APRE offers flexibility, leading to results that often out-pace most of the older training models. It also helps safely return athletes to previous loads and beyond after any setbacks. If you’ve been thinking of implementing APRE training, here is everything you need to know.

What Is APRE?

Autoregulatory progressive resistance exercise (APRE) refers to an auto adjustment of load. It’s a way for coaches to fully maximize their programs without having to put in extra work. The more extended response for what an APRE truly is includes an exercise program that adjusts load on the fly and moves forward by focusing on repetition limits. The program focuses on strength, hypertrophy, or endurance in athletes by using repetition maximums. Then, auto-adjusting the prescribed load or repetitions that follow.

An athlete is prescribed the total percentage and repetition schemes throughout their warm-up sets based on a repetition-max test chosen by a coach. The following loads are then adjusted accordingly to the results of those sets. Essentially after the warm-up, athletes are given an amount of weight they can add or subtract from their assigned program weight. If their warm-up shows they are underperforming from their expected maximums, they are able to reduce the weight as needed to stay safe. Further, if the athlete completes more than expected, the program can be adjusted.

When a session is complete, any newly recorded maximums can be used in future programs. Even in purely strength-based 1RM programs, an APRE approach has been shown to improve an athlete’s 1RM more over an extended period.

When Should You Use APRE?

An APRE program is an ongoing process. It is best for both the coach and athletes. This works particularly well in a group setting (like coaching a whole team). It keeps things more manageable for coaches and keeps it customized for athletes. It also allows you to work within an athlete’s limit at any given time. This way, your athletes aren’t over-straining or under-working.

Our bodies already autoregulate based on how we feel, so using APRE is taking advantage of that concept and applying it to strength training. Instead of telling an athlete to hit 70% of their 1RM from 3 weeks ago, you can work within their limit of the day, whether that is better or worse than a past assessment.

APRE is not an advisable training program for beginners and requires some foundational training. If you have an athlete who is a beginner in training, it’s better and safer to start them with more straightforward methods before advancing them to APRE.

How Does APRE Relate to 1RM?

You can use a 1RM (predicted or tested) for working sets. It is taking your current or most recent 1RM and regulating past it. 1RM is usually derived by testing an athlete’s strength before starting a new program and after they’re through with it. This allows the coach to identify if the athlete is improving their strength or not. APRE uses a lot other than 1RM and can be used with RPE. Using RPE is another tool to use in APRE, such as 3- or 5RMs, and can be used as a reference to keep track of the changes in the athlete’s muscle strength as a function of the training program.

RPE refers to the rate of perceived exertion and measures how intense an activity really is. With RPE, you can tell the effort an athlete requires to complete the prescribed volume of sets and reps. The RPE scale runs from 0 to 10, with 0 signifying no exertion. If an athlete is reporting a high RPE, auto-adjust the next set load or rep count. You can also increase their rep count based on their RPE if they are recording a low score.

Repetitions in Reserve

An alternative tool to use in APRE is repetitions in reserve or RIR. RIR is related to RPE but is a subjective measure of an exercise where the numbers correspond to the reps an athlete has remaining in the tank. RIR allows you to be able to quantify the number of repetitions that are still achievable before failure. The RIR uses a scale similar to that of the RPE but is a more practical method of regulating daily training load. Using an RIR scale allows coaches to accurately track their athletes’ progress in terms of load and intensity, especially for advanced athletes.

How Does APRE Relate to Velocity-Based Training (VBT)?

Velocity-based training refers to a training method that uses technology to keep track of the movement speed during exercise. It’s a valuable tool for strength training for coaches and trainers. VBT typically uses technology such as laser optic devices, linear position transducers, and wearable accelerometers to measure movement speed during an exercise. With VBT, the coach and athlete are aware of their exercise performance. Thus, the coach provides targeted feedback such as lifting barbells quickly to achieve better and faster results.

If your goal is to move a prescribed load at a certain speed or tempo, you can adjust as needed with VBT. This can be used in explosive programs. If you are using biometrics or finding a way to increase the rate of force production, you can adjust to fit the needs.

While some training variables such as rest, frequency, and volume are easy to test, others like intensity aren’t. For instance, if two athletes with similar strength levels performed a 70% of 1-RM back squat, but only one of them lifted the bar with a high movement velocity, while the other didn’t, the subsequent intensities would not be the same.

What Is the Value of APRE Training?

