The 8-12 week mark following ACL reconstruction is one of the most critical phases of rehab. Early on, the focus is on restoring range of motion, managing swelling, and regaining basic function – something that most PT clinics do very well. However, by the 8-12 week mark, the priority must shift toward building meaningful strength. Research has shown that lingering quadriceps and hamstring asymmetries are significant predictors of future ACL injuries, especially graft re-tears (1). If these deficits aren’t addressed head-on, athletes often return to activity with imbalances that compromise their performance and increase their risk of reinjury. This is why underdosing strength work at this stage is such a common and costly mistake.
At Mend, we emphasize progressive and targeted strengthening as soon as it is safe, taking into account graft type and tissue healing timelines. 2-3 months post-op, we feel confident in the integrity of the healing ligament to begin to tolerate this higher intensity exercise. This isn’t just about lifting heavier, it’s about restoring muscle symmetry, control, and confidence. We have seen many individuals come to our clinic who have yet to be appropriately progressed, so we use evidence-based tools such as handheld dynamometry to measure quad and hamstring strength objectively, ensuring both sides are progressing toward true balance. We also incorporate functional testing batteries that evaluate movement quality, agility, and readiness for sport. Even exercises some patients are hesitant about, such as knee extensions, are reintroduced at the right time, because they are proven to be safe and effective when used appropriately.(2)
Our clinic is equipped with everything needed to prepare patients for the next level: squat racks, sleds, and open space for plyometrics allow athletes to progress from controlled strength work to dynamic, sport-specific drills that replicate the demands of skiing, climbing, and other high-level activities. If you or anyone you know is nearing this stage of post-ACL surgery, this is the window where it truly matters to push forward safely but aggressively. Don’t settle for being undertrained. Schedule an appointment with Mend today and let’s make sure your knee is ready not just to heal, but to perform.
1) Palmieri-Smith 2016. Quadriceps Strength Asymmetry Following ACL Reconstruction Alters Knee Joint Biomechanics and Functional Performance at Time of Return to Activity
2) Forelli et al 2023. Evaluation of Muscle Strength and Graft Laxity With Early Open Kinetic Chain Exercise After ACL Reconstruction: A Cohort Study