READ THIS FIRST

The protocol is four criterion-based phases. Progress when the phase's exit criteria are met, not on a calendar. The `/session/today` view resolves the correct session for today from your current phase and day-of-week; this page is the whole plan laid out for reference — every exercise, every phase, in reading order. Load progressions are shown at a representative week; open the session page for the actual load for a specific week.

Full evidence base, citations, and the running-forward timeline (first jog wk 3–4, first 5K wk 12–14) live in PROTOCOL.md at the project root.

PHASE 1 · RESTOREWEEKS 1–2

Quiet the joint, reactivate quads, full painless ROM. No running yet.

MON
P1-A
TUE
P1-B
WED
P1-A
THU
REST
FRI
P1-B
SAT
P1-A
SUN
REVIEW
SESSIONS IN THIS PHASE
P1-A≈ 30 MIN
Phase 1 · Reactivate
Quads on, joint warm
Warm-up10 MIN
  • 10 minRPE 4/10
    Stationary cycle warm-up
    Low resistance, cadence 80–90 rpm. If no bike, brisk walk substitutes.
Main20 MIN
  • 4 × 105-sec hold, voluntary max
    Quad set with towel roll
    Lie on back, rolled towel under knee. Push knee DOWN into the roll; feel the front thigh contract without moving the knee. 5-sec hold, 3-sec release.
    ▸ Contract the muscle, don't push through pain.
  • 3 × 15BW → 2 kg ankle wt from wk 2
    Short-arc quad (0–30°)
    Same setup as quad set. Lift heel a hand's width off the floor, straighten the knee fully at the top, slow lower.
    ▸ Keep the load low (< 3 kg); heavy open-chain leg extension loads the anterior meniscus horn per Wu 2022.
  • 3 × 12 eachBW
    Straight-leg raise, four directions
    Back for hip flex; side for hip abd; stomach for hip ext; other side for hip add. Keep the moving leg straight, glutes tight.
  • 3 × 30 secBW, shallow depth only
    Wall sit (0–45° flex)
    Back flat against wall, feet ~50 cm from wall. Slide down until thighs at about 45° — NOT parallel. Hold.
    ▸ Stop if medial pain climbs above 3/10.
  • 3 × 15BW
    Standing calf raise
    Both feet flat, rise on to balls of feet, slow lower.
  • 15 min—
    Ice, only if joint warm/swollen
    Reactive use only, not prophylactic. ~14% pain reduction at 48h per Culvenor 2022 OPTIKNEE.
P1-B≈ 25 MIN
Phase 1 · ROM + Hip
Extension bias, hip stability
Warm-up8 MIN
  • 8 minRPE 3/10
    Stationary cycle warm-up
    Low resistance, cadence 80–90 rpm. If no bike, brisk walk substitutes.
Main17 MIN
  • 4 × 20 slowBW
    Heel slide (flex)
    Lie on back, slide heel toward buttocks until you feel a firm stretch (no sharp pain), slide back. Progress the end-range each set.
  • 3 × 90 secGravity
    Prone hang (extension)
    Face-down on a bed with the whole leg off the edge, ankle propped on a rolled towel. Let gravity press the knee straight.
  • 3 × 15BW
    Standing hamstring curl
    Stand, bend the injured knee, bring heel toward buttock. Slow eccentric.
  • 3 × 15 eachBand above knees
    Clamshell
    Side-lying, knees stacked. Lift top knee keeping heels together and hips still.
  • 3 × 12 eachBW
    Single-leg glute bridge
    On back, one foot flat, other leg straight in air. Push hips up through the planted heel.
  • 3 × 15BW
    Standing calf raise
    Both feet flat, rise on to balls of feet, slow lower.
REST DAY — off, or 15–20 min easy bike. REVIEW DAY — Sunday check-in on adherence, trends, criteria.
EXIT CRITERIA · PHASE 1 → PHASE 2
  • Full painless extension
    Heel-height test symmetric with the uninjured knee
    manual
  • Flexion ≥ 130°
    Heel to buttock within 5 cm of the left side
    manual
  • Voluntary quad contraction
    VMO fires without needing to press on the muscle
    manual
  • Morning stiffness ≤ 10 min · 5 days
    Auto-checked from the daily log
    auto
  • Rest pain ≤ 2 / 10 · 5 days
    Auto-checked from medial pain rest value
    auto
  • Activity pain ≤ 4 / 10 · 5 days
    Auto-checked from medial pain activity value (or complaint score)
    auto
  • Swelling: none/mild · 5 days
    Auto-checked from swelling field
    auto
PHASE 2 · LOAD & RE-INTRODUCE RUNNINGWEEKS 3–8

