Strength Training With BFR Through the Later ACL Rehab Phases

The general strength principles: three sessions a week, at most two exercises per muscle group, 30, 15, 15, 15 repetitions (75 in total) at 20 to 40% of 1RM and 50 to 80% of limb occlusion pressure, with at least three minutes of reperfusion between exercises. The target is a rating of perceived exertion of 8 out of 10; failure is not needed. Pressure and load are adjusted by the reps reached in the last set. Unilateral training causes less central fatigue than bilateral. Each phase has criteria. The non-weight-bearing phase needs a closed wound, no reactive swelling, voluntary quadriceps and hamstring control and pain at most 4 out of 10, and starts with isometric single-joint work. The partial weight-bearing phase adds full passive extension, five seconds of single-leg stance and a dynamic gait with crutches. Full weight-bearing needs minimal swelling, quality single-leg exercise and gait without crutches. The speaker's message is that BFR complements but does not replace traditional rehab, and external load should keep progressing.