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ACL Injury & Reconstruction Rehabilitation — Exercises Studied in Research

Research has examined 58 approaches for this condition. This page shows what the studies found and where clinical guidelines landed — with a source behind every claim.

1.See what science says2.Open the exercises3.Get the Complete Review (PDF)

Clinical guidelines support 12 of the 58 approaches studied for this condition.

Compiled and reviewed by: Milena OrlandićLicensed Physiotherapist — Specialist in Applied Physiotherapy (Neurorehabilitation) · Nikola OrlandićLicensed Physiotherapist — Specialist in Applied Physiotherapy (Neurorehabilitation) · Bachelor of Pharmaceutical Technology

Evidence last updated:

Partner of the Chamber of Physiotherapists of Montenegro

What studies found

Each approach below was tested in clinical research. Sorted by where clinical guidelines stand.

📋

Closed Kinetic Chain Exercise

Evidence supports it

This systematic review identified both closed-chain (CKC) and open-chain (OKC) exercise as viable approaches for rebuilding quadriceps strength.

Studied at3 times each week · squatting on 1 leg was the primary quadriceps strengthening exercise. The squat was also used as a means to sufficiently load the hip extensors.

Source: PubMed 17940146

📋

Exercise Therapy

Evidence supports it

A large-scale trial to evaluate the effectiveness of a physiotherapist-guided exercise-therapy and education program for individuals with persistent symptoms at 1-year post-ACLR is feasible.

Studied atminimum 3 sessions per week · 30 min duration · standardised (with individualised progression) lower-limb, functional and cardiovascular exercises, and individualised, ACL-specific education

Source: PubMed 33430844

📋

Neuromuscular / Motor Control Training

Evidence supports it

The Stop-X as a late-stage rehabilitation intervention might add a small, additional benefit to usual care approaches after ACL reconstruction and formal rehabilitation completion.

Studied at3 times per week · 30 min · teaching basic preventive strategies, running exercises/agility exercises, self-perturbed postural control exercises, jumping exercises, plyometrics and strengthening exercises

Source: PubMed 38479249

🔒Open Kinetic Chain ExerciseEvidence supports it
🔒Progressive Resistance TrainingEvidence supports it
🔒Quadriceps StrengtheningEvidence supports it
🔒Early Weight-BearingEvidence supports it
🔒PrehabilitationEvidence supports it
🔒Aquatic TherapyMay help
🔒Blood Flow Restriction TrainingMay help
🔒Core Stability TrainingMay help
🔒CryotherapyMay help
🔒Cycling Aerobic TrainingMay help
🔒Home-Based RehabilitationMay help
🔒Isoinertial TrainingMay help
🔒Plyometric & Agility TrainingMay help
🔒Accelerated RehabilitationMay help
🔒SAP + Perturbation TrainingMay help
🔒Conservative Management (Non-surgical)
🔒Kinesio Taping
🔒Perturbation Training
🔒Elastic Resistance Band Training
🔒Treadmill Walking Training
🔒Cross-Education / Bilateral TrainingScience does not support it

See all 24 exercises with full details

Complete exercise plans from studies
Study findings and where guidelines stand
Direct links to PubMed sources
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What science does not support

These approaches are widely offered, but published research found they do not help for this condition. Listed so you know before spending money — not as advice about any individual case.

  • Continuous Passive Motion (CPM)Not supported by research

    van Melick 2016 (Dutch ACL Rehab CPG) · Aspetar 2023 ACL Rehab CPG

  • Whole-Body VibrationNot supported by research

    van Melick 2016 (Dutch ACL Rehab CPG) · Aspetar 2023 ACL Rehab CPG

Whether any of this applies to your situation is something your physiotherapist or doctor can assess after examining you.

Does it work? — what research found

Every approach studied for this condition, sorted by where clinical guidelines stand. Not by popularity or marketing — by published research.

