ACL RECOVERY

GUIDE
OPTIMISE YOUR ACL RECOVERY & COME
BACK STRONGER THAN EVER

EVIN KEANE
 TABLE OF CONTENTS
PAGE
I. MY STORY 01

II. INTRODUCTION 04

III. WHAT IS THE ACL 07

IV. FUNCTIONS OF THE ACL 08

V. HOW INJURIES HAPPEN 09

VI. WHY SO MANY ACL TEARS 10

VII. THE SOLUTION 14

VIII. THE EXERCISES 21

IX. TRAINING PROGRAMME 35

X. ACL STRENGTH STANDARDS 38

XI. OTHER CONSIDERATIONS FOR 39

SUCCESSFUL REHAB

XII. THANK YOU & NEXT STEPS 41

 DISCLAIMER
The information provided in this ebook book is intended for
general informational purposes only. It is not a substitute for
professional medical advice, diagnosis, or treatment. Always
seek the advice of your physician or other qualified health
provider with any questions you may have regarding a
medical condition or your individual fitness goals.

The author and publisher of this book are not responsible for
any injury, illness, or adverse effects that may result from the
use or application of the exercises, workouts, techniques, or
dietary recommendations described within. The reader
assumes full responsibility for any actions taken based on the
information in this book.

Participating in physical activities, exercises, and fitness

programs carries inherent risks. It is recommended that you
consult with a qualified healthcare professional before
beginning any exercise program, especially if you have pre-
existing health conditions or concerns.

The author has made efforts to ensure the accuracy of the

information provided in this book at the time of publication.
However, the author and publisher do not warrant the
accuracy, completeness, or usefulness of the information. The
reader should use their own discretion and judgment when
following any recommendations, and the author and
publisher disclaim any liability for any claims or damages
arising from the use of this book.

By using this ebook book, you acknowledge and agree to

the terms of this disclaimer.
 01
MY STORY
I have been an athlete my whole life!

I began playing Gaelic Football (Irish sport) when I was just 4

years old.

Sport has been my whole life, so naturally my physicality and

health is one of the most important things to me and
something I take very seriously!

As I progressed through my career I was always looking for

ways to improve my performance and make myself a stronger,
faster and better athlete! At 16 years old I was exposed to
S&C and immediately fell in love with strength training.

I was never the biggest and strongest guy on my team but I

was fascinated by how this could help me get closer to that.

I religiously followed my coaches and the programmes they

were giving me. However, after years of following everything
I was being told to do, my body started to feel more stiff,
more restricted, heavier and I stared having chronic pain and
picking up more and more injuries.

I spent years going to weekly physio appointments just so I

could make it to the next game and last until the end of the
year before my body broke down. I was always stiff and sore,
I would pick up niggly injuries on a regular basis and my
energy levels were always below where I felt they should be.
I would need to foam roll and stretch before every training
session and even at that I still didn’t feel like my body was
fully ready to go.
 02
All of this came to a head over a period of 5 years where I
dislocated both my shoulders multiple times and eventually
had shoulder stabilisation surgery. I then fractured my left
shin bone from my knee hyper extending and then just 9
months later I suffered the dreaded ACL tear on the same leg
from the exact same hyper extension!

I had ACL reconstruction surgery and followed the traditional

route of rehabilitation. But after almost 2 years I felt the way
most athletes who have come through ACL rehab feel; like I
still wasn’t fully right again!

Even though my tests showed I had good quad and hamstring

strength compared to my non-injured side, I still had knee
pain, I still lacked full range of motion and certain types of
movements and exercises would aggravate my knee. My knee
still felt unstable in high speed movements and I didn’t feel
like I could produce the same level of force as I could with
my non-injured leg.

And on top of the issues I was still having with my knee after
a largely unsuccessful rehab process, at just 25 years old my
body was broken and my athletic future looked extremely
bleak!

I was hell bent on finding a solution! There was no way I was

going to live the rest of my life like this! Weak, frail and with
fear of movement!

And so, I have spent the past 5 years finding the answer and I
have transformed my body from weak and frail, to being
stronger, more mobile, more resilient and more athletic than
I have ever been before.
And now this is what I help other athletes do too!
03
Too many athletes are suffering from unnecessary ACL
injuries and re-injuries and it is my mission to make all these
injuries stop and make sure that it is the last time you ever
have to go through this again!

Having gone through the challenge of ACL injury, ACL

reconstruction surgery and a below par rehab process, I know
the challenges you and countless others are facing and I
know that experiencing that once is more than enough!

