Restoring Quadriceps Strength, Power, and Hypertrophy Following Long-Term Deficits with a Post-Operative ACL Repair

Start Date

23-4-2026 12:00 AM

Description

This case study will look at a Division I football wide receiver who is approximately three years post-operative from an ACL reconstruction via quad tendon graft. He presents with significant quadriceps deficits and visible atrophy years later due to ineffective early rehabilitation. Complications from severe quadriceps deficits provide a negative impact in sport with acceleration/deceleration, cutting, or explosive change in directions. Outcome measures included quadriceps strength symmetry through BioDex testing, power was assessed through force plates, and girth measurements at the thigh for change in muscle size. The goal was to evaluate the potential gains through targeted rehabilitation in a high-level athlete several years post-surgery. This case brings awareness to the potential for significant strength and muscle deficits to persist years after ACL reconstruction when early rehabilitation is insufficient and help inform future rehabilitation strategies for athletes with delayed or inadequate post-operative care.

Research Highlights

  • The Problem: A 20-year-old college football player experienced persistent quadriceps atrophy, strength, and power loss three years after undergoing an ACL reconstruction surgery using a quadriceps tendon graft. 

  • The Method: Researchers conducted a single-participant case study over an 8-week intervention period utilizing progressive rehabilitation focused on hypertrophy, strength, and power, while incorporating blood flow restriction during the first four weeks. 

  • Quantitative Finding: At week 0, the affected limb (R) showed a peak torque of 195.6 Nm at 60 deg/s compared to 302.6 Nm in the unaffected limb (L); week 0 girth measurements 6 inches above the patella were 56cm (L) and 52.5cm (R); by week 4, girth measurements 6 inches above the patella improved to 56cm (L) and 54cm (R); peak torque deficit at 60 deg/s was 35.3% at visit 1 and 39.6% at visit 2. 

  • Finding: Progressive rehabilitation programs utilizing objective testing tools like BioDex dynamometers and force plates can effectively identify and address muscular asymmetries and strength deficits several years after an initial surgery.

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Apr 23rd, 12:00 AM

Restoring Quadriceps Strength, Power, and Hypertrophy Following Long-Term Deficits with a Post-Operative ACL Repair

This case study will look at a Division I football wide receiver who is approximately three years post-operative from an ACL reconstruction via quad tendon graft. He presents with significant quadriceps deficits and visible atrophy years later due to ineffective early rehabilitation. Complications from severe quadriceps deficits provide a negative impact in sport with acceleration/deceleration, cutting, or explosive change in directions. Outcome measures included quadriceps strength symmetry through BioDex testing, power was assessed through force plates, and girth measurements at the thigh for change in muscle size. The goal was to evaluate the potential gains through targeted rehabilitation in a high-level athlete several years post-surgery. This case brings awareness to the potential for significant strength and muscle deficits to persist years after ACL reconstruction when early rehabilitation is insufficient and help inform future rehabilitation strategies for athletes with delayed or inadequate post-operative care.