ApproachWhat science says
Closed Kinetic Chain Exerciseyou can do this at homeStudies: 3 · van Melick 2016 (Dutch ACL Rehab CPG), Aspetar 2023 ACL Rehab CPGEvidence supports it
Early Weight-Bearingyou can do this at homeStudies: 3 · van Melick 2016 (Dutch ACL Rehab CPG), Aspetar 2023 ACL Rehab CPGEvidence supports it
Eccentric Quadriceps Exercisedone with a specialistStudies: 3 · van Melick 2016 (Dutch ACL Rehab CPG), Aspetar 2023 ACL Rehab CPGEvidence supports it
Neuromuscular / Motor Control Trainingyou can do this at homeStudies: 6 · van Melick 2016 (Dutch ACL Rehab CPG), Aspetar 2023 ACL Rehab CPGEvidence supports it
Neuromuscular Electrical Stimulation (NMES)done with a specialistStudies: 5 · van Melick 2016 (Dutch ACL Rehab CPG), Aspetar 2023 ACL Rehab CPGEvidence supports it
Open Kinetic Chain Exerciseyou can do this at homeStudies: 4 · van Melick 2016 (Dutch ACL Rehab CPG), Aspetar 2023 ACL Rehab CPGEvidence supports it
Prehabilitationyou can do this at homeStudies: 6 · van Melick 2016 (Dutch ACL Rehab CPG), Aspetar 2023 ACL Rehab CPGEvidence supports it
Progressive Resistance Trainingyou can do this at homeStudies: 4 · van Melick 2016 (Dutch ACL Rehab CPG), Aspetar 2023 ACL Rehab CPGEvidence supports it
Proprioceptive Trainingdone with a specialistStudies: 2 · van Melick 2016 (Dutch ACL Rehab CPG), Aspetar 2023 ACL Rehab CPGEvidence supports it
Quadriceps Strengtheningyou can do this at homeStudies: 2 · van Melick 2016 (Dutch ACL Rehab CPG), Aspetar 2023 ACL Rehab CPGEvidence supports it
Exercise Therapyyou can do this at homeStudies: 5 · Aspetar 2023 ACL Rehab CPGEvidence supports it
Self-Efficacy Trainingdone with a specialistStudies: 1 · van Melick 2016 (Dutch ACL Rehab CPG)Evidence supports it
Show all 58 approaches
ApproachWhat science says
Cryotherapyyou can do this at homeStudies: 6 · van Melick 2016 (Dutch ACL Rehab CPG), Aspetar 2023 ACL Rehab CPGMay help
EMG Biofeedbackdone with a specialistStudies: 3 · van Melick 2016 (Dutch ACL Rehab CPG), Aspetar 2023 ACL Rehab CPGMay help
Home-Based Rehabilitationyou can do this at homeStudies: 3 · van Melick 2016 (Dutch ACL Rehab CPG), Aspetar 2023 ACL Rehab CPGMay help
Plyometric & Agility Trainingyou can do this at homeStudies: 2 · van Melick 2016 (Dutch ACL Rehab CPG), Aspetar 2023 ACL Rehab CPGMay help
Supervised Rehabilitation Trainingdone with a specialistStudies: 1 · van Melick 2016 (Dutch ACL Rehab CPG), Aspetar 2023 ACL Rehab CPGMay help
Aquatic Therapyyou can do this at homeStudies: 2 · Aspetar 2023 ACL Rehab CPGMay help
Blood Flow Restriction Trainingyou can do this at homeStudies: 8 · Aspetar 2023 ACL Rehab CPGMay help
Core Stability Trainingyou can do this at homeStudies: 4 · Aspetar 2023 ACL Rehab CPGMay help
Cycling Aerobic Trainingyou can do this at homeStudies: 1 · Aspetar 2023 ACL Rehab CPGMay help
Isoinertial Trainingyou can do this at homeStudies: 1 · Aspetar 2023 ACL Rehab CPGMay help
BMAC + PRP Augmentationdone with a specialistStudies: 2 · not yet reviewedMay help
Extracorporeal Shockwave Therapy (ESWT)done with a specialistStudies: 1 · not yet reviewedMay help
Modeling Videosdone with a specialistStudies: 2 · not yet reviewedMay help
Peripheral Nerve Stimulationdone with a specialistStudies: 1 · not yet reviewedMay help
Pilates Exercisedone with a specialistStudies: 1 · not yet reviewedMay help
Biofeedback Trainingdone with a specialistStudies: 2 · van Melick 2016 (Dutch ACL Rehab CPG), Aspetar 2023 ACL Rehab CPGNot enough research yet
Kinesio Tapingyou can do this at homeStudies: Six studies · Aspetar 2023 ACL Rehab CPGNot enough research yet
Perturbation Trainingyou can do this at homeStudies: 5 · Aspetar 2023 ACL Rehab CPGNot enough research yet
Treadmill Walking Trainingyou can do this at homeStudies: 1 · Aspetar 2023 ACL Rehab CPGNot enough research yet
Visual Feedback Balance Trainingdone with a specialistStudies: 1 · Aspetar 2023 ACL Rehab CPGNot enough research yet
Accelerated Rehabilitationyou can do this at homeStudies: 1 · not yet reviewedNot enough research yet
Cognitive-Behavioral Physical Therapydone with a specialistStudies: 1 · not yet reviewedNot enough research yet
Conservative Management (Non-surgical)you can do this at homeStudies: 4 · not yet reviewedNot enough research yet
Digital Structured Educationdone with a specialistStudies: 1 · not yet reviewedNot enough research yet
Elastic Resistance Band Trainingyou can do this at homeStudies: 1 · not yet reviewedNot enough research yet
Exercise + Cryotherapydone with a specialistStudies: 1 · not yet reviewedNot enough research yet
Exercise + TENSdone with a specialistStudies: 1 · not yet reviewedNot enough research yet
Functional Knee Bracedone with a specialistStudies: 2 · not yet reviewedNot enough research yet
Guided Imagerydone with a specialistStudies: 1 · not yet reviewedNot enough research yet
In Vivo Exposure Therapydone with a specialistStudies: 1 · not yet reviewedNot enough research yet
Interferential Current Therapy (IFC)done with a specialistStudies: 1 · not yet reviewedNot enough research yet
Internet-Delivered Psychological Supportdone with a specialistStudies: 1 · not yet reviewedNot enough research yet
Motor Imagerydone with a specialistStudies: 1 · not yet reviewedNot enough research yet
Myofascial Release / Mobilizationdone with a specialistStudies: 1 · not yet reviewedNot enough research yet
Nordic Hamstring Exercisedone with a specialistStudies: 1 · not yet reviewedNot enough research yet
Percussion Massage Therapydone with a specialistStudies: 1 · not yet reviewedNot enough research yet
Platelet-Rich Plasma (PRP)done with a specialistStudies: 3 · not yet reviewedNot enough research yet
RegentK Manual Therapydone with a specialistStudies: 1 · not yet reviewedNot enough research yet
Robotic-Assisted Rehabilitationdone with a specialistStudies: 1 · not yet reviewedNot enough research yet
SAP + Perturbation Trainingyou can do this at homeStudies: 1 · not yet reviewedNot enough research yet
TENSdone with a specialistStudies: 2 · not yet reviewedNot enough research yet
Virtual Reality Rehabilitationdone with a specialistStudies: 1 · not yet reviewedNot enough research yet
Continuous Passive Motion (CPM)done with a specialistStudies: 3 · van Melick 2016 (Dutch ACL Rehab CPG), Aspetar 2023 ACL Rehab CPGScience does not support it
Whole-Body Vibrationdone with a specialistStudies: Six studies · van Melick 2016 (Dutch ACL Rehab CPG), Aspetar 2023 ACL Rehab CPGScience does not support it
Cross-Education / Bilateral Trainingyou can do this at homeStudies: 1 · Aspetar 2023 ACL Rehab CPGScience does not support itdepends on the stage of recovery
Dry Needlingdone with a specialistStudies: One study · Aspetar 2023 ACL Rehab CPGScience does not support itdepends on the stage of recovery

