ACL reconstruction, long term health

[Chris Puckett]

Hi Mark,

Ok, so I made it to page 11 of SSv.2, and I have my first question. Do you think the squat is key to long term knee health, post ACL surgery? I had my ACL done back in 1996, and since then have remained fairly injury free after picking up bicycling. I have yet to find anything written on long term knee health/maintenance, post ACL surgery. I want this thing to last the rest of my life, and so far, your explanation of the squat would make me think the squat is the best thing I can do for my knee. My cycling experience(mid-level amateur racing 6+ yrs) proved to be a very risky time sucking activity. So I wanted to get your thoughts on maintaining knee health with the full squat, by properly developing the legs function.

Thanks,
Chris

[Mark Rippetoe]

Well, I don't have an ACL in my right knee, having ruptured the repair graft some years ago after the surgery. I partially ruptured it playing soccer (I know, don't tell me, I don't want to hear it...), and finished it off stepping down off a tall horse onto bad footing. The squats have never hurt it, either when I had the graft or after the second rupture, and the other knee is fine. I have used squats to rehab several knees that I had the opportunity to work with, with excellent results. Done correctly, the squat is an ACL-neutral movement, one that provides balanced strength anterior/posterior, unlike any machine-based program of rehab or exercise. But you can rupture an ACL or an ACL graft despite your correct rehab if you engage in ACL-risky behavior. You just can't rupture it doing squats correctly, and they will keep your leg strength in balance to reduce the likelihood of it happening.