1. It allows you to adjust on the fly while focusing on the big picture. You take in an immediate performance, and you can avoid pushing beyond where you should be.
2. You can add difficulty and adjust up if the athlete is having a particularly powerful day. Because you can use this to increase gains, you are able to improve more quickly and see results sooner.
3. You can push harder than planned if the athletes are able to. However, you are also able to adjust down, so there isn’t injury. In both cases, you will see improvement faster than if you were to use a rigid structure.
4. Additionally, APRE easily implements the rep schemes for the athlete and the coach. Thus, making it a time-saver for coaches who have a lot of the responsibility of developing their athletes.
5. APRE is a practical approach to regaining lost strength following a period of detraining. Sports coaches benefit the most as sometimes they have to train athletes without knowing whether they finished training or not. With such an athlete, APRE is excellent for the first 4 to 6 weeks as it helps them regain their lost strength.

How Do You Use APRE With CoachMePlus?

The best way to use APRE with CoachMePlus is in a 1RM or 3RM test during the warm-up program. This allows the program to automatically adjust the weights for the rest of the program. Right now, CM+ is able to adjust load/weight on the fly automatically in the following ways:

1. Coach assigns a “test set” – 1RM, 3RM, 5RM, etc.
2. The following sets are assigned a percentage of the 1RM calculated from the Test set
3. The athlete then performs the test set
4. After they do the test set, the CM+ calculates that athlete “new” 1RM
5. CM+ then uses that new baseline to calculate the remainder of their working sets. Optionally, you can do more than one test set to customize your athlete’s program load further

Start APRE Training Today

Autoregulatory progressive resistance exercise is a great training program best used when an athlete is coming off a layoff. This is because it offers a great way to return them back up to their previous training levels without risking injury or strain. It gives each athlete a chance to move at their own pace and not an expected rate that may be too slow or too fast for them.

If you like to learn more about how CoachMePlus can help, schedule a personalized demo with one of our experts today.

Join Chase Pfeifer, President and CEO of Dashr Performance Systems and Michael Gallivan, Human Performance Specialist from CoachMePlus as they discuss the relationship between the two companies and some of the most frequently asked questions regarding the Dashr and CoachMePlus integration.

Dashr is built for coaches to collect data and manage it however they want. CoachMePlus works to take the next step with this data regarding higher end analytics, data visualization, and expanding on the player profile side of things. 

FAQ #1

Are the gates part of CoachMePlus? How do they work together?

While Dashr gates are not a part of CoachMePlus, the two work in sync. Once testing is complete, CoachMePlus instantaneously pulls the data into their system. All Dashr users have to do is turn on integrations for CoachMePlus in their settings and the integration is seamless.

FAQ #2

How do I switch between my athletes if I am testing a whole group? How do RFID bands work?

There are a multitude of ways to identify athletes within Dashr. The first of which is with the use of RFID bands that are activated as athletes check in at each drill by bumping the band against an RFID module. This tells the system who is up and automatically saves the data accordingly. The RFID bands can be reassigned to different athletes so you do not need to have bands for each person participating. An alternative method is looking at your list of athletes within the app and selecting who is up to run. This method is cost effective but also calls for more manual input on the part of the coach. Additionally, coaches can assign numbers to athletes or distribute barcodes to help identify an athlete with their data. 

FAQ #3

What happens to the data? Do I use this instead of my spreadsheets? How can I share this information with my team?

CoachMePlus is designed to make things easier for the coach and give them access to more data. It is an easy transition from spreadsheets to the CoachMePlus system simply because everything is instantaneous. Once created, there are multiple ways to share the data with your team. First off, if an athlete has their own personal login, you can release information to their dashboard so that they can see it on their devices. However, if they do not have a login, the data  can be exported via PDF and you can pull out dashboards and reports for distribution. It is up to the coach on how transparent they want to be, but if you want to be fully transparent with your team, you absolutely can with just a few clicks.

FAQ #4

How are leaderboards and data visualization used?

In certain situations, teams and athletes will set up TVs in gyms or facilities that automatically update or refresh as the data is being pulled in. So if somebody takes over first place in a drill, athletes can all see that in live action which helps to grow competition and show people where they stand amongst their teammates. Additionally, the data is instantaneously delivered to the coach who has access to a wide variety of tables, charts, and graphs that auto populate in order to see results and trends of their athletes. The display allows for both coaches and athletes to easily digest the data in an effective and efficient manner. (More on how to set up a leaderboard in CoachMePlus)

“Not so much a ‘no pain, no gain’ culture anymore in coaching and training. It’s a lot of load monitoring and careful planning, but it also includes making adjustments on the fly.” — Michael Gallivan, ACSM.

In the 2020 Olympics, Naomi Osaka, a multiple grand slam winner, surprised the world when she said she didn’t want to participate in the most anticipated event in sport. From the outside looking in, everything looked okay. She appeared to be prepared and ready for athletic competition, and many just couldn’t understand why she would choose not to perform.

Even before the dust from the Naomi Osaka controversy had settled, four-time gold medalist Simeon Biles would shock the airwaves again. This time, by pulling out of the competition at a time when many said, “her team needed her most.”