Prevention

Factors that published studies link to higher or lower risk for this condition.

Balance & Proprioception Training

Shown in prevention studies

This study found that when balance training formed part of a programme, the overall ACL injury rate per 1,000 exposure hours fell by 58% (IRR 0.42, 95% CI: 0.27 to 0.66).

Source: PubMed 40051003

Knaecontrol Program

Shown in prevention studies

This RCT observed that the intervention group experienced a 64% lower rate of anterior cruciate ligament injury (rate ratio 0.36, 95% confidence interval 0.15 to 0.85).

Source: PubMed 22556050

Neuromuscular Training Programs

Shown in prevention studies

This RCT reported that, among adolescent female football players, a 15 minute neuromuscular warm-up lowered the overall anterior cruciate ligament injury rate by 64%.

Source: PubMed 22556050

Show all 19 prevention factors

Plyometric Training

Shown in prevention studies

Pooling across trials, this study found that adding plyometric drills to prevention programs cut ACL injury risk by 60% for every 1,000 hours of exposure relative to controls (injury risk ratio 0.40, 95% CI 0.26 to 0.63).

Source: PubMed 36244964

Strength Training

Shown in prevention studies

Drawing on four studies, this pooled analysis reported a strength-training estimate of RR 0.315 (0.207–0.480, I2=0%, χ2 p=0.808).

Source: PubMed 24100287

Biomechanical Risk Factors

Risk factor in studies

This study describes stronger gluteus maximus as potentially protective against future ACL injury, whereas an elevated body mass index emerges as a risk factor for such injury.

Source: PubMed 40356533

Biomechanical Screening

Risk factor in studies

This study reported that ROC analysis produced an area under the curve of 0.6, reflecting poor-to-failed combined sensitivity and specificity for the test.

Source: PubMed 26867936

BMI & Body Composition

Risk factor in studies

This study found that among women whose BMI sat at least 1 SD above the mean, the relative risk of noncontact ACL injury reached 3.5 times that seen in women with lower BMI.

Source: PubMed 14623646

Coach Education & Implementation Support

Risk factor in studies

A systematic review of neuromuscular training implementation found that stakeholder-engaged models with professional support achieved higher compliance (73.5-85.6%) than education-only approaches.

