Best Exercises for Recovering ACL/MCL Injuries

It’s important for personal trainers working with clients recovering from anterior cruciate ligament (ACL) or medial collateral ligament (MCL) knee injuries to understand the rehabilitation process, including knowing the right exercises to use. ACL and MCL injuries are common, especially among athletes, and proper guidance in the gym can significantly aid recovery. 

It is worth noting that we don’t recommend developing rehab strategies for your clients without them consulting a professional such as a physiotherapist. However, it can be a great option to work with your client’s physio to help expedite recovery.

Understanding ACL and MCL Recovery Phases

ACL and MCL recovery typically occur in three main phases: acute, intermediate, and advanced. 

Each phase presents different physical capabilities and limitations, so you as a personal trainer will need to pick exercises based on your client’s current stage.

Phase 1: Early Stage Recovery Exercises

In the early stages of recovery, your primary goals with your client will be to manage pain, reduce inflammation, and maintain muscle activation around the knee without excessive strain. Exercises in this phase should be low-impact and should focus on isometric and gentle mobility exercises. Quadriceps sets, heel slides and ankle pumps may all be suitable here.

• Quadriceps Sets: Sit with your leg extended. Tighten your thigh muscles by pressing the back of your knee into the floor. Hold for 5-10 seconds before releasing, then repeat.
• Heel Slides: Lie down with your legs extended. Slowly slide the heel of your injured leg toward your buttocks, bending your knee gently, then return. Repeat.
• Ankle Pumps: Lie on your back with your legs extended. Flex and point your toes up and down repeatedly, maintaining your ankle movement and promoting blood flow.

Phase 2: Strength-Building and Stability Exercises

With phase 1 done, now you will want to introduce low-resistance strength exercises that focus on muscle balance and knee stability for your client (though be sure to get their own physiotherapist or medical practitioner to sign off on it all). At this stage, you’re really looking to reinforce the surrounding muscles, which will support the healing ligaments and prevent further injury. Mini squats with a stability ball are good here, as are resistance band lateral steps and step-ups.

• Mini Squats with a Stability Ball: Place a stability ball between your back and the wall. Space your feet hip-width apart and slowly squat down a few inches, keeping your knees aligned over your toes. Return to standing and repeat.
• Resistance Band Lateral Steps: Place a resistance band just above your knees. With a slight knee bend, step sideways, stretching the band. Take 10 steps in each direction.
• Step-Ups: Stand in front of a low platform – as high as you can without it hurting. Step up with your injured leg, then bring the other leg up to meet it. Step back down carefully and repeat for both legs.

Phase 3: Advanced Functional Exercises

Once your client has gained a solid foundation in strength and stability, you’re ready to begin some advanced functional exercises with them – phase 3. Again, speak to their physiotherapist or medical practitioner before moving into this phase. 

The advanced phase focuses on restoring full functionality, and exercises should challenge balance, coordination, and muscle endurance, preparing your clients for a safe return to regular activities or sports. Single-leg balance work, lunges using proper form, and leg press machines are all good exercises for phase 3.

• Single-Leg Balance Work: Stand on your injured leg, lifting the other leg slightly off the ground. For an added challenge, extend your arms or balance on a foam pad. Hold for 20–30 seconds, then switch legs.
• Lunges Using Proper Form: Step forward with one leg, bending both knees to form a 90-degree angle, keeping your knee aligned with your toes and as close to the ground at the bottom of each lunge without touching it as possible. Push back to standing and repeat, switching legs.
• Leg Press Machine: Set the machine to a limited range of motion. With feet shoulder-width apart, press up using light weights, keeping the movement controlled. Avoid deep bending. Repeat.

Prehab Exercises for ACL/MCL

As well as exercises for ACL and MCL injuries themselves, we can also invest some time in ACL prehab exercises. Prehab exercises for MCL/ACL focus on building strength, stability, and flexibility to reduce injury risk. Key exercises include squats for leg strength, single-leg balances to enhance knee stability, glute bridges for hip support, and lunges to improve coordination. These movements help fortify muscles and joints, preparing the body for activity.

Conclusion

You can make a profound difference in your client’s journey to full rehabilitation simply by incorporating these ACL and MCL recovery exercises in their program, tracking them through each successive phase as appropriate and closely monitoring their progress.

They may be nervous, in pain, and feeling a little like they’ll never recover. This is where you step in – inspire, encourage, sympathise, motivate, and get them to where they need to be. Because let’s be honest – what else is a personal trainer for?