Exercise Overview

The leg press is an excellent machine-based exercise for building quad strength after ACL surgery. It allows you to load your legs in a controlled environment with adjustable resistance and range of motion.

Why Leg Press Works Well for ACL Rehab

  • Controlled environment: Machine guides movement path
  • Adjustable ROM: Limit depth to protect graft early on
  • Scalable resistance: Start light, progress over months
  • Bilateral or unilateral: Can work both legs or single-leg
  • Safe loading: No balance demands or fall risk

Range of Motion Guidelines

In early phases, limit your leg press ROM to protect your graft:

  • Weeks 6-8: 0-60° knee flexion
  • Weeks 8-12: 0-70° knee flexion
  • Month 3+: Progress toward full ROM (0-90°+)

Follow your surgeon's and PT's specific guidelines for your graft type.

How To Perform

1

Adjust the Machine

Set the seat back position so your knees are at the appropriate starting angle (based on your ROM restrictions). Your lower back should be flat against the pad.

2

Foot Position

Place feet shoulder-width apart on the platform, toes pointing slightly outward. Position feet in the middle or slightly higher on the platform.

3

Unrack and Prepare

Release the safety handles and straighten your legs (don't lock out completely). This is your starting position.

4

Lower with Control

Slowly bend your knees to lower the platform toward you. Stop at your prescribed ROM limit (e.g., 60° knee bend). Don't let your lower back round off the pad.

5

Press Up

Push through your heels (not toes) to extend your legs. Keep knees tracking over toes—don't let them cave inward.

6

Don't Lock Out

Stop just short of full knee lock at the top. This keeps tension on the muscles and protects the joint.

Common Mistakes

✗

Going Too Deep Too Soon

Early in recovery, deep leg press increases graft stress. Stick to your prescribed ROM limits.

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Knees Caving In

Keep knees aligned with toes. If they cave in, reduce weight or stop.

✗

Locking Out Knees

Hyperextending at the top is unnecessary and potentially harmful. Stop just before lockout.

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Butt Coming Off Seat

If your lower back rounds and butt lifts off, you're going too deep for your mobility.

✗

Too Much Weight Too Soon

Start light and progress slowly. The goal is building strength, not testing max.

Sets, Reps & Progression

Phase ROM Sets x Reps Weight Frequency
Week 6-8 0-60° 2-3 x 10-12 Light 2-3x/week
Week 8-12 0-70° 3 x 10-15 Moderate 2-3x/week
Month 3-4 0-80° 3 x 10-12 Progressive 2-3x/week
Month 4+ Full (0-90°+) 3-4 x 8-12 Progressive 2-3x/week

Start with a weight you can control for all reps with perfect form. Progress by 5-10% when the current weight becomes easy.

Variations

Bilateral Leg Press

Both legs working together. Standard version—start here.

Beginner

Single-Leg Press

One leg at a time to address asymmetries. Use lighter weight (less than half of bilateral).

Intermediate

High Foot Position

Feet higher on platform emphasizes glutes and hamstrings more than quads.

Variation

Low Foot Position

Feet lower on platform emphasizes quads. Be careful with knee stress.

Variation

Narrow Stance

Feet closer together—more quad dominant.

Variation

Wide Stance

Feet wider apart—more adductor and glute involvement.

Variation