Close the strength gap, start walk-run intervals gated by plyometric tolerance. This is the phase that gets you back.

MON
P2-A
TUE
P2-RUN
WED
P2-B
THU
REST
FRI
P2-C
SAT
P2-RUN
SUN
REVIEW
SESSIONS IN THIS PHASE
P2-A≈ 55 MIN
Strength A · Squat pattern
Bilateral squat + hinge, close the strength gap
Warm-up10 MIN
  • 5 minRPE 4/10
    Stationary cycle warm-up
    Low resistance, cadence 80–90 rpm. If no bike, brisk walk substitutes.
Main35 MIN
  • 3 × 1016–20 kgRIR 3
    Goblet squat (to a box)
    Hold a dumbbell at chest. Squat to touch a box (start knee-height, progress to bench-height). Knees track over the second toe.
    ▸ Anterior-horn radial tears TOLERATE deep squat (femoral condyles offload the anterior structures). If medial pain > 3/10, reduce depth first, then load.
  • 3 × 10 each side2 × 8 kgRIR 3
    Bulgarian split squat
    Rear foot on a low bench (~30 cm), front foot 60 cm forward. Drop straight down until back knee brushes the floor. Keep front shin vertical.
    ▸ No valgus collapse — knee tracks over the toes throughout.
  • 3 × 10Add 5%/wk (wk 5)RIR 3
    Leg press (or double-leg wall press)
    Sit on sled; feet shoulder-width, mid-foot. Press knees toward chest and back. Don't lock knees at top.
  • 3 × 6 slow eccentricBW; arms assist upRIR to failure
    Nordic hamstring curl (assisted)
    Kneel on a pad, ankles held down (or under a couch). Lean forward slow, using hamstrings to control the fall. Push back up with hands.
  • 3 × 20 sec each sideBW
    Copenhagen adductor plank
    Side plank with top leg on a bench, bottom leg hanging. Hip stays lifted the whole time.
Cool-down5 MIN
  • 5 mineasy
    Walk cool-down
    Cadence drops naturally. Then hamstring / calf / hip-flexor stretch 30 sec × 2 each.
NOTES
  • · Week 5 of 6. Load adds 5% next week when top set closes at RIR ≥ 3.
  • · Stop at 3 RIR — 0–1 RIR gives no extra strength gains per Robinson 2023 and costs recovery.
P2-RUN≈ 40 MIN
Walk-run · Delaware RTR 2
Progressive return-to-running, criterion-gated
6 min run : 1 min walk × 2–4 · TOTAL 25–35 minCadence +5–10% above baseline
Warm-up5 MIN
  • 5 minbrisk pace
    Walk warm-up
    Get HR up gradually. Do NOT stretch statically pre-run.
Run intervals — 6 min run : 1 min walk, 2–4 reps30 MIN
  • 25–35 minRPE 4–5, conversational
    6 min run : 1 min walk × 2–4
    Cadence +5–10% above baseline. Flat surface (park path or treadmill 0% incline). Use a metronome app for cadence.
    ▸ Stop and revert one row if: medial pain > 4/10 during, effusion moderate/marked next morning, stiffness > 20 min next day.
Cool-down5 MIN
  • 5 mineasy
    Walk cool-down
    Cadence drops naturally. Then hamstring / calf / hip-flexor stretch 30 sec × 2 each.
NOTES
  • · Entry gate: 200–250 pain-free plyometric contacts in one Strength C session before starting RTR 1.
  • · Ratios from University of Delaware Advanced Return-to-Running protocol.
  • · Cadence +5–10% cue reduces tibiofemoral + patellofemoral load without changing metabolic cost (Heiderscheit 2011).
P2-B≈ 50 MIN
Strength B · Hinge + Balance
Hinge pattern, single-leg, neuromuscular control
Warm-up10 MIN
  • 5 minRPE 4/10
    Stationary cycle warm-up
    Low resistance, cadence 80–90 rpm. If no bike, brisk walk substitutes.
Main35 MIN
  • 3 × 1050 kgRIR 3–4
    Romanian deadlift