The two instances would bring to the surface two discussions the athletic performance and coaching community has been avoiding for years—the balance between subjective wellness and objective measures of performance.

What Is Subjective Wellness?

Recent advances in human performance show that objective measures alone aren’t sufficient to evaluate and diagnose an athlete’s performance. This necessitates the need for the athlete’s own perspective of readiness, also known as subjective wellness. 

Subjective wellness is an athlete’s perception of how they feel. Perception is reality; they might not have a physical reason to underperform, but if they are mentally unfocused and encumbered by stress, mood or expect to perform badly, their performance will likely mirror those thoughts. All types of physical training induce strain on an athlete’s body. That said, there are healthy levels of strain that improve the athlete, as well as chronic unhealthy ones that are unproductive.

Coaches track an athlete’s objective and subjective performance as indicators of the strain on the athlete and whether they are over, optimum, or under training the athlete. A coach can then use this data to adjust load and workouts.

Determining Objective Wellbeing (Load and Threshold) Before Subjective Wellness Is Considered

Subjective wellness can be used to diagnose and fix problems in an athlete’s performance. However, this process is much more efficient if objective wellness (load and recovery) precedes subjective well-being. 

In layman terms, a coach or an athlete can use objective wellness to diagnose performance (find out the “if”) and subjective wellness to get to the root cause of the problem (the “why”). There is no one-size-fits-all approach for determining objective well-being. One of the most efficient ways is by determining the load as shown below:

1. Determine load (for example, you can test vertical jump twice a week.)

To develop an efficient objective measurement process, the schedule should have consistency. For example, the athlete should be tested at the same time each day of each week. This consistency helps to control for other factors such as hormonal levels and body weight that fluctuate throughout the day.

Once you find a preferable day of the week for internal load monitoring, you can then test for vertical jump and come up with a trajectory each week.

If the numbers over time are staying the same – Little or no change in numbers means the athlete’s performance is okay. Moreover, it shows consistency and that the athlete is comfortable with the level of strain during workouts and practice.

If their numbers are improving  – An improvement in numbers is great. It shows that the workouts are effective and that the athlete’s body is responding positively to the workouts. Coaches should take improvements as seriously as they handle deteriorations. The data on why an athlete is making improvements goes a long way in finding ways to further cement those habits.

If their numbers are getting worse – A worsening performance is a cause of concern for all parties. That said, load determination alone doesn’t give a clearer picture. For more insight, the coach should analyze the data from wearable devices.

Analysis of Strain Data from Wearable Devices

If the dashboard on a wearable fitness device reads high strain and low recovery scores, the coach should take a very calculated approach to the matter.

Trainers should consider steering clear of talking points that are complete, conclusive sentences like:

• “You’re not pushing yourself.”
• “Try harder.”
• “You can do better.”

A better alternative would be to ask open-ended questions from a subjective wellness perspective about what’s going on outside the workouts and practice. Topics one can touch on include sleeping patterns, eating patterns, and stress levels.

Where Subjective Wellness Comes In

Subjective wellness adds insight whenever the numbers don’t follow as expected. This doesn’t necessarily mean that the athlete is underperforming; it goes both ways. Context of the data is sometimes more important than the outcomes of the data alone.  Understanding where an athlete is within their performance helps complete the picture. 

Subjective wellness could also come in handy when there are significant improvements in performance. If this is the case, the coach can proceed to find what the athlete is doing differently (outside practice) and encourage it. A trainer should take into account how the athlete feels during load management, and adjust workouts based on stress, sleep and nutrition.

Stress 

An optimum amount of stress can help an athlete prepare, train, and perform at optimum levels. However, an unhealthy amount of stress can impact an athlete’s performance. That said, when determining load and workouts, a coach must have the stress of the athlete in mind.

Sleep

The amount, quality, and pattern of sleep have a significant effect on an athlete’s performance. A Stanford study shows that collegiate basketballers who were able to increase their sleep to 10 hours a night improved their shooting by 9%. That said, data on an athlete’s sleep comes in handy when determining both loads and training intensity. Even more crucial is when a coach is diagnosing fluctuations in performance.

Nutrition

Nutrition is another outside practice variable that has a huge vote on the performance of an athlete. That said, nutrition is a broad area. It covers everything from hydration, supplementation, portions, medications, and diet, all parameters that trainers should put under the spotlight. 

Of all external factors, the nutrition of an athlete is the most crucial for both long-term and short-term performance. Any issues that arise from improper nutrition should be identified and mitigated as quickly as possible.