Source: PubMed 41815969

Fatigue Management

Risk factor in studies

Among the 14 kinematic variables reviewed, strong evidence indicates increased knee internal rotation angles at peak vertical ground reaction force (vGRF) during landing tasks after the knee flexors and extensors peripheral fatigue protocols (Effect size = 0.24–0.68).

Source: PubMed 40567252

FIFA 11+ Warm-Up Program

Shown in prevention studies

This study points to a structured warm-up programme as capable of preventing injuries in young female football players.

Source: PubMed 19066253

Hamstring:Quadriceps Strength Ratio

Risk factor in studies

This study's best-evidence synthesis found only very limited support for the H:Q strength ratio as an independent risk factor in hamstring and ACL injury, a finding that held across the different ratio types.

Source: PubMed 35065297

HarmoKnee Program

Shown in prevention studies

This study describes how knee-injury incidence in young female soccer players may be lowered by rolling out a multifaceted, soccer-specific exercise programme that also educates each player.

Source: PubMed 20065198

Hip Strengthening

Risk factor in studies

This study linked weaker hip strength to a higher risk of future injury (external rotation: OR = 1.23 [95% CI, 1.08-1.39], P = .001; abduction: OR = 1.12 [95% CI, 1.05-1.20], P = .001).

Source: PubMed 26646514

PEP (Prevent Injury Enhance Performance)

Shown in prevention studies

This study reported that swapping in a warm-up centred on specific neuromuscular and proprioceptive drills - the PEP Program - may cut the risk of noncontact ACL injuries among collegiate female soccer players.

Source: PubMed 18658019

Physical Activity Level

Risk factor in studies

According to this study, once socioeconomic, health, and lifestyle factors were accounted for, subjects taking part in organised sports >4 times/week carried an adjusted hazard ratio for knee cruciate ligament injury of 8.5 (95% CI 4.3 to 16.4) among women and 4.0 (95% CI 2.7 to 6.1) among men.

Source: PubMed 18390920

Psychological Readiness & Kinesiophobia Screening

Risk factor in studies

Patients with a TSK-11 score of ≥19 at the time of RTS were found to be 13 times more likely to suffer a second ACL tear

Source: PubMed 39041333

Sport Exposure & Training Load

Risk factor in studies

At all skill levels, match incidence (professional: 0.343; semi-professional: 0.249; amateur: 0.319) was significantly higher than training incidence (professional: 0.015; semi-professional: 0.004; amateur: 0.005).

Source: PubMed 34524500

Sportsmetrics Program

Shown in prevention studies

young female athletes in sports that entail jumping, pivoting, and cutting, such as basketball, volleyball, and soccer, be trained before participation with a proven effective jump training program that includes progressive resistance weight training for the lower extremity

Source: PubMed 10569353

Frequently asked

What works for ACL Injury & Reconstruction Rehabilitation according to research?

Research supports: Closed Kinetic Chain Exercise, Early Weight-Bearing, Eccentric Quadriceps Exercise, Neuromuscular / Motor Control Training, Neuromuscular Electrical Stimulation (NMES), Open Kinetic Chain Exercise. Based on van Melick 2016 (Dutch ACL Rehab CPG); Aspetar 2023 ACL Rehab CPG.

What does not work for ACL Injury & Reconstruction Rehabilitation according to research?

Research found no benefit from routine use of: Continuous Passive Motion (CPM), Whole-Body Vibration. Based on van Melick 2016 (Dutch ACL Rehab CPG); Aspetar 2023 ACL Rehab CPG.

How much research is this based on?

For ACL Injury & Reconstruction Rehabilitation, 58 approaches were evaluated, of which 31 have been reviewed by research bodies. Every data point traces to a published source.

Why do so many approaches say 'not enough research yet'?

Because that is the honest state of the research. 'Not enough research yet' means clinical guidelines have not taken a clear position, or few controlled trials exist for that approach. This page shows the entire landscape — not only the flattering rows.

What if the exercises don't lead to improvement?

Studies report results at the population level — individual responses vary. The literature also describes signs that call for a medical check (listed under 'When to see a doctor'), and a clinician is the right address for an individual assessment.

🚩 When to see a doctor

Some symptoms call for a medical check before any exercise: severe pain after an injury, numbness or tingling, weakness, fever with pain, night pain that does not ease, or bladder/bowel changes. If any of these are present, see a doctor first.

More safety signs

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The professional platform adds full source traceability — every data point leads to the exact study page.

Professional evidence

Educational InformationPhysioSense is an educational reference tool based on published research. It does NOT replace a medical examination or physiotherapy assessment. If you have severe pain, new symptoms, or are unsure — see a doctor or physiotherapist. You always make the final decision about your exercise. Pain is a signal to stop.