During this stage you might look to introduce running. We have used an alter-gravity machine in the past to introduce running which takes away some of the gravity and allows us to put less stress on the knee. Obviously not everyone will have access to these machines so if running on grass is the option for you, then that is completely fine, just be sure to stay away from the harder surfaces at first. I am more than 2 years post my 4th ACL and I still place high importance on having a long and thorough warm up pre training sessions. This is to ensure that my muscles are ready and activated by the time I run. You don’t want your quads, hamstrings or glutes not firing as that is dangerous on the knee. Exercises which can be seen below such as glute band walks, arabesques, hurdles, leg extensions, hip extensions, balance work, bosu balance, calf raises, leg swings and patterning are all part of my movement prep to get my body warmed up and ready to go. Try different exercises and work out what works for you, what switches your muscles on, gets you warmed up and gives you the best chance to run and train with as little difficulty as possible.


I recommend that you have a physiotherapist or someone present who can assess whether you are moving freely or at least close to your normal technique. Another good idea is to film your running to assess your patterning and technique, which might allow you to adapt and tweak small things when you see yourself run. Recovery and icing is still so critical, you don’t want to have a good session on the track and then pull up sore for a few days afterwards because you didn’t recover adequately.


During this phase you must not go away from the strengthening phase. You might be training longer and harder with running being introduced into the program, but you must continue to strengthen your quad, gluteals and hammy’s as well as improving the proprioception around your knee. Some exercises that are key to this are the leg extension to build strength through the VMO, as well as various glue exercises such as hip extensions or band walks and hamstring exercises such as hammy curls with the swiss ball or an introduction of nordics back into the program which I demonstrate below.

Training loads will increase in this period and therefore you should allow and adjust for that. If you are running multiple times a week then have at least a day in between each run to allow for the best recovery. We opt for off legs days therefore meaning run one day, swim or upper body weights the following day and back into running on the third day.