2. Using wearables to monitor the metabolic rate and sprint times or other loads

Another effective approach to measuring objective well-being is leveraging data from wearables to monitor metabolic rates and sprint times continuously. Both techniques, using wearables and load determination, are crucial in monitoring objective wellness. In fact, they are equally effective, and it’s recommended that trainers use them simultaneously. 

Direct data has fewer external variables and hence allows coaches to err on the side of caution. You need both because someone may feel great despite being at a threshold or tapped out before reaching the expected limit. Both mismatched expectations must be addressed for healthy and sustained growth.

Benefits Beyond Physical Monitoring

The benefits of subjective well-being spill beyond physical monitoring and the development of better practices. Athlete subjective wellness monitoring helps make the life of an athlete better both in practice and outside the court.

Some of its benefits include:

1. Improved Motivation and Well-being

Show me a stressed athlete, and I’ll show you an underperformer. If an athlete is stressed and just going through the motions because the coach is pushing while ignoring the issues, it can lead to burnout.

However, if the coach takes the athlete’s stress and subjective well-being into account and assigns a recovery program, trust is built. The athlete feels genuine concern from the coach and is inclined to work harder for the coach in the future.

2. Self-Awareness

Humans value autonomy and the feeling of being in charge. Self-reporting raises awareness on the athlete’s part about how decisions outside of the gym can affect performance.

With self-reporting through subjective awareness, athletes can see for themselves the consequences of each action they take. An athlete can see for themselves that once they start to eat certain foods, they perform better or worse later. Similarly, if they’ve been sleeping poorly, they will notice that they can’t meet their performance expectations, further showing them that actions have consequences.

This gives them the incentive to address the actual sleep issues and concentrate on plausible causes such as caffeine intake.

3. Better Mental Health 

The mental health question in elite athletes started way before Naomi Osaka and Simone Biles came to the spotlight.

With thousands of fans, supporters, friends, and family, it’s hard for many to believe that athletes sometimes may suffer from depression, loneliness, and have deep-seated issues of their own. To make it worse, objective forms of measurement fail to identify mental health challenges athletes face.

An approach that focuses on mental health, such as subjective well-being, can help identify early signs of deterioration that may slip through the fingers of objective forms of measurement. As a result, athletes get the necessary treatment and counseling early and before it’s too late.

How to Track Subjective Wellness

As you’ve seen above, self-awareness and putting the athlete in the driver’s seat of the subjective wellness process come with several benefits. One of the best ways to track subjective wellness while at the same time offering the athlete both autonomy and self-awareness is using a wellness questionnaire for athletes.

CoachMePlus was founded with the dream of leveraging modern technology to help coaches and athletes achieve their fitness goals. For more information about objective and subjective measurement of athletes’ performance, contact us today, and our teams will be more than willing to help.

Keep Reading:

What does an Athlete Management System do? 

Athlete Management Systems (AMS) are expanding to do more than ever before. But with all the features and integrations, it is important not to lose sight of why AMS systems can be an essential tool to any athletic or fitness organization. Athlete management systems allow coaching relationships to develop outside the traditional constraints of time and proximity. A good coach and athlete relationship is built on trust and understanding the personalized goals of the athlete. By using an AMS, coaches and athletes can develop strong relationships inside and outside of the training facility. 

Note: CoachMePlus is designed as a Human Performance Software that goes beyond an Athlete Management System. To us, a “coach” can refer to a physical therapist, strength and conditioning coach, personal trainer, athletic trainer, military leadership, or other human performance monitoring roles.

The job of an AMS is to allow coaches to communicate and monitor their athletes and provide context to the data that is being collected. Expected functions include the ability to assign workouts in an app, pull in information from wearable devices, and monitor load and progress. These functions are only useful if they are combined to add transparency into the workload and lifestyle of the athlete. Tools like Subjective Wellness Questionnaires and Load Monitoring can be used to help make on-the-fly decisions about training and recovery though the use of alerts, dashboards and reports. 

Benefits of an Athlete Management System

Save Time 

Athlete management systems streamline every step of the coaching process. From testing and programming, to analyzing and adjusting plans. When building a workout plan for an athlete, regularly scheduled set and rep progressions can easily be made into a test for updating key performance indicators such as one-rep-maximum (1RM). 

This allows workouts that are based on 1RM to automatically update with the given information to help personalize the experience for the athlete. If the same program is assigned regularly, an athlete’s workouts scales as the athlete’s strength and ability scales. This also helps when assigning workouts to groups of people; the workout is tailored to their abilities, while keeping in line the group’s goals.

With an athlete management system there is less paperwork to process. There is no need for endless excel documents. This allows coaches to focus on the important parts of human performance improvement. (Gyms, clubs, and personal trainers specifically can Monetize Online Training Services with a system like this.)