    Bar starts at hip. Push hips back until you feel firm hamstring stretch (bar just below knees). Return by squeezing glutes. Knees soft, not bent.
  • 3 × 8 each2 × 6 kgRIR 3
    Single-leg RDL
    Balance on injured leg. Free leg extends backward as torso hinges forward — both form a straight line. Return by squeezing the standing glute.
  • 3 × 10 each8 kgRIR 3
    Step-up (30–40 cm box)
    Step up under control, drive through mid-foot. Return by lowering slow — the down phase is the point.
  • 3 × 30 seceyes open → eyes closed → foam
    Single-leg stance progression
    Stand on injured leg. Progress to eyes closed once 30 sec is easy. Then stand on a folded towel. Then foam pad.
  • 3 × 3 reaches each direction each legBW
    Y-balance reach
    Balance on one leg. Reach the free leg forward, posteromedially, and posterolaterally. Note the max reach; symmetric target.
  • 5 minRPE 4/10
    Backward walking on treadmill (10% incline)
    Face away from console, hold rail lightly. Contracts quads through short-arc range without heavy anterior loading.
Cool-down5 MIN
  • 5 mineasy
    Walk cool-down
    Cadence drops naturally. Then hamstring / calf / hip-flexor stretch 30 sec × 2 each.
P2-C≈ 55 MIN
Strength C · Unilateral + Power primer
Unilateral load + plyometric primer
Warm-up12 MIN
  • 5 minRPE 4/10
    Stationary cycle warm-up
    Low resistance, cadence 80–90 rpm. If no bike, brisk walk substitutes.
Main38 MIN
  • 3 × 10 each2 × 8 kgRIR 3
    Reverse lunge
    Step backward and drop the back knee to just above the floor. Front shin stays vertical. Drive through front foot to return.
  • 3 × 8 each2 × 12 kgRIR 3
    Front-foot elevated split squat
    Front foot on a small 5-cm plate, rear foot flat. Split-squat drop. This shifts load onto the front quad.
  • 3 × 12 each8 kg DBRIR 3
    Single-leg calf raise
    Stand on one foot, other lifted. Rise on to ball of foot, slow lower under control.
  • 3 × 20BW
    Pogo hops in place
    Small, fast hops — heel barely leaves the floor. Cushions the tissue for later plyos.
  • 3 × 5BW, bilateral
    Broad jump to stick landing
    Jump forward for distance, land soft with both feet. HOLD the landing 3 sec. No wobble, no valgus.
    ▸ Both feet at once; single-leg broad jumps belong to Phase 3.
  • 3 × 30 sec each sideBW
    Copenhagen adductor plank
    Side plank with top leg on a bench, bottom leg hanging. Hip stays lifted the whole time.
Cool-down5 MIN
  • 5 mineasy
    Walk cool-down
    Cadence drops naturally. Then hamstring / calf / hip-flexor stretch 30 sec × 2 each.
REST DAY — off, or 15–20 min easy bike. REVIEW DAY — Sunday check-in on adherence, trends, criteria.
EXIT CRITERIA · PHASE 2 → PHASE 3
  • Isometric quad LSI ≥ 90%
    Handheld dynamometer or single-leg wall-sit hold time
    manual
  • Isometric hamstring LSI ≥ 90%
    Nordic curl reps or unilateral hip-bridge holds
    manual
  • Pain-free 24 kg full-depth goblet squat
    Bilateral, full range, medial pain ≤ 3/10
    manual
  • Exercise pain ≤ 3 / 10 · 5 sessions
    Auto-checked from medial pain complaint after strength days
    auto
  • 30 mini-squats in 30 sec, symmetric
    Single-leg mini-squat, both limbs equal
    manual
  • 3 continuous 20-min jogs, pain ≤ 3 / 10
    Conversational pace, no next-morning flare
    manual
PHASE 3 · PERFORMWEEKS 9–14

