To Leg Press or Squat if You have an ACL Injury?

To Leg Press or Squat if You have an ACL Injury?

Squat and leg presses exercises improve one’s overall lower body strength. In recent research, they experienced male lifters performing squats, high foot placement leg presses, and common foot placement.

Leg presses with technique variations to measure the amount of force at the knee joints and the muscle activity while performing these activities. This was a way to determine which among these exercises is more effective in muscle development. The results revealed that the squat appeared to be more successful in achieving this goal.

However, because muscle activity and knee forces are more significant with squats, those diagnosed with posterior cruciate ligament and patellofemoral disorders must be especially cautious on knee bending at great angles (> 50 degrees). ACL patients in rehabilitation may effectively do the squats and leg presses.

Highlights of Leg Press and Squat Forces and Muscle Activity

1. No difference in muscle activity or knee force when feet were straight ahead or turned out 30 degrees.
2. Squat had greater quadriceps and hamstring activity than the high and low foot placement leg press.
3. The wide stance foot placement leg press generated more excellent hamstring activity than the narrow stance foot placement leg press.
4. Wide stance foot placement created greater posterior cruciate ligament tensile force than a narrow foot position.
5. The narrow stance foot placement generated greater tibiofemoral joint and patellofemoral joint compressive force than the wide stance foot position during the low and high foot placement leg press.
6. The wide stance foot placement generated greater tibiofemoral and patellofemoral joint compressive force than the narrow stance during the squat.

Take Home Message about Squat and Leg Press for ACL

• PATELLOFEMORAL DISORDERS
  – Avoid wide stance squats
  – Avoid narrow stance leg press
  – Patellofemoral  joint force increased with the depth of the squat or leg press
• ANTERIOR CRUCIATE LIGAMENT DISORDERS
  – All exercises are suitable for ACL rehabilitation due to low force on the ACL
• POSTERIOR CRUCIATE LIGAMENT DISORDERS
  – Avoid wide stance leg press
  – Greater force placed on posterior cruciate ligament with deeper squat and leg press
• TIBIOFEMORAL JOINT DISORDERS (Meniscus or Osteoarthritis)
  – Avoid wide stance squats
  – Avoid narrow stance leg press
  – Tibiofemoral joint force increased with deep squat or leg press
• FOOT POSITION
  – Changing the foot position does not affect muscle activity or knee forces.
• FOCUSING ON QUADRICEPS
  – The squat is better
• FOCUSING ON HAMSTRINGS
  – The squat is better
  – Wide stance is better

The Last Word from Rick Kaselj

What does all this mean?

If you have a client in early rehabilitation with the above conditions, the above points are essential. The above are some excellent guidelines for exercise modification for clients that may come to you with the above conditions.

When a client fully recovers from their injury, the above may not influence their goals and training.

If you are looking for practical exercises for knee injuries, I recommend checking out the Exercises for Prevention, Rehabilitation, and Overcoming Knee Injuries webinar.

If you want to attend one of the Exercise Rehabilitation of the Knee live courses, CLICK HERE.

Rick Kaselj, MS