The reason I have written this ebook and the reason why I
now help other athletes who are going through ACL rehab
(and other injury rehab) is because I believe that the current
mainstream approaches DO NOT work, DO NOT get good
results and DO NOT solve the problem! I believe there is a far
better way! A way that makes you stronger than you ever
were before! A way that fills in the gaping holes left by
traditional approaches!

Being an athlete and part of team, I have seen so many ACL

injuries happen and I always wondered why! But now, I
believe I have found the reasons why and I have also found
how to implement a solution!

My opinions and beliefs, which I will share with you in these

pages, are not popular or mainstream opinions. But the
popular and mainstream approaches just aren’t working. They
didn’t work for me and they aren’t working for countless
others. If they did, then I wouldn’t have written this ebook!

I really hope you enjoy and find all the answers you are
looking for in these pages.

Evin
 04
INTRODUCTION
“The definition of insanity is doing the same
thing over and over and expecting different
results.” - Albert Einstein
ACL injuries are becoming worryingly more and more common
among athletes in the last decade. Over 175,000 ACL
surgeries are performed every single year in the US alone!
With this exponentially sharp rise in ACL injuries, which
didn’t seem to exist before, you have to ask questions about
what’s going on!

Another extremely worrying stat is that less than 50% of

athletes who return to their sport after an ACL tear will never
get back to the level they were playing at before the injury,
and up to 30% of those who get back to that level will tear
their ACL a second time within the first 2 years.

And just as many tear their ACL on the other leg within a
similar time frame.

Why have ACL injuries become one of the most common and
feared injuries in sports where they were almost non-existent
before?

In my opinion this is not normal and is NOT OK!

To me, this highlights a major problem not just in the way

athletes are training, but also a major problem and
misunderstanding in how ACL rehab is approached!
 05
If only 50% of people who have had ACL surgery return to
their sport only to tear their ACL again, then to me that
signals an unsuccessful rehab!

A rehab programme for any injury, not just ACL injuries,

should have you returning to your sport in a position where
you are stronger than you were before the injury happened!

A huge mistake I see most physiotherapists and coaches

make, is just wanting to get the athlete back to where they
were before the injury!
But this doesn’t make any sense!

Think about it!

The level of strength you were at before the injury happened

wasn’t enough, otherwise you wouldn’t have got injured! Your
body wasn’t strong enough to do the things you were asking
it to do! Instead, your focus should be on becoming stronger
than you ever were before the injury and addressing any weak
links along the way

And to do this you need to take a different approach! If you

take the same approach that you always have (or follow the
same approach as everyone else) then you are going to end
up with the same results you’ve always gotten, and that
others have always gotten!

And in the case of ACL rehab, the results are overwhelmingly

bad!
 06
In this guide I am going to show you a different approach!

An approach that thinks differently and targets the areas that

traditional and conventional ACL rehab approaches miss! My
goal with this ebook is to educate and show you that there is a
far more effective and successful way to approach your ACL
rehab to ensure it is your last ever ACL rehab!

Not only will you learn a different perspective and approach to

ACL injuries and rehab, but you will also learn the principle of
training that will optimise your athletic ability and have you
performing pain free and at levels you have never reached
before!

If you are reading this guide I am assuming that you have

recently had ACL reconstruction surgery. However, if it's been
some time since your surgery, and maybe you have even
returned to your sport and training but your knee just doesn’t
feel quite the same as before the injury, then this framework
and approach is still the same for you!

And finally, whether you’ve just had ACL surgery, or simply

have had chronic knee pain, your knee will still benefit from
this approach to training.

A strong and resilient knee is a strong and resilient knee no

matter what!
 07
WHAT IS THE ACL?
The anterior cruciate ligament (ACL) is one of four major
ligaments stabilising the knee joint. A ligament is a tough band
of tissue, connecting bones at a joint. In this case, the ACL
links the femur (thigh bone) to the tibia (shin bone). It is one of
two ligaments crossing each other deep within the centre of
the knee joint.

The ligament towards the front (anterior) is the ACL, and the
one toward the back of the knee (posterior) is the posterior
cruciate ligament (PCL). The ACL is a vital structure that helps
to prevent the tibia from sliding forward and rotating too much.

It mainly provides stability in twisting and turning movements.