Convert strength to power. Single-leg landings. Continuous running with tempo work.

MON
P3-A
TUE
P3-EASY
WED
P3-B
THU
REST
FRI
P3-INTVL
SAT
P3-LONG
SUN
REVIEW
SESSIONS IN THIS PHASE
P3-A≈ 55 MIN
Strength A' · Heavy squat + power
Maintain strength, introduce power
Warm-up12 MIN
  • 5 minRPE 4/10
    Stationary cycle warm-up
    Low resistance, cadence 80–90 rpm. If no bike, brisk walk substitutes.
Main38 MIN
  • 4 × 580–85% 1RMRIR 2
    Back squat (or front squat)
    Bar on upper traps, feet shoulder-width, sit between hips. Depth: thigh parallel if pain-free, above if not.
  • 3 × 6 each2 × 20 kgRIR 2
    Bulgarian split squat
    See Phase 2. Heavier load, tighter rep range.
  • 4 × 5BW
    Countermovement jump
    Stand tall, dip fast, jump for max height. Land soft, absorb through hips + knees. Rest 60 sec between sets.
  • 3 × 15 eachBW
    Single-leg pogo
    Small hops on one foot, cadence > 120/min. Contact time as short as possible.
  • 3 × 6 slow eccentricBW; arms assist upRIR to failure
    Nordic hamstring curl (assisted)
    Kneel on a pad, ankles held down (or under a couch). Lean forward slow, using hamstrings to control the fall. Push back up with hands.
Cool-down5 MIN
  • 5 mineasy
    Walk cool-down
    Cadence drops naturally. Then hamstring / calf / hip-flexor stretch 30 sec × 2 each.
P3-EASY≈ 36 MIN
Easy run
Aerobic base
Warm-up5 MIN
  • 5 minbrisk pace
    Walk warm-up
    Get HR up gradually. Do NOT stretch statically pre-run.
Continuous run · 26 min
  • 26 minRPE 4/10 conversational
    Continuous easy run
    Cadence held at +5–10% above baseline. Flat surface.
Cool-down5 MIN
  • 5 mineasy
    Walk cool-down
    Cadence drops naturally. Then hamstring / calf / hip-flexor stretch 30 sec × 2 each.
P3-B≈ 55 MIN
Strength B' · Hinge + plyometric block
Heavy hinge, single-leg landings, plyometric progression
Warm-up12 MIN
  • 5 minRPE 4/10
    Stationary cycle warm-up
    Low resistance, cadence 80–90 rpm. If no bike, brisk walk substitutes.
Main38 MIN
  • 4 × 580% 1RMRIR 2
    Trap-bar deadlift
    Stand inside bar handles, hinge to grip, drive through mid-foot, lock out at hip.
  • 3 × 8 each2 × 16 kgRIR 2
    Single-leg RDL
    See Phase 2.
  • 3 × 5 each directionBW
    Lateral bound to stick landing
    Push off one leg sideways, land on the other, stick 3 sec. Progress distance weekly.
  • 3 × 5BW
    Drop-to-landing (30 cm box)
    Step OFF the box (don't jump). Land soft, quiet, no valgus. Progress box height weekly: 30 → 45 → 60 cm.
  • 3 × 45 sec eachBW
    Copenhagen adductor plank
    See Phase 2. Longer holds.
Cool-down5 MIN
  • 5 mineasy
    Walk cool-down
    Cadence drops naturally. Then hamstring / calf / hip-flexor stretch 30 sec × 2 each.
P3-INTVL≈ 30 MIN
Interval run · 4 min on / 2 min easy
Higher-intensity running exposure (tempo primer)
Warm-up5 MIN
  • 5 minbrisk pace
    Walk warm-up
    Get HR up gradually. Do NOT stretch statically pre-run.
Intervals
  • -RPE 6, controlled
    [4 min RPE 6 / 2 min easy] × 4
    Not a race. Hold form; if cadence drops or stride pattern breaks, cut the interval short.
    ▸ Stop if medial pain > 4/10; step back to easy running until next planned interval day.
Cool-down5 MIN
  • 5 mineasy
    Walk cool-down
    Cadence drops naturally. Then hamstring / calf / hip-flexor stretch 30 sec × 2 each.
P3-LONG≈ 49 MIN
Long easy run
Aerobic capacity
Warm-up5 MIN
  • 5 minbrisk pace
    Walk warm-up
    Get HR up gradually. Do NOT stretch statically pre-run.
Long run · 39 min
  • 39 minRPE 4–5 conversational
    Continuous long run
    First 5K time trial happens on the week-12 long run.
Cool-down5 MIN
  • 5 mineasy
    Walk cool-down
    Cadence drops naturally. Then hamstring / calf / hip-flexor stretch 30 sec × 2 each.
REST DAY — off, or 15–20 min easy bike. REVIEW DAY — Sunday check-in on adherence, trends, criteria.
EXIT CRITERIA · PHASE 3 → PHASE 4
  • Single-leg hop for distance LSI ≥ 90%
    Injured : uninjured limb distance
    manual
  • 6-metre timed hop LSI ≥ 90%
    Injured : uninjured limb time
    manual
  • Triple crossover hop LSI ≥ 90%
    Distance ratio
    manual
  • Y-balance composite within 4 cm
    3-direction reach, injured vs uninjured
    manual
  • Drop-jump: no valgus 5/5
    Video the landing; hips + knees track over toes
    manual
  • 5K at RPE 5 pain ≤ 2 / 10
    No next-morning flare
    manual
  • TSK-11 < 20 (kinesiophobia low)
    Weekly review score trending down
    manual
PHASE 4 · RETURNWEEK 15+