Improve Communication

Good relationships are built on good communication. CoachMePlus offers in-app messaging to groups or to individuals. File sharing between coaches and athletes is very simple too. Store photos, videos, and other important content with the Athlete and Coach Library, the perfect repository for teams needing file sharing to be embedded and streamlined. With all this data flowing back and forth, you don’t need to worry about privacy challenges. CoachMePlus allows coaches to manage permissions for their organization and athletes so they can access a personalized experience on any mobile device.

Track

The need to import any human performance data set is a burden that every team needs to solve, and we designed a universal importer for teams of all sizes. Coaches can quickly upload different types of training or fitness related datasets with ease, which means they’ll have less time on the sideline recovering from training injuries so they can focus more heavily on coaching their athletes. 

Analyze

Engage athletes with live dashboards showing real-time performance information. Coaches can view real-time performance data and fitness levels, compliance, and training readiness. 

Training assessment – not just strength-based assessments, but also functional movement screening tools, sleep, mood, stress, and wellness questionnaires. With so much information out available to coaches, assessing how individuals have performed over time has never been easier.

Assess the quality of your training sessions through a variety of metrics, including heart rate, sets, reps, intensity, training load, and more. Track progression towards set goals to make sure your athletes are improving and ready for intense competition.

Who can benefit from having an Athlete Management System?

Gym Owners

AMS systems give people the ability to coach remotely or implement a hybrid in-person/online training program. CoachMePlus allows you to communicate with your members through their mobile devices and track their fitness progress. Both the members and gym owners benefit from the ease and transparency in workout programs. Trainers save time, increase retention rates, and provide accurate data about progress. Read More 

Strength and Conditioning Coaches

Human Performance Software helps coaches maximize the potential of the full team of athletes. Coaches can assign workouts based on position, or to each player individually. Professional sports teams like the Chicago Bulls, Nashville Predators and the Buffalo Bills have all benefited from Athlete Management Systems. Many high school and university coaches have used our software to manage individual and team growth. AMS systems provide coaching staff with transparency on progress and potential recovery or performance issues with players. Read more 

Physical Therapists

Therapists can help with many aspects of life including injury prevention, range of motion, rehabilitative care programming, recovery programming, ergonomics, and more. An athlete management system can be used for patients that may be experiencing pain or discomfort or rehabilitating after an injury. The body needs a balance between mobility and stability to avoid injury and physical therapists use athlete management systems to assess movements and improvement. 

Military

Monitoring warriors’ readiness is just as important during peacetime and training periods. Success relies on proper preparation, so it’s vital that commanders receive the information they need to make decisions about what is best suited for their own command. It’s crucial that evaluations be tailored to each unique command because different requirements can greatly affect performance metrics like strength or physical fitness levels when evaluating them against other units in a larger force structure. Evaluate your unit by taking into account all aspects such as skills learned throughout activities, injury rates from both combat-related injuries and noncombat related incidents, fatigue levels among troops who must balance both military and family roles simultaneously. Read More

Workplace Management / Industrial

The aging US workforce will require employers to implement programs that reduce the cost of musculoskeletal (MSK) injuries. Current options are inefficient and lack 1:1 coaching, which can lead to a high rate of failure in driving interventions at scale for MSK conditions such as low back pain, shoulder mobility or other overuse related injuries. More testing technology options have become available as wearables become more commonplace. Our platform provides a future-proof position as practitioners update hardwares and technology as it evolves.  As these factors change, it is crucial for providers who want to enter their practice field be up-to-date on recent innovations so they provide patients with improved care outcomes while also reducing costs associated with treating overuse and role-specific injury issues.

Mike Tyson is well-known for his quote, “Everybody has a plan until they get punched in the mouth.” As a strength and conditioning coach, do you have a plan when you or your athletes get “punched in the mouth?”

I know I didn’t. I have been obsessed with discovering and utilizing the most optimal methods for increasing strength, power, speed, and endurance just like many other strength and conditioning coaches. However, this quest is usually focused on the healthy or non-injured athlete. That was also my focus. Then, one day, I was thrown into rethinking the way I’ve always done things.

During my time as a coach for women’s soccer and women’s basketball, the inevitable had occurred: an athlete experienced a season-ending injury by tearing their ACL. This was our equivalent to getting punched in the face, and it propelled me to dive deeper into the return-to-play process in search of a more effective rehabilitation protocol.

We can all agree that we are doing our best to reduce the likelihood of injuries from occurring, but how are we measuring and monitoring to ensure the likelihood that these injuries won’t happen again? I wrote this article to share our processes at DePaul University of having checkpoints during the return-to-play process (RTP) and how they impact progressions. The information found in this article is based on an athlete returning from an ACL injury in women’s soccer and the checkpoints created by myself, our physical therapist Ted Kurlinkus, and our Director of Sports Medicine Sue Walsh. This protocol was inspired by current research available and other practitioners who are doing remarkable work with this subject. The information should not be taken as gospel since it fits our unique situation and the equipment we have available. Rather, I hope this article inspires other coaches to adapt a similar framework that best fits their situation.