The PCL is essential in stopping the tibia from moving
backwards and is much less frequently injured. There are two
ligaments on the sides of the knee (collateral ligaments). These
give stability to sideways motions: the medial collateral
ligament (MCL) on the inner side and the lateral collateral
ligament (LCL) on the outer side of the knee.
 08
FUNCTIONS OF THE ACL?
The ACL is one of four main stabilizing ligaments in your knee.
Three of the key functions of the ACL are:

STABILISING THE KNEE

The primary function of the ACL is to provide stability to the
knee joint. It acts as a critical stabiliser during activities that
involve sudden stops, changes in direction, and pivoting
motions. Without a properly functioning ACL, the knee becomes
vulnerable to excessive movement, leading to instability and
potential injury.

CONTROLLING RANGE OF MOTION

The ACL helps control the range of motion in the knee joint. It
prevents hyperextension and limits excessive forward movement
of the tibia relative to the femur. This control is crucial for
protecting the knee from abnormal stresses and strains during
various activities, including sports and daily movements.

FACILITATING SMOOTH MOVEMENT

By working in conjunction with other ligaments and structures in
the knee, the ACL contributes to the smooth and coordinated
movement of the joint. This is particularly important during
activities that involve jumping, landing, and sudden changes in
direction.
 09
HOW INJURIES HAPPEN
In order to understand the solution, it is first necessary to
understand the problem and how it comes about!

How injuries occur and their specific mechanisms is a very broad

and nuanced topic and probably warrants an entire ebook for
itself, so I will not go into too much detail here on the subject.

When we look at injury from a mechanical point of view and in

the context of the ACL, it can be explained in a way that makes
it quite simple to understand!

That is, when the load that a tissue experiences is greater than
the load bearing capacity of that tissue, the tissue will yield (i.e.
it will tear, snap, break).
 10

WHY SO MANY ACL TEARS?

I believe there is a long list of potential reasons why ACL
injuries have become so common among athletes and I think
that they are all probably true to varying degrees, depending on
individual circumstances. To say there is just one reason or one
main cause, I believe, would be incorrect and would blind us to
other influences that may be the cause of any one individual
ACL tear case.

However, there are two primary factors that I believe are

present in most ACL injury cases that I will briefly detail here.

I believe that these two factors are ignored and missed by the
vast majority of coaches and professionals who prescribe
strength training and rehabilitation programmes, leading to re-
injury and unsuccessful rehabilitation.

FACTOR 1: SEDENTARY LIFESTYLE

I believe the first factor is the increasing sedentary lifestyle
that most athletes and people in general now live. Being
sedentary and in particular, spending large amounts of time
sitting every day, has a whole host of negative health effects.

But for its relevance to and influence on ACL injury risk, it de-
conditions and weakens your tissues (muscles and connective
tissues) and decreases your range of motion. It has been long
understood and proven that both these factors have negative
effects on athletic performance and injury risk.
 11
As humans, it is completely unnatural for us to sit in chairs, in
the same position, all day with very low levels of activity. Your
body adapts to the inputs and signals you expose it to and this
lack of activity gives the signal to your body that you don’t
need strong muscles, tendons or ligaments to get through life.
And your body will not waste energy on preserving something
it doesn’t think it needs to survive and get through the day.

So the results are reduced range of motion, increased pain and

stiffness and weak muscles and connective tissues.

To counteract this lack of activity in our daily lives we

strength train. We do this to signal to our body to keep our
tissues strong and healthy. And that leads to another big
problem and the second factor I believe is causing so many
ACL injuries!

FACTOR 2: STRENGTH TRAINING

The second factor is the way we strength train. Strength
training is hugely beneficial for athletes and humans in
general, particularly when you consider the fact that we are
far more sedentary than ever in our day-to-day lives!
However, our modern approach to strength training largely
focuses on increasing the strength and mass of muscles, and
ignores strengthening and developing connective tissue.

From a biological perspective, connective tissues are pound

for pound stronger than muscle tissue. Ligaments are stronger
than tendons, which are stronger than muscles.
 12

But the way most athletes strength train actually promotes

muscle to become stronger than ligaments and tendons.

To put it in very simple and understandable terms: Muscles are

what produce movement and help our joints to move, and our
connective tissues are what hold us together.

But when you only train your body to be stronger at producing

force for movement (i.e. training the strength of your muscles)
and not stronger at holding itself together, you create a body
that becomes too strong for itself and can no longer handle the
newfound force it has the potential to produce and experience!

This is what results in higher rates of injury and athletes who

are “injury prone”!
 13
Further to this, most modern athletic training focuses on
improving our ability to produce force and reach greater and
greater levels of speed, power and acceleration! However, we
completely ignore improving our strength and ability to
decelerate and absorb force. And it is in this portion of
movement, the deceleration phase, where most ACL injuries
will happen!

