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Zach ACL Reconstruction Plan
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Supplements AM(1hr pre workout is optimal) Vitamin d3/k2 4 drops (2,000 iu), 2 omega 3 capsules, 15 mg Zinc Picolinate, 5g creatine monohydrate, beta alanine 4g, collagen peptides (15g), vitamin c 1000 mg
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Supplements PM30g whey protein, magnesium
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TimeExercisesStretchesMilestonesSports/LiftingBracingNotes
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0-2 Weeks• Quad Flexes 5x a day, 20 reps, hold 5 seconds
• Quad Raises, 3 x a day, 20 reps
• Ankle Pumps 3x a day, 20 reps
• Heel-Toe Walking with crutch
• Hip Abduction 3x a day, 20 reps		• CPM 6-8 Hours Daily (stretch but no pain)
• Patellar Mobilization 3x a day, 5 minutes
• Band hamstring and calf stretch laying down		• Straighten knee to 0°
• Knee Flexion 90°
• Quad Control (quad set + SLR)
• Mobilized Patella
• End of Week 2, walk with Limp (FWB with crutches week 1-2)		• Side leg lifts
• Dead Bugs
• No Biking		• Crutches
• Locked at straight for walking week 1 with crutches
• Full weight bearing with crutches at end of 2 weeks		• Graft most vulnerable, necrosis phase
• Wrapped icing rotation
• Avoid NSAIDs
• MARC PRO NMES 72 hours post-op? Quad?
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2-6 Weeks• Bike 20-30 mins once a day (2-3 weeks no resistance, >3 weeks add resistance slowly)
• Straight leg raises
• Partial Squats
• Hamstring Curls
• Wall Slides
• Bridges
• Single-Leg Balances
•Monster walk? Clamshells? 		• CPM 6 hours (aim for >120 degrees and 0 degrees)
• Prone quad stretches
• Band calf and hamstring stretches		• Straighten knee to 0°
• Knee Flexion 120°
• Walk without crutches (~4 weeks), minimize limp
• Single leg stand 10 seconds
• Step-ups with good form		• Begin stationary bike and PT
• Begin seated/laying down upper body exercises and weights
• Around end, begin walking on concrete flat surfaces
• Body weight pull ups and push ups
• Planks?		• Brace for everyday activities or sketchy stuff
• Start to walk without crutches and don't limp
• Compression sleeve otherwise		• Graft most vulnerable, reperfusion and collagen laydown in process
• avoid aggressive quad stretching
• BFR cuff
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6-12 weeks• Medium weight leg press, single leg press?
• Single leg step up
• Calf Raises (8 weeks double, 12 weeks single)
• Lateral lunges, Partial lunges, split squats, single leg squat (10 weeks)
• Nordic hamstring curls (10 weeks)
• RDL/Good mornings/deadlifts (10 weeks) light weight
• Goblet squats (12 weeks, half depth)		• Dynamic stretches: leg swings, hip circles, hamstring stretches+D7:D8• Full ROM compared right to left
• Quad/Hamstring ~70% strength left vs right (single leg press/squat), full body weight squats
• Short jogs
• Two legged jump
• single-leg hops		• Resistance biking
• Walk on flat surfaces
• Weighted Pull ups
• Standing overhead press
• Planks, side planks, Pallof Press
• Elliptical, stair climber (8 weeks)
• Light farmer's walks (10 weeks)		• No assistive devices
• MAYBE brace for heavier weight lifting		• Graft still very vulnerable, revascularization and remodeling begins of graft
• Avoid exercises that cause pain at graft site, pain, or swelling
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Month 3-6• Progressive overload (4 months) deadlift, lunges, leg presses, farmers walks, squats medium weight (4-6 rep range at 6 months)
• Bulgarian split squats, single leg RDLs
• Double leg hops (4 months)
• Single leg hops (5 months)
• Ladder, cone, and shuttle drills (no pivot on a fixed foot, don't twist on a planted foot)
• Hip flexor stretch
• Kneeling hip flexor
• Adductor frog stretch back and forth
• figure 4 / half pigeon (take it easy)
• AVOID deep flexion still, triangle, chair twist 		• Quad at 80% strength, single-leg to 70°, 10-15 single-leg forward hops, equal hamstring strength
• Running 2-3 miles comfortably, gentle hills
• single leg lateral movements safely, agility drills at 80 %		• Light Jogging flat surface (supportive shoes, knee sleeve)
• Still avoid yoga (other than gentle home yoga)
• 20-30 minutes continuous running (month 4.5)
• Light weight rucking/hiking (month 4.5)
• 70% max speed run (month 6)
• Mostly back to full body exercises, single arm rows in a lunge		N/a• Collagen remodeling, 50-70% native ACL
• Brace for everyday activities
• Start to walk without crutches and don't limp.
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Month 6-9• Push towards normal strength
• Squats, lunges, deadlifts, step ups, hamstring curls, calf raises, excellent form
• Single leg plyometrics		• Everything except: extreme passive knee flexion, loaded twisting with knee flexed (full revolved triangle), deep pigeon, camel, hero pose
• Always keep a micro bend
• Deep squat holds, couch stretch, pigeon pose, supine twists, full quad and hamstring stretch		• 90% + symmetry
•Squat/deadlift/lung and pre-injury weights
• Sprint at max speed
• Normal vertical jump		• Normal weight weightlifting (farmers walks 100 lbs each hand)
• Back normal hiking
• Rucking with normal weight flat surface
• Return to yoga, hand stands (listen to body)
• Start surfing! (month 7)
• Full surfing sessions (month 9)		n/a• Graft collagen realigned, 80-90% tensile load
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Month 9-12back to normal, no restrictionsback to normal, no restrictionsequal strength, return to sport (slowly)• Start rucking with weight any surface
• Full power yoga return
• Consider soccer again (month 12), SLOW WITH WARMUPS		n/aWE BACK
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