Eccentric Cycling for ACL-R Rehabilitation: A Masterclass
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Michalak, Margaret M
Cronin, John
Ryan, Chloe M
Rumpf, Michael
O'Brien, Daniel
Slocum, Christopher
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Elsevier BV
Abstract
Eccentric training is a well-established method for developing strength and its implementation has become increasingly common in anterior cruciate ligament reconstruction (ACL-R) rehabilitation. Although traditionally introduced in later stages of recovery, early progressive eccentric exercise has been investigated from approximately three weeks post-operation in selected patients, with evidence suggesting potential benefits for quadriceps atrophy and strength deficits. Beyond improving strength, eccentric training may also enhance performance in return-to-sport (RTS) assessments. However, its implementation should be gradual and individualized, with consideration of clinical status and loading tolerance, particularly during the early phases of rehabilitation. Eccentric recumbent cycling offers a practical solution, allowing clinicians to monitor power outputs and regulate intensity through rate of perceived exertion (RPE) scales. This article explores the benefits of integrating eccentric cycling into ACL-R rehabilitation and outlines an exemplar eccentric cycling program.
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ACL rehabilitation, Load management, Muscle activation strategies, Quadriceps strength, Recumbent eccentric cycling, 4201 Allied Health and Rehabilitation Science, 42 Health Sciences, Physical Rehabilitation, Rehabilitation, Clinical Research, Physical Activity, 6.7 Physical, 1103 Clinical Sciences, 1106 Human Movement and Sports Sciences, Sport Sciences, 4201 Allied health and rehabilitation science, 4207 Sports science and exercise
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Phys Ther Sport, ISSN: 1466-853X (Print); 1873-1600 (Online), Elsevier BV, 81, 101965-. doi: 10.1016/j.ptsp.2026.101965
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Creative Commons Attribution CC-BY 4.0
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Except where otherwise noted, this item's license is described as Creative Commons Attribution CC-BY 4.0