Laurie's Blogs.


Dec 2021

Returning to Sport & Function BETTER and FASTER after ACL Surgery

Laurie Edge-Hughes, BScPT, MAnimSt, CAFCI, CCRT

Photo Credit:


Just as the title suggests… Isn’t that the ultimate goal of our post-operative rehab?  Better outcome!  Faster outcome!  


That’s the subject of a human research paper that looked at High-Intensity (HRT) versus Low-Intensity (LRT) resistance training after ACL-reconstruction.


Bieler T, Sobol NA, Andersen LL, Kiel P, Løfholm P, Aagaard P, Magnusson SP, Krogsgaard MR, Beyer N. The effects of high-intensity versus low-intensity resistance training on leg extensor power and recovery of knee function after ACL-reconstruction. Biomed Res Int. 2014;2014:278512. 


Since this ties in quite closely with our animal practices, I thought we could make some correlations here.


What they did:
Two groups were created by single blinded randomization (High-Intensity or Low-Intensity resistance training).  Both groups underwent 7-weeks of standardized rehabilitation, after which the resistance training protocol was varied.


At 8-weeks weight training commenced and consisted of a 2-week familiarization period for both groups and consisted of bilateral and unilateral exercises:

•Leg Press (from 90 to 0 degrees in knee).

•Prone Leg Curls (0–90 degrees).

•Seated Knee Extension (90–0 degrees).


Intensity is what differed.  See the Table below:



Power was regained more with HRT compared to LRT without adverse effects on joint laxity:

•Week 14 (84% versus 73% of non-injured leg)

•week 20 (98% versus 83% of non-injured leg)

Note: Power was measured using the “Leg Extensor Power Rig”.

No other between-group differences were found (i.e. self-reported outcome scores, or hop tests).


A great line from the paper: “Most likely, the accelerated/amplified gains observed with high-intensity resistance training were caused by more marked neuromuscular adaptations and/or greater muscular regrowth induced by this training modality.”


What to make of it and why you might care


So, if your patient (canine or human) resides more towards the ‘potato’ side of the activity scale, then you can carry on with low intensity strengthening activities.  However, if your patient is an athlete of sorts then a high intensity protocol is likely to be the way to go.


Either way… and I’m throwing personal opinion in on this, and backing it up with this study… you need to get that dog out of the underwater treadmill and into the ‘gym’ for some strength training.  Additionally, a home program should incorporate strength training as well.


That’s your Knowledge Nugget for the week!

Have a good one folks!

Cheers,  Laurie