Here I have briefly covered just two points in a potentially

infinite list of factors that could be the cause of an ACL tear, or
any other knee injury for that matter.
To say that these two things are the only contributing factors
would be to ignore the complex nature of ACL injuries.

However, I do believe that these are probably two of the

largest contributors to the sharp rise in ACL injuries and are the
lowest hanging fruits to pick when it comes to resolving this
issue. This sharp rise in ACL injuries, that apparently didn’t
exist before, signals to me that something has changed and
these are the two things that stand out most to me!
 14
THE SOLUTION
I have already outlined the problem and most common missing
links, so now the remainder of this ebook will be focused on
solutions and how you can begin to implement them for your
own recovery!

The solution, in many ways, now becomes obvious!

You need to strengthen your weak areas and all the areas you
have typically neglected to strengthen in your training and
which conventional rehab typically ignores.

That is, the knee joint itself, the connective tissues and
ligaments, and increase strength through length in your tissues.

However, the topic of this ebook is about ACL recovery and if you
have just recently had surgery, it is essential that you know
where the best place to start is and how to safely progress.

The best approach will always be to follow a logical, structured

and progressive approach that is designed to achieve your goals
and increase your ability over time, under the guidance of a
coach!

I have helped a lot of athletes recover from ACL surgery and

other knee issues, and help them return to their sports stronger
then they ever were with even greater levels of pain free ability.
 15
Below I am going to share with you the 3-step framework I use,
one that simply gets results!

The 3-Step Solution is as follows:

1. Maximise Circulation & Blood Flow
2. Build Key Muscles
3. Strengthen Joint & Connective Tissue

STEP 1: MAXIMISE CIRCULATION & BLOOD FLOW

The first step of the ACL recovery process is all about
maximising a constant fresh supply of fluid and nutrients to the
joint and encouraging as much circulation as possible to your
knee and surrounding tissues. Blood carries nutrients, and
nutrients are what brings healing to your tissues, which is
essential early in the recovery process.

Movement is life and circulation heals. Maximising pain free

movement and circulation maintains the neural connections and
decreases the need for chronic pain signals by restoring ability
and confidence to the area.

The connective tissues of the knee are bathed in a fluid that sits
in the joint space between the tibia and femur, called synovial
fluid. This fluid is what keeps the ligaments hydrated and
nourished. Moving the joint is how you keep the synovial fluid
fresh.

Think of movement as a pump for your joints, which pumps out

old, stale and stagnant fluid and pumps in fresh nutrient rich
fluid.
 16
STEP 2: BUILD KEY MUSCLES
The next step of the solution is to build the local muscles
around your knee joint! After surgery and a period of
immobilisation you will have muscle shrinkage around the knee
joint, most noticeable in the quad. However, it is essential to
train the muscles both above and below the joint to maintain
structural balance.

Most ACL rehab protocols will have you perform exercises like
box squats and leg presses, but these exercises are more
typically hip and glute dominant, more than they are quad
dominant. And even if you do get some quad activation from
these, it is typically more of the lateral (outside) quad.

The muscle that tends to atrophy (shrink) the most is the Vastus
Medialis Oblique (VMO), which as the name suggests, is on the
medial side of your quad (opposite to where the above exercises
typically target).

This muscle is the tear shaped muscle on the inside of your knee
and is an extremely important muscle for knee protection and
plays the largest role of any muscle in providing strength and
stability to the knee.

Even though this is the most important muscle for knee

protection, mainstream and conventional rehab approaches
unfortunately tend to neglect directly training this muscle.

One of the best and most impactful exercises I have experienced

for progressively building mass and strength in this muscle is
Poliquin Step-Ups.
 17
STEP 3: STRENGTHEN JOINT & CONNECTIVE
TISSUE
And the final piece of the solution is to strengthen the joint
internally, and not just externally!

Once you have started bringing blood flow and building neural
connections with key muscles, now it is time to slowly and
progressively start training the area that has been neglected for
so long; your joint and connective tissues.

Contrary to popularly held beliefs, your ligaments and tendons

have the same anabolic properties as muscles. What this means
is they have the same growth properties, which basically means
you make them bigger and stronger, just like muscles.

This is a key part of the ACL and knee pain equation that most
physiotherapists and S&C coaches will miss, and is what will
make all the difference to you having a successful outcome from
your rehab.

