During ACL rehabilitation, it's important to isolate the quads from the glutes, hamstrings and calf muscles as the body will find a way to cheat during closed chain exercises such as squats/leg press; thus underloading the quads and the knee. Knee extensions are therefore important to load the knee appropriately (in conjunction with squats/leg press etc), but we need to consider knee joint angles before choosing knee extensions as an exercise.

As the ACL graft is under the greatest amount of strain from 0-30deg knee flexion, isometric contractions at 60 and 90deg are well away from angles that could stretch the graft during the first 12 weeks of rehab; and in fact at these angles, it has been shown to have 0% strain on the ACL (Beynnon et al)

The benefit of doing isometrics is that you can minimse the quads wasting in those first few post-op weeks, and also help with swelling and pain. FYI: You don't need a Swiss Ball to do this exercise, you just need an immovable resistance at those specific angles, making sure you don't drift up towards 30deg knee flexion. If any doubt, consult with your physiotherapist.

For more information on ACL injury rehabilitation, download the Melbourne ACL Rehabilitation Guide by clicking on the link below
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