Unrestricted running. Pivoting sport under criterion gates. Long-term strength maintenance.

MON
P4-HEAVY
TUE
P4-INTVL
WED
P4-PLYO
THU
P4-EASY
FRI
REST
SAT
P4-LONG
SUN
REVIEW
SESSIONS IN THIS PHASE
P4-HEAVY≈ 55 MIN
Strength · heavy
Maintain 80–85% 1RM patterns
Warm-up12 MIN
  • 5 minRPE 4/10
    Stationary cycle warm-up
    Low resistance, cadence 80–90 rpm. If no bike, brisk walk substitutes.
Main
  • 3 × 580–85% 1RMRIR 2
    Squat / trap-bar DL — maintenance
    Rotate top exercise weekly. One heavy day/week is the maintenance minimum long-term per the OA-risk framing.
  • 3 × 8 each2 × 16 kgRIR 2
    Single-leg RDL
    See Phase 2.
  • 3 × 6 slow eccentricBW; arms assist upRIR to failure
    Nordic hamstring curl (assisted)
    Kneel on a pad, ankles held down (or under a couch). Lean forward slow, using hamstrings to control the fall. Push back up with hands.
P4-INTVL≈ 40 MIN
Interval / tempo / hill run
Tempo, hills, or fartlek
Warm-up8 MIN
  • 5 minbrisk pace
    Walk warm-up
    Get HR up gradually. Do NOT stretch statically pre-run.
Session
  • Weekly rotationRPE 6–7 hard
    Rotate: hill reps / mile repeats / fartlek
    Full-effort day. Recover on the easy-run day that follows.
Cool-down5 MIN
  • 5 mineasy
    Walk cool-down
    Cadence drops naturally. Then hamstring / calf / hip-flexor stretch 30 sec × 2 each.
P4-PLYO≈ 55 MIN
Strength · light + plyometrics
65% 1RM top set + hop battery
Warm-up12 MIN
  • 5 minRPE 4/10
    Stationary cycle warm-up
    Low resistance, cadence 80–90 rpm. If no bike, brisk walk substitutes.
Main
  • 3 × 1016–20 kgRIR 3
    Goblet squat (to a box)
    Hold a dumbbell at chest. Squat to touch a box (start knee-height, progress to bench-height). Knees track over the second toe.
    ▸ Anterior-horn radial tears TOLERATE deep squat (femoral condyles offload the anterior structures). If medial pain > 3/10, reduce depth first, then load.
  • 4 × 5BW
    Countermovement jump
    Stand tall, dip fast, jump for max height. Land soft, absorb through hips + knees. Rest 60 sec between sets.
  • 3 × 5 each: single-hop, triple-hop, crossover, 6m-timedBW
    Hop battery — light day
    Cycle through hop tests as a training stimulus. Compare limbs; keep the LSI ≥ 95%.
  • 3 sets eachBW
    Change-of-direction: 5-10-5 shuttle + T-drill