It is by training the strength and resilience of the connective

tissues and internal structures of your joint that you will start to
set yourself apart from traditional ACL rehab approaches and
really start to bulletproof your knee and reduce the chances of
ever tearing your ACL again.

It is important to know however, that training the internal

strength of your joint and connective tissues requires a patient,
measured and consistent approach. Connective tissue takes
longer to adapt and strengthen than muscle tissue, but the extra
patience and consistency is well worth it!
 18
Training connective tissue strength requires that you train your
joints at long ranges, which can put your tissues into
compromised positions and potential injury if not done in a
careful and progressive manner.

In order to increase the strength of your connective tissue

successfully and without causing issues, you must be willing to
put your ego aside and meet your body at its current level of
ability! A few weeks of performing exercises at body weight to
condition your connective tissues is worth the long term
athletic, injury prevention and longevity benefits it will give
you.

The more time you spend on mastering these kinds of exercises

and creating real strength here, the far greater likelihood you
have of making your knees stronger than they have ever been
before and minimise the chances of ever injuring your knee
again!

There are so many benefits to training the strength, resilience

and health of your joints and connective tissues.

These benefits include:

Greater range of motion
Improved athletic performance
Great athletic longevity
Greater capacity for movement
Reduced risk of injury
Greater strength, speed and power potential
Reduced pain and stiffness
 19
PROGRAMMING THE PHASES
Below is a general recommendation on what phases you should
focus on more depending on where you are along your ACL
rehab journey.

Please note that it is impossible to give specific

recommendations and guidelines on how much emphasis should
be placed on each of the phases during each stage of your rehab
process. Specific exercises selection and implementation is very
much dependent on your individual case, your current pain level
and the rate at which you are progressing with your knee ability.

With this in mind, here is a general approach and logic that can
work well in most cases:

MONTHS 1-3

STEP EMPHASIS
MAXIMISE CIRCULATION &
HIGH
BLOOD FLOW

BUILD KEY MUSCLES MEDIUM

STRENGTHEN JOINT &

LOW
CONNECTIVE TISSUE

MONTHS 3-6

STEP EMPHASIS
MAXIMISE CIRCULATION &
MEDIUM
BLOOD FLOW

BUILD KEY MUSCLES HIGH

STRENGTHEN JOINT &

MEDIUM
CONNECTIVE TISSUE
 20
MONTHS 6-9+

STEP EMPHASIS
MAXIMISE CIRCULATION &
MEDIUM
BLOOD FLOW

BUILD KEY MUSCLES MEDIUM

STRENGTHEN JOINT &

HIGH
CONNECTIVE TISSUE
 21
THE EXERCISES
MAXIMISING CIRCULATION & BLOOD FLOW
The best place to begin is with short range concentric only
movements for the knee. By working in a short range of motion
with concentric only muscle contractions, you optimise blood
flow to the working area.

Using these short range concentric only movements means that

you can train them at high volume and high frequency as they
do not cause a lot of tissue damage, which means you will have
more rapid recovery. In the early stages of your ACL rehab when
you cannot heavily load your knee, frequency is your best friend.

The more frequently you perform these kinds of healing

exercises and movements, the more you signal to your body to
repair and strengthen the knee.

Like I mentioned above, maximising blood flow to the area,

particularly after surgery, is paramount to bring healing to the
knee joint and the surrounding tissues.

Here are the 3 best ways you can start to do that after your
surgery:
 22
BACKWARDS
WALKING/REVERSE SLED
Don’t be fooled by its
simplicity, backwards walking
is the ultimate healing
exercise for the knee! The
most powerful and
transformative solutions are
generally the simplest, and
this is definitely the case when
it comes to backwards walking
and knee health.
By the end of this ebook, if you still feel awkward or
embarrassed walking backwards in public, then you simply have
not fully understood its benefits for your knee health and
longevity!

When you walk backwards you automatically put your knee into
a knee over toes position, which means you already start to
strengthen the knee joint.

It is the easiest and most simple form of knees over toes

training.

In the case of an ACL surgery, you need a gentle, targeted, and

scalable method of quad loading to help wake the muscle up,
bring blood flow for healing and to prepare it for further
strengthening.

Backward walking has also been shown to be far superior to

forward walking when it comes to improving quad recruitment
and activation, in particular the VMO muscle, which is essential
for knee health and function.
 23
People who have knee pain generally have a hard time
activating their VMO muscle, and backwards walking allows you
to start recruiting this key muscle again in a safe and pain free
way.

And the best thing about it is that you don’t need any equipment
to do it! All you need is your body and open space.

