Exercises To Prevent an ACL Tear

The anterior cruciate ligament, or ACL, is an important stabilizing structure located within your knee joint. This ligament is attached diagonally from the shinbone (tibia) to the thigh bone (femur) and helps prevent the tibia from shifting forward on the femur. The structure also provides stability to the knee during higher-level activities like running, cutting, and jumping.

Regrettably, tears to the ACL are common, particularly in people with more rigorous occupations or those who play more physically demanding sports. Not only is this type of ligament injury extremely debilitating when it occurs, but it can also have long-lasting consequences. Individuals who tear their ACL are less likely to return to more demanding sports or activities and more likely to develop osteoarthritis in their knee.

Woman holding knee in pain

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Fortunately, recent research has shown that exercise can help to decrease your risk of sustaining this type of tear. By building strength in your leg and core muscles, improving your overall balance, and fine-tuning your body mechanics, you can reduce the likelihood of a knee injury.

In this article, we'll review the specific techniques that can help prevent an ACL tear.

Target the Hamstrings

The hamstrings are a set of three muscles that span from the hip to the knee in the back of your thighs. These muscles, like the ACL, help to resist the forces that slide your tibia forward on your femur. Because of this, strengthening the hamstrings plays an influential role in preventing an ACL tear.

One effective way to target this area is the Russian hamstring curl. To perform this exercise:

  1. Begin in a tall kneeling position and have a partner apply downward pressure on both of your ankles to keep them from lifting off the ground.
  2. Lean forward and lower your torso toward the floor as low as
    you can while maintaining control.
  3. When you can’t lean forward any further without losing control,
    use the muscles in the back of your legs to slowly return to the tall kneeling position.
  4. Try to complete three sets of 10 repetitions.

Strengthen the Core

The abdominal and back muscles that make up your “core” play an important role in controlling your trunk and pelvic movements when you jump or cut. Weakness in these areas can contribute to improper mechanics and may increase your risk of an ACL tear.

One way to build strength in this area is a plank. To properly complete this exercise:

  1. Lie on your stomach and prop up onto your forearms.
  2. Contract your stomach and lift your body off the ground, forming a straight line from your forearms to your tiptoes. Your back should be straight, and your butt should be in line with the rest of your body.
  3. Hold this position until you are fatigued, and then take a break.
  4. Try two to three planks each session. Gradually try to increase the time spent holding the pose.

Build Up Your Glutes

The glute muscles in your hip region (including the gluteus maximus, gluteus medius, and gluteus minimus) carry out several important functions. To start, these muscles help to dissipate some of the forces that travel through the leg when completing tasks like running or jumping.

In addition, these muscles help to keep your leg in proper alignment during these activities and reduce some of the strain placed on the ACL.

To build strength in these consequential muscles, try the single-leg bridge exercise:

  1. Lie on your back with one knee bent and the other leg extended in the air.
  2. Lift your buttocks as high as you can off the ground using the bent leg. Make sure your pelvis stays level and does not tilt to the side as you do this.
  3. Hold this position for a second or two before slowly lowering your butt to the ground.
  4. Repeat three sets of 10 bridges on each leg.

Incorporate Balance Training

Improving your balance with proprioceptive exercises helps your body and legs stay in a more stable position during demanding activities.

By building up your overall stability, you decrease your chances of sustaining a tear in your ACL while running, cutting, or jumping.

One effective way to increase your balance is the single-leg stance technique. To perform this exercise:

  1. Stand on one leg with the other lifted in the air. Make sure the knee on your stance leg is slightly bent.
  2. Hold a ball in your hands and slowly lift it over your head and back to your stomach without losing your balance.
  3. Continue the up and down movements with the ball for 30 seconds before taking a break. Try this two times before switching legs.
  4. When this is easy, progress the exercise by playing catch with a partner while balancing on one leg.

Focus on Your Form

Plyometric exercises are another type of technique that is important to incorporate into your ACL prevention program. These movements, which focus on improving your form during impact activities, can be helpful in several ways.

First, they help reduce the forces that travel through your knee when you land. They also help prevent the knee from falling into a knock-kneed or valgus position, which puts more stress on your ACL.

One example of a plyometric is the squat jump. To try this at home:

  1. Stand with your feet slightly wider than shoulder-width apart.
  2. Bend your knees and squat towards the floor with your arms at your side.
  3. Jump upwards out of the squat as you swing your arms backward.
  4. Land quietly back into the squatted position and continue to quickly repeat the jumps. Be sure not to let your knees move inwards during the takeoff or landing phase.
  5. Continue jumping for 30 seconds straight before taking a break. Try two to three sets of the exercise.

A Word From Verywell

Strengthening exercises such as the ones described above can help you avoid an ACL tear and the long-term consequences that are associated with it. To properly prevent this type of injury, your training sessions should last between 20 and 30 minutes and be performed at least twice weekly.

It is also important to note that each person’s body mechanics are unique. Because of this, it is important to speak to your healthcare provider about a referral to a physical therapist (PT) if you are at risk of an ACL tear and are interested in starting an ACL prevention regimen. Your PT can help customize a program to meet your individual needs and increase your chances of staying injury free.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Academy of Orthopaedic Surgeons. Anterior cruciate ligament (ACL) injuries.

  2. Cheung EC, DiLallo M, Feeley BT, Lansdown DA .Osteoarthritis and acl reconstruction—myths and risks. Curr Rev Musculoskelet Med. 2020;13(1):115-122. doi:10.1007/s12178-019-09596-w

  3. Nessler T, Denney L, Sampley J. ACL injury prevention: what does research tell us? Curr Rev Musculoskelet Med. 2017;10(3):281-288. doi:10.1007/s12178-017-9416-5

  4. Acevedo RJ, Rivera-Vega A, Miranda G, Micheo W. Anterior cruciate ligament injury: identification of risk factors and prevention strategiesCurrent Sports Medicine Reports. 2014;13(3):186-191. doi:10.1249/JSR.0000000000000053

  5. Sadigursky D, Braid JA, De Lira DNL, Machado BAB, Carneiro RJF, Colavolpe PO. The FIFA 11+ injury prevention program for soccer players: a systematic review. BMC Sports Sci Med Rehabil. 2017;9(1):18. doi:10.1186/s13102-017-0083-z

By Tim Petrie, DPT, OCS
Tim Petrie, DPT, OCS, is a board-certified orthopedic specialist who has practiced as a physical therapist for more than a decade.