, but use it for only stability (not really putting your weight on it). Holding a barbell or two dumbbells, perform a single-leg deadlift. For this version, I would go down slowly (for 3-5) seconds and then power back up as quickly as possible by driving up through my foot and propelling my hips forward.

  • Requirements: SL balance and strength
  • Purpose: Hamstring and glute strength, balance, SL strengthening
  • Muscles Targeted: hamstrings, glutes
  • Timeline in recovery: 7 months+
  • Approximate reps/sets: 6-10 reps, 3 sets
  • How to add difficulty: Heavier weight, go down slower

Eccentric SL Split Squat to Box Jump Combo

Hold one dumbbell in each hand. Go down eccentrically into a split squat. Once at the bottom, drop the dumbbells and at the same time jump up into an SL box jump. This exercise combo was great for overall SL control, power, and sport-specific movement.

  • Requirements: SL jumping, sufficient SL power and stability
  • Purpose: power, jumping mechanics, and control
  • Muscles Targeted: quads, hamstrings, glutes
  • Timeline in recovery: 9+ months
  • Approximate reps/sets: 4-6 reps, 3 sets
  • How to add difficulty: Heavier weight, higher jump

SL Lateral Box Jump

In previous months, I focused first on forward jumps. As I continued to progress, I also trained more and more jumping in other directions. A basic SL lateral box jump was a staple I began with. Simply jump up to a box next to you using one leg. Focus on a controlled landing and keeping the knee from caving in. I also did other variations of this exercise, shown in the video above.

  • Requirements: SL jumping clearance
  • Purpose: power, SL control
  • Muscles Targeted: quads, glutes, hamstrings, calved
  • Timeline in recovery: 7 months+
  • Approximate reps/sets: 6-10 reps for 3 sets
  • How to add difficulty: Jump higher, jump faster

Split Squat Jump with Pause

Start in a split squat stance. From the bottom position, jump up as high as possible. Stick the landing back in the same split-squat position. Hold that position for 1-2 seconds before repeating. There are plenty of ways to adjust this exercise to work on different things, but this version is great to nail down first before making changes.

  • Requirements: SL jumping, jumping/landing mechanics
  • Purpose: power, landing control, SL control
  • Muscles Targeted: quads, glutes, hamstrings
  • Timeline in recovery: 7 months+
  • Approximate reps/sets: 6-10 reps for 3 sets
  • How to add difficulty: Jump higher, add some weight, perform a variation (switching legs in the air, moving the back leg forward and back again before landing, etc)

SL Banded Split Squat Jump

The band-assisted split squat jump was another variation that I did to prepare my leg for the force of sport. Using the bands, you can jump higher, and thus have to deal with more force as you come down. Attach workout bands to a secure higher surface. Loop one band around each shoulder so that it’s pulling you up toward the ceiling. From there, perform a split squat jump, aiming to jump as high as you can. Repeat 6-10 reps and then change sides.

Tip: You can try other variations here as well, like changing feet mid-air

  • Requirements: SL jumping ability
  • Purpose: Power, sport movement
  • Muscles Targeted: quad, glute, hamstring, calves
  • Timeline in recovery: 9 months+
  • Approximate reps/sets: 6-10 reps, 3 sets
  • How to add difficulty: Thicker band, move the band to ankles, more sets/reps

SL Box Jump Series

Various jumping and plyometric series were instrumental in returning to sport. I did many variations at physical therapy and would replicate them/ create my own at the gym as well. One example, shown above, was to jump forward onto a box with one leg. Immediately from there, I jumped forward off of the box and onto the ground. Then, I jump laterally and stuck the landing.

  • Requirements: SL jumping in all directions
  • Purpose: power, balance, coordination, sport-specific movement
  • Muscles Targeted: quads, hamstrings, glutes
  • Timeline in recovery: 8 months+
  • Approximate reps/sets: 4-6 reps, 2-3 sets
  • How to add difficulty: Higher jumps, further jumps, longer sequences, more challenging versions

Split Squat Switch Jump

Here’s a variation of the split squat jump I showed earlier. This is a more difficult version that’s great to progress to. It can help even more with speed and power. Perform a split squat jump up in the air. But mid-air, switch the position of your feet and then switch them back again before landing.

  • Requirements: SL jumping and landing with high force
  • Purpose: power, speed, coordination
  • Muscles Targeted: quads, glutes, hamstrings
  • Timeline in recovery: 8 months+
  • Approximate reps/sets: 6-10 reps, 2-3 sets
  • How to add difficulty: Jump higher, create a “bigger” switch by driving your back quad forward more

Banded Broad Jump

Working on broad jumps (jumping out) is also important. In the earlier stages, I practiced broad jumps without resistance. As I built up my power and stability, I began to make them more challenging with a resistance band. Secure the band to a stable object. Put the band around your waist. Jump out as far forward as possible and stick the landing.

  • Requirements: Jumping, full squat, adequate stability
  • Purpose: Power, landing mechanics
  • Muscles Targeted: quads, hamstrings, glutes
  • Timeline in recovery: 8 months+
  • Approximate reps/sets: 4-10 reps, 2-3 sets
  • How to add difficulty: Thicker band, jump further, hold the landing longer

Banded Squat Jump

The banded squat jump is similar to the split squat version that I showed earlier. Secure large workout bands to a stable object that’s taller than you. I often use a pullup bar or the top of the squat rack. Place one arm in each band, so the band rests under your armpit. Jump up as high as possible. As you land, try to immediately continue to the next jump.

  • Requirements: sufficient jumping and landing control
  • Purpose: power, coordination, sport demands,
  • Muscles Targeted: quads, hamstrings, glutes
  • Timeline in recovery: 6 months+
  • Approximate reps/sets: 4-10 reps, 2-3 sets
  • How to add difficulty: Jump higher, increase reps/sets

Speed and Agility Running

During this part of my recover, I began to add more speed and agility work. I ran faster for short bursts. I added more challenging turns, and practiced explosive runs in all directions (forward, backward, laterally). There are endless patterns I did with my physical therapist and on my own. Some were reactive (I responded to where he pointed, what color he said, etc). and others were planned routes. I show some examples of ones I did on my own in the video above.

  • Requirements: clearance to sprint, cut, running backwards, shuffling, etc
  • Purpose: speed, explosiveness, sport-specific movement
  • Muscles Targeted: complete body
  • Timeline in recovery: 9 months +
  • Approximate reps/sets: 4-6 reps per exercise/pattern
  • How to add difficulty: Run faster, sharper turns, longer courses, make it reactive

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