The best protocol to follow in the early stages of your ACL

recovery is to spend at least 10 minutes daily walking
backwards, ideally outside! Do this at least once per day, but
you can do this even 2-3 times per day in the early stages of
your rehab.

Remember, backwards walking is the ultimate healing exercise

for the knee and you can’t do too much!

Once you have built some strength you can start to add some
progressive resistance using a sled. Reverse sled drags are the
best way to add increasing load in a safe and progressive way.

Similarly to backwards walking, I recommend you work in 5-10

minute sets of continuous reverse sled drags.
 24
BANDED KNEE
EXTENSIONS
This is another great and gentle
option that allows you to create a
real and safe pain free pump on
your quads! This is a concentric
dominant exercise with a small
eccentric component. All you need
for this one is a light band and an
upright post to wrap the band
around.

Just like backwards walking, I

recommend you work with this one
in 5-10 minute sets at least once
EVERY DAY!

REVERSE TREADMILL
WALKING
Another great option is reverse
treadmill walking. You can do this
on a regular treadmill with the
motor turned off. The reason why
the reverse treadmill is so
powerful is that you have the
added benefit of continuous
backward walking with some added
resistance from the motor and belt
of the treadmill. This is opposed to
the resisted reverse sled drag
where you will need to turn the
sled often depending on the length
of the area you have to perform it
in!
 25
BUILDING KEY MUSCLES
When it comes to building the key muscles, it is important to
approach it with structural balance in mind. This means
strengthen the muscles both above and below the knee joint and
the muscles in the front of the leg and the back of the leg.

QUADS
POLIQUIN STEP UP
As I mentioned above, the Poliquin
Step Up is the absolute best
exercise to use to target and
strengthen the most important
quad muscle that most traditional
mainstream ACL rehab approaches
miss, the VMO. This will also
slowly start to improve your
strength and ability for Step 3:
Joint and Connective Tissue
Strengthening.

The best place to start with this

exercise after surgery is at its most
regressed version, which is at
ground level using assistance.
Then, once you've mastered this
and feel strong in the movement,
you can move to unassisted, to
loaded with dumbbells. You can
then start to progress by
increasing the step height.

3-4 sets of 20-50 repetitions can

be used for this exercise!
 26
LOWER LEGS
When it comes to building back strength, mass and resilience in
the calves, it’s best to approach it from two angles for optimal
results.

FHL CALF RAISE

The FHL Calf Raise will help
build the gastrocnemius, the
upper more visible calf muscle.

To perform this exercise, lean

into the wall until you feel
your heel about to lift off the
ground. Then push through the
ball of your big toes while
maintaining a straight line
between your ankles and ears.

Begin by training both legs at

the same time.

You can then progress the exercise by training single leg

strength.
 27
KOT CALF RAISE
The KOT calf raise is a not-so-
commonly utilised calf exercise.

This exercise is extremely

important for training the
Soleus muscle, which is your
lower deeper calf muscles. This
exercise will also begin to
strengthen your knee in a knees
over toes position.

Start with your knees bent over

your toes as far as possible.
Push through the balls of your
feet while maintaining your
knee in front of your toe.

Just like the FHL calf raise, this

can be regressed by performing
it with both legs at the same
time.

You can then progress the

exercise by training single leg
strength.
 03
TIBIALIS ANTERIOR
The tibialis muscle is one of the most under trained muscles in
the human body. This is an essential muscle to train for knee
longevity and health and also for providing structural balance to
your lower leg.

Perform this with your back against the wall and feet stepped
away from the wall. The further your feet, the harder this will be.
Keep a slight engagement on your quads and pull your toes
towards your face.

The easiest and most effective way to train this muscles is with
tib raises and you can perform this exercises safely for high
repetitions.
 28
HAMSTRINGS
The hamstrings play a key role in unloading and protecting the
ACL. For optimal hamstring strength and ability, as well as knee
health and protection, it is important to make sure the
hamstrings are both strong and long! This means strengthening
the hamstrings at both a long and short range of motion! It is
also essential to train the distal (lower) part of the hamstring to
have freakish levels of strength.