With creating checkpoints for RTP, it is important to consider that the process ultimately needs to be adaptation-led. While I provide timelines that have worked well for us, each RTP depends on the individual, what that athlete needs to look like at the end of RTP, and the physical qualities needed to perfect that form. Certain athletes may have a larger requirement for absolute strength and power, whereas other athletes may require more relative strength work and work capacity. Once you identify the qualities that underpin the sport form, you can create a logical sequence to structure these qualities in order to potentiate them. This will drive the sport form to the maximum point at the end of this process. This is typical as any strength and conditioning coach usually works from general to specific throughout a periodization layout.

Weeks 1-2 : Recovery

The athlete should dedicate the first two weeks post-surgery to recovery. Consistent and sufficient sleep should be particularly emphasized as a priority in this time period given how ACL reconstruction surgery is traumatic to the knee. “Sleep has been shown to have a restorative effect on the immune system, the endocrine system, facilitate the recovery of the nervous system and metabolic cost of the waking state and has an integral role in learning, memory and synaptic plasticity, all of which can impact both athletic recovery and performance. ” (Doherty et al., 2019)

Moreover, most of the body’s essential processes such as body temperature, hormone release, and eating habits operate on a 24-hour internal clock known as circadian rhythm (Guo et al., 2014). Any disruption to the athlete’s circadian cycle also disrupts many processes in their body, including recovery. It is worthwhile to educate athletes about the importance of maintaining a proper circadian schedule in order to optimize their recovery. This means being diligent about keeping a consistent sleep schedule that is aligned with the circadian biology.

Proper nutrition should also be a priority. Assess the unique needs of your athlete to consider any supplementation that is required in addition to a proper diet. Cumulative macronutrient deficits have important clinical outcomes in surgical intensive care patients; thus it is recommended to eat at least at maintenance calories  following surgery (Yeh et al., 2016).  For most athletes, this is generally about 15-20 calories per pound of bodyweight. In addition to adequate amounts of protein, carbohydrates, and fats, one may need to consider additional supplementation for the following: calcium, iron, zinc, vitamin A, vitamin D, vitamin E, vitamin K, and vitamin C.

Weeks 3-8: Return to Fitness

Our training in the weight room begins after the 2 weeks of recovery. During the initial 2–4 weeks, the athlete will see the physical therapist and perform the basic range of motion exercises in order to get full extension in the knee and get the quadriceps firing. Much of the training during this first phase occurs with the physical therapist, but I begin to train the opposite limb which will encourage cross-education. Cross-education describes the strength gain in the opposite, untrained limb following unilateral resistance training (Hendy and Lamon, 2017). Communication with the physical therapist is important during this phase to ensure the acutely post-operative athlete is not being overloaded to allow for appropriate healing. The main goal of this cycle for me is to develop strength in the non-surgical limb. The checkpoints for this timeline include:

• Passive knee extension of zero degrees
• Passive knee flexion of 125 degrees plus
• Single leg squat test
• 1RM test performed on a 45-degree leg press, occurring on the non-surgical side
• 1RM max test on a prone hamstring curl machine, occurring on the non-surgical side

During this phase, the PT is making the call when it is time to advance to our second phase of training. This occurs when the athlete demonstrates good technique and alignment during the single leg squat and regains full range for passive knee flexion and extension. I am concerned with strengthening the non-injured limb and may retest once every 3-4 weeks.

Once the PT gives approval, I can begin to train the surgical limb in the following phase. Conditioning may include steady state bike workouts if ROM allows and/or non-impact circuits and is typically performed the day after the strength session.

Sample weight training block from phase 1:

The volume of sets and reps is kept the same throughout the phases, but progressive overload is occurring on a weekly basis.

Weeks 9-12: Basic Strength

In this phase, many of the checkpoints are led by the PT. Since strength in both limbs is a goal, I may add more checkpoints to monitor this quality and assess the strength in the injured limb versus the non-injured limb. It is assumed that both limbs are still considered weak at this point, so the overall emphasis is to make the athlete stronger while considering the asymmetries between each limb. Once the athlete achieves the goals outlined below, they progress into the next phase. The testing during this phase will most likely occur every 3 to 4 weeks, or as needed. The checkpoints for this timeline include:

