Episode 244 | Why Junk Volume Is Holding Back Your ACL Progress

What is up team? Welcome back to another episode on the ACL Athlete Podcast. First, I just wanted to say thank you for the messages and the conversations. For those of you who have listened to the OR series, which was the past three episodes on being inside the operating room, observing some ACL surgeries, pulling some nuances out that we can carry over to our ACL rehab, and some practical takeaways.

If you haven’t caught that, go check out those episodes. Put a lot into them. And maybe it will highlight a few things that have been on your brain about your process. And maybe trying to vet essentially some ideas within this process. Check that out if you haven’t; otherwise, digging into today’s podcast episode, which is focused on why junk volume is holding back your ACL rehab and your progress. 

Working with hundreds of ACLers all over the world, observing hundreds of different protocols at this point, research papers, auditing tons of physical therapists’ programs, strength and conditioning coaches’ programs via our mentees, via the mentorship, people sending me programs, I get to see a lot in this space, and this is all that I focus on. This is my world. This is what I’m obsessed with. As you guys know, at this point, if I’ve done 243 episodes at this point, you can say I am a little weird about the ACL rehab space. But it’s because this is very personal to me, and I think that this is just a place where there is in need of help for the ACLer, for the clinician, for the coach, for the entire community as a whole. As we know, injury rates are increasing, and there are more complexities with this process, and return to sport rates are not really great. They continue to decrease. I’m just really obsessed with this space, and I want to just share my thoughts in terms of something that I do notice. Obviously, this whole podcast is based on that. 

But one thing about this that just being able to observe, especially talking with the ACLers and auditing a ton of these PT programs that we see from our mentees, there’s one thing that I consistently see—and that is junk volume. Junk volume is something that we use as a team, and this is basically doing excessive training volume. Think more exercises, more sets, more reps, that does not drive meaningful adaptations. And at the end of the day in ACL rehab, that is all that we care about. Are we moving the needle forward with the stimulus and the adaptation that we need to be able to get back to doing the thing? None of you guys are here because you enjoy ACL rehab unless you are a physical therapist or a coach helping other people. You are here because this rehab has taken away something that you want to do; whether it is your physical activity, whether it is particular sports activities that you love to do, whether it is just being able to move and use your body, whether it is to engage in a group setting, whether it is just for you to be able to play with your kids or to be able to just be yourself. It is very meaningful to be able to move. Therefore, this injury, this rehab, and this surgery, if you had them, are standing in the way of something that you really care about. All we care about is getting you back to that thing. That’s all you really care about at the end of the day.

All we are trying to do is design something very strategic that is going to give you the adaptations, those changes that we need structurally, physically, and also mentally, to be able to get you back to doing those things. Commonly, in ACL rehab, people are doing eight plus exercises, 10 plus exercises, 12 plus exercises in a session. Random circuits might be happening. They might be copying stuff from Instagram or YouTube to add to their rehab. And while I don’t fault some of you guys who maybe feel like there is some incompleteness to your rehab, I know that this is probably the biggest challenge that you just feel like you’re not getting enough, which I will touch on here in a second. But with that said, I get it. You’re someone who’s struggling with extension, you might be someone who is struggling to activate your quads or getting quad strength to develop. I know these things all exist. You’re trying to essentially explore all the depths of the world and trying to figure out what’s going on.

What happens is that you’re like, oh, this won’t hurt. This looks like a cool exercise. Let me add this in. Or maybe your physical therapist is giving you a ton of exercises. And this can be essentially what happens, especially post-op, because there are so many different things you might be doing daily. You start to have this accumulated list. Often you’ll start off with six to eight exercises, and then what happens is that you’ll keep those, and then there’ll be more added. And then you’ll keep those, and there’ll be more added. It depends on the physical therapist or training, how intentional they are. These are things that we typically see in this process. 

And while, yes, in some sessions you could do eight exercises, but the thing is, it just really depends on where you are in this process and the intention behind each exercise and the structure. Now, if you’re doing like three easy warm-up movements, for example, just to get you prepped. Sure, that could be a part of that, and then maybe you’re doing five additional movements. Now, the specific number itself doesn’t matter nearly as much as the structuring and the why behind it all. There are sessions where you may end up doing more exercises, but the thing is that I see it’s just constantly just more exercises or maybe just more stuff being done in your sessions or every single day. With this kind of junk volume terminology or too much training volume, they end up doing too much moderate output, which is essentially what we’re looking at these ACLers, when they’re doing this, there’s too much moderate output that doesn’t have much intent. It doesn’t have a ton of strategy or structure around it. It also doesn’t have a ton of built-in recovery, which is intentional. 

What happens is that it leads to stalled progress, some lingering symptoms you might be dealing with, maybe some confusion around what’s going on. The thing that I wanted to bridge this into was essentially having multiple calls with athletes, where this thought just started to stir up more and more. And as we talk about it as a team, I was just like, you know what? Let’s do a podcast episode on this. I want to share some of these calls that I literally had this past week with people in terms of where they are. 

One athlete was training their legs six days a week. And while there can be certain structures, don’t get me wrong, that you can do legs six days a week. Three of those days might be super light days. You might be doing some isometrics, you might be doing some mobility work, but y’all, no one is training the legs six days a week. I promise you, especially if you are hitting it hard with the movements, the sets, reps intensity. You shouldn’t be able to do six days a week. That’s just not good strength and conditioning; it’s not good rehab. Six days a week is going to dig you a deep hole that you’re not going to be able to come out of. She was doing four hours of rehab work a day, and there were fresh post-op. Four hours of rehab work a day and they were literally fresh post-op. It just doesn’t really add up here, like why she’s doing so much work every single day. Yes, you are doing some stuff more frequently post-op. But with that said, four hours of work, you might be almost doing too much.