HAMSTRING CURLS
Hamstring curls are a great starting point, particularly in the
early stages of recovery. They will help to begin strengthening
the distal part of the hamstrings and is also a good exercise to
use to bring more blood flow and neurological connection to
the hamstrings. They are also a great tool to use to help
strengthen your ability in the Nordic curl, which is a key
exercise for knee protection and bulletproofing!
 29
NORDIC ECCENTRIC
Nordic curls are one of the best hamstring exercises to provide
real freakish levels of strength and bulletproofing to the ACL.
Most hamstring exercises in the later stages of ACL rehab
include exercises like, RDL’s and single leg RDL’s. However,
these exercises will predominately strengthen the proximal
(upper) part of the hamstrings. But in order to strengthen and
protect the ACL it is essential to strengthen the distal
hamstring, an area often neglected as rehab progresses.
Developing real strength, particularly through the eccentric
portion of the Nordic curl is critical for a successful rehab.
 30
FULL STRETCH RDL’S
RDL’s, when performed correctly, are one of the best exercises
for bulletproofing your hamstrings as they allow you to
increase their strength through length. As mentioned above,
this is an excellent exercise for strengthening the proximal
(upper) hamstring.

You can begin by loading this exercise with dumbbells before

progressing to barbell weighted.

Key Form Points:

Knees stacked above or slightly behind ankles
Slight knee bend
Push Hips back to the wall (hinge)
Flat spine
Neutral neck
Weight stays close to legs, not away from body.
 31
STRENGTHENING JOINT & CONNECTIVE
TISSUES
Without doubt, the two best exercises to increase the internal
strength of your knee and all its connective tissues are the ATG
Split Squat and VMO Squats.
ATG SPLIT SQUAT
The ATG Split Squat is one of the best exercises to help
improve your athleticism. It allows you to gently and
progressively strengthen your knee in full knee flexion and in a
knees over toes position! It also has the added benefit of being
a brilliant active mobility exercise for your hip flexor, which is
a commonly tight and weak area in most athletes and people!

And because the Split Squat is a unilateral exercise, it also

allows you to balance strength and mobility between both sides
of your body to ensure structural balance. This makes it a lot
easier to close the gap between your injured knee and non-
injured knee.
 32
The best place to start with this exercise is with your front foot
elevated as high as you need to be able to perform the exercise
pain free! Then as you become stronger and more mobile over
time you can reduce the height at which your front foot is
elevated!

Key Form Points:

Shoulders stacked over hips
Squeeze back glute
Full hamstring covering calf on front leg
Back knee doesn’t touch ground
 33
VMO SQUAT
The focus with this squat is to strengthen your knee at full knee
bend. Performing the VMO squat in this way with your heels
elevated and a narrower stance, really allows you to get
maximal recruitment of the VMO muscles and build real
resilience and bulletproofing in your connective tissues!

As with all other exercises, you should first find your pain free
starting point and progress your ability and strength over time.
 34
FREAK LEVEL STRENGTH
Two bonus movements you can begin to strengthen and explore
as you progress along your rehab are the Sissy Squat and Reverse
Nordic.

Both these movements are extreme long range movements for

the knee joint, it’s connective tissue, and will place a huge
demand on quad strength through length.

Becoming strong at both these exercises will have immense

benefits for your knee strength and health. However, because
these are extremely long range movements, you should progress
slowly with these and increase your ability in a progressive
manner over time.

Being able to perform a full reverse nordic and sissy squat will
provide freak levels of bulletproofing to your knee joint and
connective tissues, but these movements are not the starting
point!

If you increase your strength and ability at all the exercises

listed above you will be on the right path to achieving a full
sissy squat and reverse nordic.
 35

TRAINING PROGRAMME
MONTH 1-3
ABILITY BUILDER SESSION
BACKWARDS WALKING/
REVERSE TREADMAILL
Perform for 5 minutes

A1. TIBIALIS RAISE

3x25 reps

A2. FHL CALF RAISE

3x25 reps

A3. KOT CALF RAISE

3x25 reps

B. POLIQUIN STEP UP
3x25 reps/side (extra set on surgery leg)
 36
MONTH 3-6
STRENGTHEN ABILITY SESSION
BACKWARDS WALKING/
REVERSE TREADMAILL
Perform for 5 minutes

A1. TIBIALIS RAISE

3x25 reps
A2. FHL CALF RAISE
3x25 reps
A3. KOT CALF RAISE
3x25 reps

B. POLIQUIN STEP UP
3x25 reps/side (extra set on surgery leg)

C1. ATG SPLIT SQUAT

3x10 reps/side (extra set on surgery leg)
C2. HAMSTRING CURLS
3x12 reps

D. NORDIC ECCENTRICS
5x5 reps (5 second eccentric)
 37
MONTH 6-9+
BULLETPROOF ABILITY SESSION
BACKWARDS WALKING/
REVERSE TREADMILL
Perform for 5 minutes
A1. TIBIALIS RAISE
3x25 reps
A2. FHL CALF RAISE
3x25 reps
A3. KOT CALF RAISE
3x25 reps