• Passive knee extension equal to the other side
• Passive knee flexion of 125 degrees plus
• Single leg bridge test > 85% compared with the other side and >20 reps
• Single leg calf raise test >85% compared with the other side and >20 reps
• Side plank endurance >85% compared with the other side and at least 30 seconds
• Single leg rise test >85% compared with the other side and >10 reps with each leg
• Single leg balance with eyes open=43 second hold and with eyes closed=9 second hold
• 1RM test single leg press =1 x Bodyweight
• 1RM squat to 90 degrees (can be hex bar squat, front squat, back squat etc.) =1 x Bodyweight

In this phase, I am training the non-surgical limb as the strength and conditioning coach. Since the PT was already training the surgical limb in the prior phase, I can accelerate the type of loading we are using during this phase. The leg extension is performed using a 2-up/1-down method which I classify as “eccentric” above, since we can have a larger load during the eccentric portion of the lift due to lowering with 1 limb. The volume of sets and reps is kept the same throughout the phases, but progressive overload is occurring on a weekly basis. Strength training is occurring on Mondays and Thursdays, while conditioning work is performed on Tuesdays and Fridays. Depending on the athlete, we may begin incorporating box drops or low-level box jumps at this point as a warmup to weight training in addition to beginning a dynamic warm–up.

The warm–up consists of basic mobility exercises and leg swings to encourage full range of motion at the hip, as well as sprint development drills like A-skips, skip variations, and shuffles. I may also begin bilateral pogo jumps in place with the goal of extending these out to 5 to 10m in the coming weeks. I typically end the session with some type of medicine ball throw to ensure we are still training some type of power/neural work during these general strength phases.

Conditioning may progress to include non-impact tempo/aerobic based interval parameters, as we are continuing to build the aerobic system. At the end of this phase, our PT is also performing the first phase of the Dynamic Movement Assessment looking at quality and equality of movements, quad strength, and the athlete’s ability to control the involved lower extremity.

Weeks 13-16: Maximal Strength

During this phase of training, more testing is performed by the strength and conditioning coach  as the training is slowly progressing to include running, agility, and landings. Strength is still the major quality being trained—it is performed with higher absolute loads and with less reps than the previous cycle. The athlete will most likely be completing a return-to-run with the PT at this point, typically from Weeks 12 to 16, and will have been exposed to low level jumps and landings with myself and the PT. Once the athlete achieves the goals as outlined below, they progress into the next phase. The testing during this phase will most likely occur every 3 to 4 weeks, or as needed. The checkpoints for this timeline include:

• Star excursion test >95% compared with the other side
• Single leg rise test to 90-degree box with hands behind head >22 reps on both limbs
• Isometric mid-thigh pull on force plates to analyze peak vertical force and rate of force development
• Counter movement jump on force plates to analyze jump height and reactive strength index. This is done both double leg and single leg to look at force, as well as equality of loading.
• Broad jump for distance
• 1RM test single leg press =1.3 x Bodyweight
• 1RM squat to 90 degrees (can be hex bar squat, front squat, back squat etc.) =1.3 x Bodyweight

We progress to training 3x per week during this phase with 2 days of conditioning on Tuesdays and Thursdays. As noted in the tables, we are progressing to include more complex movements, such as the clean pull from mid-thigh and the hack squat, and we are including the 2-up/1-down method for the leg press, leg extension, and hamstring curl. The intensities are higher than the previous block, since we are now working in our 3’s block. The jump training is progressing at this point to include countermovement jumps, broad jumps, higher volumes of pogo jumps performed at distances of 10m, and short bounds during our warmups. All sprint development drills are occurring as we get closer to sprinting. Since the athlete will be finishing the return to run program with the PT at this point, I will begin to introduce sprinting in short distances of 5-10m with submaximal intensity. Once the athlete is cleared by the PT, the sprint training will remain acceleration based at 10m, but timing gates are used to record every rep to ensure max intensity and volume will continue to build during the next phase. Conditioning is progressed to include extensive tempo runs with short intervals/short distances depending on where the athlete is running. The conditioning occurs twice a week, with one day of tempo runs and one day of lactic power intervals on a bike.

Week 17-21:Basic Strength

Most of the training in this phase is performed by the strength and conditioning coach, especially as training becomes more specific and more complex. While strength is still the major quality being trained, we are shifting back to a 5’s block since newer exercises are being introduced. We will also transition into a power block during the final phase. Once the athlete achieves the goals as outlined below, they progress until the next phase. The testing during this phase will most likely occur every 3 to 4 weeks, or as needed. The checkpoints for this timeline include:

