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Updated: Aug 6, 2026
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Early Weight-Bearing Rehabilitation Protocol After Anterior Cruciate Ligament Reconstruction
Published on: March 1, 2024
Eccentric cycling for ACL-R rehabilitation: A masterclass
Margaret M Michalak1, John Cronin1, Chloe M Ryan2
1Sports Performance Research Institute New Zealand, Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand; Athlete Training and Health, Cypress, TX, USA.
Summary
Early eccentric exercise, including cycling, can help rebuild quadriceps strength and reduce deficits after anterior cruciate ligament reconstruction (ACL-R). Gradual implementation is key for safe and effective recovery and return to sport.
Area of Science:
- Sports Medicine
- Rehabilitation Science
- Orthopedics
Background:
- Eccentric training is a proven method for strength development.
- Its use in anterior cruciate ligament reconstruction (ACL-R) rehabilitation is growing.
- Early eccentric exercise shows promise in mitigating quadriceps atrophy and strength loss post-surgery.
Purpose of the Study:
- To explore the benefits of incorporating eccentric cycling into ACL-R rehabilitation.
- To provide an exemplar eccentric cycling program for clinicians.
Main Methods:
- Review of current literature on eccentric training in ACL-R.
- Discussion of eccentric recumbent cycling as a practical tool.
- Outline of an individualized eccentric cycling program considering clinical status and loading tolerance.
Main Results:
- Early progressive eccentric exercise may improve quadriceps strength and reduce atrophy.
- Eccentric training can potentially enhance return-to-sport (RTS) performance.
- Eccentric cycling allows for controlled intensity monitoring via power output and RPE.
Conclusions:
- Integrating eccentric cycling into ACL-R rehabilitation offers significant benefits for strength recovery and functional outcomes.
- A gradual and individualized approach to eccentric exercise is crucial, especially in early recovery phases.
- Eccentric recumbent cycling provides a safe and effective modality for managing ACL-R rehabilitation.