ACL Rehab Part 5: Time To Strengthen
Welcome back! If you missed Part 1 and Part 2 or Part 3 or Part 4 of this blog go back and read them so you have some context before diving into today’s blog, which is all about post-op rehab 3 – 5 months post-surgery.
Time To Strengthen
It was time to get my rehab on track. This leads us to the next big phase of the ACL rehab: STRENGTH AND NEUROMUSCULAR CONTROL
During this next phase of my ACL rehab journey it was crucial for me to have access to a gym and equipment. Without it, it is very difficult to go through the proper training you’ll need to build strength, endurance, muscle bulk and power.
With the introduction of proper strengthening, my swelling was finally starting to go down completely at the front.
I still had this weird intracapsular swelling that poked out when I bent my knee, but after speaking to a few others I found out I wasn’t the only one and that swelling will go with time.
Despite the swelling, my biggest concern was still the back of my knee. There was bulbous tissue remaining. Was it swelling? My hamstring not behaving? It was hard to tell.
Working On My Weaknesses
At this stage of my journey my hamstring was definitely my biggest limiting factor.
It was weak.
The muscle bulk was not there, and it was difficult to contract it properly.
Until the 4-month mark I hadn’t paid too much attention to my hamstrings as I was so focused on getting my quad strength and bulk back.
Don’t be like me. Don’t ignore those hamstrings!!!
If I’ve learnt one thing from my personal ACL rehab experience that I would pass on to other’s starting their strength program, it’s this: ‘listen to the knee’ and only progress as quickly as the knee will allow.
You’ll want to push and progress and there will be times when you get frustrated and feel like nothing is happening. The truth is an increase in pain and/or swelling are the two main symptoms that indicate that the knee is not tolerating the workload. I can tell you first hand that during my program there were days when my knee was sore. Don’t be afraid to deload, and then build back up again.
Persistence Not Perfection
During the rehab process it’s easy to get caught up in making things perfect. I sure did!
I wanted to get my ACL leg perfect compared to the other side. I have this weird lump at the back of my lower hamstring. My lateral quad muscle bulk isn’t identical to the other side. My single leg squats don’t have the same stability. I feel slightly uneven when doing squats or deadlifts, like I’m favouring the good side slightly. My scar site would hurt when I did lunges. When I started introducing running, I felt uneven with my strides. I got frustrated when the following day my knee would hurt from the new load. The list goes on! But like I mentioned in my last blog. Perfect doesn’t exist. Persistence does.
Mindset Matters
It’s hard to keep that mindset while you’re going through it though. I needed constant reminding. Just 3 weeks into my strength program I was experiencing hamstring tightness and knee pain mid-week.
I just kept thinking to myself “Why can’t this rehab just go smoothly!?”
I had no choice but to deload the rest of week by doing no training. I was frustrated with myself for not being able to continue but the reality was my knee needed that break. Come the following week I started again, and by the end of week 4 I was feeling stronger. Persistence, persistence, persistence!
From Strength To Stride
The next stage for me now is to start running. I’ll be honest, the thought terrifies me. I’ve been putting it off, worried that with my weak hamstring I would risk something going wrong. But I have to feel the fear and do it anyway. The trick is to start slowly with small drills first, small distances, and then build up.
So, what has this first 5 months taught me? In a nutshell:
Progress isn’t linear. Listen to your body and adjust accordingly. Stop trying to make things perfect. Don’t give up. Be persistent and patient… then repeat, again and again and again until you achieve your goals.

Joel Adelman
Joel has 7 years combined study and has gained experience and developed skills across a broad range of areas including sports, orthopedic rehabilitation, neurological rehabilitation, geriatrics, pediatrics and cardiopulmonary. Joel uses a combination of exercise therapy, manual techniques and evidence-based practice to help his clients return to optimal health and to prevent further injuries.
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