• Single leg vestibular balance test passing on both limbs
• Single leg forward hop test >95% compared with other side and equal to or greater than preoperative data
• Side hop test >95% compared with other side
• Triple hop for distance test >95% compared with other side
• Triple cross hop over test for distance >95% compared with other side
• Isometric mid-thigh pull on force plates. Peak force and RFD > previous test
• Countermovement jump on force plates. Jump height and reactive strength index > previous test
• Broad jump for distance > previous test
• 1RM test single leg press = 5 x Bodyweight
• 1RM squat to 90 degrees (can be hex bar squat, front squat, back squat etc.) = 5 x Bodyweight
• 10m sprint, assessing week to week

As noted in the tables, we continue to train 3x per week at a higher intensity Mondays, Wednesdays, and Fridays, and 2 days of lower intensity conditioning on Tuesdays and Thursdays. We progress to include more compound and complex movements like the front squat, deadlift, hang power clean, and split squats. At this point in the training, I begin to utilize a “sprint first” approach and begin to structure our weight room work around sprinting. Our sessions begin with a warmup, followed by sprint development drills, acceleration, multi-jumps, and end with strength training. Our main goals during these sessions are to train repeated sprint ability, introduce change of direction work, and progress to true plyometrics to train the elastic response. The sprint work is considered acceleration, as we are training in the range of 10 to 40m and some of these sessions may occur with a sled to teach the athlete to put force into the ground. The change of direction work includes re-education on how to properly cut. The multi-jumps become more complex as we begin to include exercises like hurdle jumps and extended bounds. The conditioning during this phase builds upon the extensive volume of tempo runs that we performed during the last phase and is meant to serve as low intensity days of training on Tuesdays and Thursdays. Communication is again important during these advanced progressions as the PT will begin to focus more on controlled lateral movements and stability of the involved leg. This prepares the athlete for higher level change of pace/direction and reactive movements that will be performed with the strength coach in the next phase. PT activities also include learning controlled deceleration from sprinting at the end of this phase.

Weeks 22-25: Power

During this phase of training, the athlete is nearly back to 100% of activity with the strength coach and will begin practice activities at 6 months post-op including warm-up, technical drills, and skill activities that do not include open environment play. At this point, PT will focus on tolerance and control of more reactionary movements, as well as progression of sport specific change of direction and pace activities on the soccer field. The PT will incorporate sport specific drills. Power is the main quality being trained, as we shift into a 3’s block of training with the intent to move loads as fast as possible. The testing that occurs during this phase is to ensure the athlete is ready for the reactive demands of their sport. The checkpoints that occur during this timeline include:

• Isometric mid-thigh pull on force plates (peak force and RFD > previous test)
• Countermovement jump on force plates (jump height and reactive strength index > previous test)
• Broad jump for distance > previous test
• 1RM test single leg press = 8 x bodyweight
• 1RM squat to 90 degrees (can be hex bar squat, front squat, back squat etc.) = 8 x bodyweight
• Sport–specific agility test
• Sport–specific conditioning test

We continue to train 3x per week at a higher intensity, and 2 days of lower intensity conditioning on Tuesdays and Thursdays. We build upon the same structure of training from the previous phase, but we may use one day for top speed and the other 2 days for high neural work, serving as reactive agility days. The multi-jumps are progressed to include an introduction to depth jumps and an emphasis on single leg reactive strength. The tempo runs may be progressed in volume, but it depends on how much activity the athlete is performing during practice. Depending on the demands of the athlete’s sport, we may run a Y shaped reactive agility test and a pro agility test to compare with pre-injury scores. The sport specific conditioning test provides the athlete with the confidence and comfort knowing they are adequately prepared to return to their sport. As strength and sport ability grow, along with athlete confidence, the athlete is progressed back to full practices around 7-8 months post-op, and back to full open environment contact practices and games participation at 9 months post-op.

This protocol was developed with the assistance of DePaul’s Director of Sports Medicine, Sue Walsh, and our physical therapist, Ted Kurlinkus. Much of this information was based off of material found in the Melbourne ACL Rehabilitation Guide 2.0 by Randall Cooper and Mick Hughes, and by material created by Boo Schexnayder.

Ryan Nosak is the Assistant Director of Sports Performance at DePaul University. Nosak primarily works with the cross country, golf, women’s soccer, and track and field programs while also assisting with the men’s basketball team. Prior to DePaul, he primarily handled the sports performance duties for women’s basketball and men’s tennis at Charlotte as Assistant Strength and Conditioning Coach. He was an Assistant Strength and Conditioning Coach at Robert Morris University in 2014-15 and worked at Vanderbilt (2014), Tennessee State (2013-14) and Penn State (2011-13). He completed his undergraduate degree from Penn State in 2013 and holds a master’s degree from Western Carolina University. He is Strength and Conditioning Coach Certified (SCCC), a Certified Strength and Conditioning Specialist (CSCS), a Certified Speed and Agility Coach (CSAC), RPR Level 1 Certified, and USTFCCCA Strength and Conditioning Certified.

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