Is Downhill Walking Good For You After Anterior Cruciate Surgery?

Posted on 10 Feb 2011 18:57

By Rick Kaselj

The knee is the largest joint in the body and has the most stress put on it. Due to this increased stress, knee injuries are one of the most common injuries that active people get.

They lead to a lot of pain and prevent you from doing the things you love to do.

One of the most common injuries to the knee is an anterior cruciate ligament tear. Just after an anterior cruciate ligament tear the focus might be to see if you can go on living your life with your anterior cruciate ligament torn. For some this may be fine. For others who have too much pain, a decrease in range of motion and lots of swelling an anterior cruciate ligament tear may lead to surgery.

After surgery often times it is encouraged to stay active in order to use the knee.

If you do start becoming active after anterior cruciate ligament surgery, there is a lot to consider.

One thing is how will your new anterior cruciate ligament graft do when walking down hill.

Will walking down hill lead to injuring your anterior cruciate ligament again?

Keep reading to find out.

Downhill Walking After ACL Surgery

Post anterior cruciate ligament reconstruction patients are recommended to engage in accelerated rehabilitation programs consisting of immediate extension of the knee joint and full weight bearing. The protocol aims to improve limited knee extension, delayed muscle strength recovery, anterior knee pain and knee stiffness.

Disturbed proprioception occurring after an ACL injury and reconstruction can cause impairment or weakness of muscles stabilizing the involved knee joint. Because downhill walking can place a lot of stress on the involved knee joint, with as much as 7 to 8.5 times the body weight, it must therefore be avoided during the postoperative period to protect the ACL reconstruction. With knee shear forces exceeding the strength of ACL graft fixations, stabilization training of the quadriceps and hamstring muscles, the main stabilizing muscles of the knee, is essential. The rehabilitation process usually employs full range of motion exercises first, followed by muscle strengthening, then balance and coordination exercises.

5 Key Points to Remember When Performing Downhill Walking After ACL Surgery

1) The tibiofemoral shear force is 1.2 times body weight for male and 1.7 times body weight for female subjects.

2) The tibiofemoral compressive force is 7 times for males and 8.5 times body weight for females.

3) Knee joint shear force is 1000 N for a 70-kg person which is greater than the 200 to 500 N strength that is the typical strength of a typical ACL graft fixation.

4) There is an increase in hamstring and gastrocnemius muscle activity in order to increase the stability of the tibiofemoral joint.

5) Downhill walking should be avoided after ACL surgery especially during postoperative phase in order to protect the ACL graft.


Kuster M, Wood GA, Sakurai S, Blatter G. (1994). Downhill walking: a stressful task for the anterior cruciate ligament? Knee Surg Sports Traumatol Arthrosc. 1994 March; 2(1): 2-7.

ATTENTION FITNESS PROFESSIONAL Get Your $299 Fitness Education Gift. Rick Kaselj specializes in helping clients use exercise to overcome their injuries. Rick shares his knowledge and experience with other fitness professionals through live courses, webinars and books. Rick has also just completed his third exercise & injury manual for fitness professionals rotator cuff exercises.

This page created 10 Feb 2011 18:57
Last updated 17 Jul 2016 20:57

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