B. POLIQUIN STEP UP
3x25 reps/side (extra set on surgery leg)

C1. ATG SPLIT SQUAT

3x10 reps/side (extra set on surgery leg)
C2. FULL STRETCH RDL’S
3x12 reps

D1. VMO SQUATS

3x15 reps
D2. NORDIC ECCENTRICS
3x5 reps (5 second eccentric)
 38
ACL STRENGTH STANDARDS
Here are 5 minimum standards I believe you should be able to
hit by month 9 of your ACL rehab. If you can hit all 5 of these
standards, I believe you will be in a position where your knee
and your lower body are stronger and more mobile than they
were before your injury.

These standards represent a level of ability, range of motion,

strength and resilience to tension in your tissues and knee
joint. These standards are not absolute or definite in any way
shape or form. they also DO NOT mean that you are 100%
guaranteed to never tear your ACL again. For even greater
bulletproofing, injury resilience and performance potential I
recommend you do not stop at these standards but instead
seek to improve your ability at these and take your abilities
further beyond!

ATG Split Squat

Flat ground ATG Split Squat, with perfect form
Poliquin Step Up
Bodyweight off 6" step for 15 reps with perfect form
Sissy Squat
5 full body weight sissy squats to 3” step
Nordic
5 second controlled eccentric to bottom position
RDL
100% bodyweight with perfect form for 12 reps
 39
OTHER CONSIDERATIONS FOR
SUCCESSFUL REHAB
TRAIN WEAK LINKS
Your ACL rehab is the perfect time to focus on turning your
weaknesses into strengths. During this time your focus is on
strengthening your knee and making it stronger and more
resilient than ever before, so why not take advantage of this
time when you are away from your sport to do the exact same
for your whole body!

STRUCTUAL BALANCE
This is about building a balanced level of strength and
resilience in your body! You body should have balanced ratio’s
of strength from front-to-back, left-to-right, side-to-side
tendon to muscle, long to short. The greater balance you have
in your body, the greater your potential for strength and
performance gains.

GOOD QUALITY SLEEP

Sleep is your superpower! Getting enough quantity and quality
sleep is absolutely essential to make consistent and fast
progress during your recovery. Sleep is your body’s way of
recovering, regenerating and adapting your body to what you
are exposing it to during the day! Sleep makes everything in
your body feel and work better! It is impossible to optimise
any aspect of your health or body without sufficient quality
sleep, and this is very much true for ACL rehab!
 40
NUTRITION
Optimising your nutrition during ACL recovery is absolutely
essential for success and consistent progress! The quality of
the food you consume will directly impact the quality of the
tissues in your body! Food is how your body gets the necessary
nutrients required to keep you healthy and thriving! These
nutrients are also the essential building blocks for repair and
recovery.

My nutritional philosophy is very simple:

The food you eat should minimise inflammation and maximise
energy! Anything that works in opposition to this has no place
in your nutrition.

I cannot over emphasise the importance of ensuring your

nutrition is on point during your recovery process. Nutritional
guidance and coaching is something I detail and provide to all
my ACL rehab clients.

My top nutrition recommendations when it comes to ACL rehab

are as follows:
Prioritise protein from quality sources
High nutrient density
NO processed foods
NO seed oils
Stay hydrated (electrolytes and quality salt)
Predominately animal based foods
 41
THANK YOU & NEXT STEPS
Thank you for downloading and using this ebook. The
information and practical steps I have shared can completely
change your rehab, your body and your athletic future.

Everyone will be at different stages of their ACL rehab journey

but so long as you stay consistent with the exercises in here
you will transform your ACL recovery and knee strength and
resilience. Consistency and patience is the key to success!

There are so many factors that go in to a successful ACL rehab

and coming back stronger than you have ever been. I believe
you have everything you need in this ebook to fill in the
missing links left by traditional rehab approaches and I go into
even greater detail on every aspect of optimising and
accelerating your ACL rehab and guide you through the entire
process in my coaching.

If you want to book a FREE consultation call with me to chat

about where you are at with your specific ACL rehab and how
to accelerate and optimise your journey towards never tearing
your ACL again, click the link down below to book a call.

Also, if you have any further questions about anything in this

ebook feel free to message me directly on Instagram
(@the.ancestral.athlete)

BOOK YOUR FREE CALL: https://zcal.co/i/J2miGwVB