    Planned first, then reactive to a verbal cue. Progress by adding a ball / stick.
    ▸ Only add pivoting sport after all Phase 4 gates pass. Cutting drills OK in isolation before that.
P4-EASY≈ 40 MIN
Easy recovery run
Aerobic recovery
Warm-up5 MIN
  • 5 minbrisk pace
    Walk warm-up
    Get HR up gradually. Do NOT stretch statically pre-run.
Run
  • 30–40 minRPE 3–4 conversational
    Continuous easy run · 30–40 min
    This IS a recovery day. If HR spikes above conversational, slow down.
Cool-down5 MIN
  • 5 mineasy
    Walk cool-down
    Cadence drops naturally. Then hamstring / calf / hip-flexor stretch 30 sec × 2 each.
P4-LONG≈ 65 MIN
Long run
Aerobic capacity
Warm-up5 MIN
  • 5 minbrisk pace
    Walk warm-up
    Get HR up gradually. Do NOT stretch statically pre-run.
Long run
  • 50–70 minRPE 4–5
    Continuous · 50–70 min
    Progress duration by 5 min every second week. Vary surface if you can.
Cool-down5 MIN
  • 5 mineasy
    Walk cool-down
    Cadence drops naturally. Then hamstring / calf / hip-flexor stretch 30 sec × 2 each.
REST DAY — off, or 15–20 min easy bike. REVIEW DAY — Sunday check-in on adherence, trends, criteria.
EXIT CRITERIA · PHASE 4 → MAINTAIN
  • All hop LSIs ≥ 95%
    Raised from 90% for pivoting sport clearance
    manual
  • Quad peak torque LSI ≥ 90% @ 60°/s
    Isokinetic dynamometer or handheld proxy
    manual
  • Zero giving-way 8 weeks
    Auto-checked from instability complaint
    auto
  • Sport-specific movement passes on video
    Cutting, jumping, kicking — no dynamic valgus, quiet landing
    manual
  • ACL-RSI ≥ 65 or TSK-11 < 20
    Psychological readiness scale
    manual
FINE PRINT

This protocol is a synthesis of the DREAM trial (Skou 2022 NEJM Evid), OPTIKNEE consensus (Culvenor 2022 BJSM), KNGF ACL rehab guidelines (van Melick 2016 BJSM), Aspetar ACLR consensus (Kotsifaki 2023 BJSM), University of Delaware advanced return-to-running program, Bregenhof 2022 JOSPT progressive-resistance RCT, Nascimento 2025 BFR-RE RCT, Robinson 2023 RIR-proximity Sports Med, Rambaud 2018 BJSM RTR criteria, and Heiderscheit 2011 MSSE cadence RCT. Every prescription in this app cites its source. See PROTOCOL.md at the project root for the full bibliography and running-timeline detail.

This is not medical advice. Show it to your ortho / physio before executing.