When does progressive strength training begin after ACL reconstruction?

When does progressive strength training begin after ACL reconstruction?

• A. Week 1
• B. Week 9
• C. Week 2
• D. Week 6

Answer: (C)

Initiating progressive strength training around two weeks after ACL reconstruction reflects balancing graft protection with early muscle reactivation. In the first weeks the focus is on reducing swelling, restoring knee extension, and reactivating the quadriceps. By about two weeks, many patients have enough ROM, less swelling, and improved quad activation to tolerate light resistance work. This allows safe introduction of low-load strengthening and closed-chain exercises (for example, controlled leg movements, gentle squats or leg presses at low resistance) while the knee is still protected by a brace and healing graft. Starting too early risks stressing the graft, while waiting much longer can lead to more rapid muscle loss and slower recovery. As healing progresses and tolerance builds, resistance and exercise complexity are increased.

Initiating progressive strength training around two weeks after ACL reconstruction reflects balancing graft protection with early muscle reactivation. In the first weeks the focus is on reducing swelling, restoring knee extension, and reactivating the quadriceps. By about two weeks, many patients have enough ROM, less swelling, and improved quad activation to tolerate light resistance work. This allows safe introduction of low-load strengthening and closed-chain exercises (for example, controlled leg movements, gentle squats or leg presses at low resistance) while the knee is still protected by a brace and healing graft. Starting too early risks stressing the graft, while waiting much longer can lead to more rapid muscle loss and slower recovery. As healing progresses and tolerance builds, resistance and exercise complexity are increased.