Hi Hayley,

I've torn both ACLs -- one 12 years ago, one 2 years ago. Both knees feel pretty good, considering, and I'm lucky insomuch that I have very few problems. I'm still an active person; I currently play in two soccer leagues and a basketball league, and go for a long run/hike on the weekends.

My main concern is whether/how I should work in strength exercises. I'm edging towards my mid-30s, and my muscle didn't really bounce back to the same degree after the most recent injury (though it's balanced with the other leg, and is strong enough to feel comfortable during cutting/side to side movements). Do you have any recommendations for working strength training into my existing routine? Or should I cut some of the fun stuff and focus on building better muscle (meh!!)? I've been a dedicated gym-goer in the past, but given time constraints and crazy work commitments, I'd like to double-task exercise with time outside and/or playing with friends. Any thoughts are much appreciated!


Thankfully, touch wood, I have yet to experience any serious injuries to my knees, but I have known, and worked with, many who have.  It sounds to me like you are doing ok, and should consider yourself lucky that you are able to play soccer, basketball and hike and run regularly without too much pain. I am actually a little shocked, however, that you are not currently doing strength exercises as this should have been something you started as soon as you began your ACL rehabilitation.

There is no need to cut out the fun stuff, because if we are not having fun then what is the point? Hiking is a great way to build your leg strength, but you will need to add in a few more exercises to ensure you are keeping your body strong to handle your other activities.

There is no need to join a gym or spend too much time doing your strength exercises and you can get away with 20-30 minutes twice a week at home, although you may want to invest in a few sessions with a physiotherapist. You are going to want to focus on strengthening your core muscles as well as making sure your pelvis is stable and the muscles that support your knees are strong.

Here are a few of my favourite strength exercises that you should incorporate into a twice a week strength routine.

Stability ball roll outs
Start on your knees on a mat and have your hands resting on a stability ball with your arms straight.  Initiate the movement forward from your knees and then allow your body to fall forward like a tree, keeping your hips in line with your shoulders and knees, as you roll the ball away from you and finish on your elbows. Go as far as you can maintain a strong core then draw your arms back in towards you, raising your body up without allowing your hips to push back behind you. Start with 1 set of 10 and work up to 3. This is one of my favourite exercises to help strengthen your core.

Stability ball leg lifts
Place the stability ball underneath your hips, with your bottom leg bent and resting on the floor, your top leg straight and lay your body over the ball. Contract the quadriceps on your top leg, ensuring your leg is straight, and lift your top leg up to hip height 10 times, without allowing your hips to move. Once you have completed 10 then do 10 small circles of your leg in each direction, ensuring the movement is coming from your legs and not your back or hips. This exercise is great for strengthening your glutes.

Stability ball hamstring curls
Lie on a mat with your heels placed on the ball. Start by elevating your hips off the ground then drive your heels heavy into the ball as you lift your hips higher while rolling the ball in towards you and then away, without allowing your hips to drop back to the floor. Complete 3 sets of 10 with your hands on the ground for support then work on being able to do them with your elbows only on the ground and eventually be able to do them without any support from your hands. This exercise is important for strengthening your hamstrings and improving your hip extension.

Front plank with “L” leg lifts
Begin in a front plank, then lift one leg straight up and then out to the side as if you are writing an L with your heel. Reverse the motion and place the foot back on the floor, repeating on the other side. You want to focus on ensuring your hips remain completely still as you are lifting your leg and bringing out to the side. This exercise is meant to target your glutes and improve your hip stability.

Back Bridge
Lie on your back with your feet hip width apart, knees bent and feet on the floor. Start by lifting your hips up by pressing heavy into the balls of your feet and initiating from your core and hamstrings rather than your back. Start with sets of 20 then experiment with using one leg or holding it and balancing on one side and then the other. A great way to target your hamstrings and hip stability at the same time.

Attached - Jean-Claude Van Damme heading to the gym in Venice yesterday.