I had one ACLer who said she literally had 20 exercises, and for all of these exercises, she had to do three sets to do almost every day. Seven of those were aiming to accomplish the exact same thing. Basically, it was all focused on knee extension, and seven of those were doing the exact same thing. But, yet they were doing three sets of all seven of those exercises. Why are we doing this? Why does it just not make sense? Another one was sneaking in exercises on days where they weren’t scheduled, thinking it wouldn’t hurt anything. Now this is almost a little bit more for the athletes themselves. But with that said, we tend to see that with some people, where they’re trying to sneak in other exercises, thinking it won’t hurt. Therefore, they just end up doing too much every single day. And the consistent theme with all of these people when talking with them is a lack of progress. They feel stalled. There is knee swelling and pain, sometimes stiffness with this, there’s a lack of structure and direction in general, and then they feel burned out. I would feel burned out too if I were doing 20 exercises every single day from my rehab.

This is all essentially a load management issue. The distribution of stress and load on the body is not being managed well, and honestly, mentally too. I think that gets overlooked, but especially as you get further in this process of ACL rehab. You just feel like you’re in this rehab purgatory where you’re just constantly doing stuff. But eventually, after you get out of those early phases, it should transition more into a strength and conditioning type program. Therefore, we are balancing days where you are in the gym training, and then maybe the next day is a low-key recovery day. Maybe it’s an off day. It just depends on what the priorities are at that point. But with that said, we want to manage the load, and that is going to be so important given all the stress on the knee, on the body, and that’s going to help us also mentally to avoid burnout. I see this as a very key problem with burnout is that people are just going hard for so long. They’re not given intentional rest. Their provider doesn’t necessarily pick up on cues whenever they’re burning out or running their bodies down into the ground, or a lack of progress. I think this is very important for us to pick up on because of the length of this process. 

The other thing that I wanted to share was just another athlete who joined us. She was working with a reputable ACL PT, who was doing two and a half hours in the gym. She would see this PT, and then other days she would’ve structured four different days, and she was spending two and a half hours in the gym on her own and was not making progress. She felt stuck. We audited our program. We’re just like, okay, so let’s just kinda look and see what are the things that you are struggling with via testing? And then also let’s audit and see what’s going on. And it was just so much volume. We reduced it down and got more surgical based on her testing. She was able to move forward with only three days a week, one-hour workouts each week. So that’s the thing that can be done. We don’t need 10 hours of work every single week for ACL rehab. We really don’t. 

Of course, different phases will require different amounts of commitment, whether you’re working on range of motion and strength. Versus if you are through the range of motion purgatory, if you will, where you’re not working on it as much daily, then therefore you are going to be able to allow a little bit more balance to your plate because you’re just focused on a more strength and conditioning focused work, which requires days where you are just not really focused on the legs. You can’t focus on it every single day. That is something that is going to be really important here because I think in this process, we see a lot of ACLers get really stuck. And don’t get me wrong. Early on, I was guilty of some of this, too. I’d get excited about certain specific exercises or not want to leave any gaps in the day. But over the years, I have embraced a less-is-more mentality, and it has not failed me. It has not failed our team in terms of the ACLers we work with. Because as we work with more, we are always trying to audit things like every single week as a team. We are always talking through programs. We are talking through programming and audit. We’re talking through cases, and we’re like, okay, here are the hard cases. Here are the ones that we seem to be having a little bit more straightforward process. 

We’re also talking about what we can do differently to improve these types of situations for our ACLers based on the context of their lives. This is important for us to make sure that we audit, and make sure that we aren’t just giving our athletes just a ton of exercises just because you know that’s what you do. We want to make sure we have a why for every single thing that is put into the program. And that is one of the essential pillars of our team, and when we program for our athletes and guide them, it is that anytime you’re doing an exercise, there is a why behind everything. I promise you that. And that is something that got drilled so heavily into me when I was doing my strength and conditioning internship, because if I didn’t, it’s got to get out. You have to be able to explain why and a rhyme in a reason as to why you were implementing that for your particular athlete, especially in this case, for ACL rehab.

This is something that I wanted to also share a caveat for is the double-edged sword of this feeling of needing to do more as an ACLer. For some with bad rehab, they’re just not getting enough or more. It’s just like they’re doing stuff, but it’s not really challenging. It might just be more of doing exercises that are actually challenging you, exactly where you’re at. That’s the big thing here. I get that if you’re not getting the right rehab where you are. There’s those people who compare themselves to who they are pre-injury; they’re high-energy, big exercise people who can’t sit still, impatient, so they feel the urge to do more. I think this is something where it’s going to be really important to work with someone who knows ACLs, who can individualize things is so key. Also, be able to make sure it meets you where you are. And also, be able to check your athletes if they are doing too much. 

I’ve had to have a lot of hard conversations with people. We tend to work with a lot of dedicated, high-exercise functioning people. Sometimes we have to have that honest conversation. Look, you don’t need to go on this walk right now. Your knee is swollen. Stop doing an extra workout on your off day because you’re not giving yourself a break. Of course, we are trying to make this more tactical and to be able to communicate with these athletes to make sure we want to have them along in this process. Understand what the goals are for them in the short term and long term, and also how this all plays together in the structure and the way that we’ve built this out together. If we need to make changes or adapt it, we are here to make that happen. If they need more of a stimulus of something we can always add or adjust things. It’s just making sure we’re communicating based on that. But today, we break down why less is more, how to use a high-low principle, the 80/20, some of these things you have heard me talk about, and also what the research says about volume and strength and hypertrophy. Because I think that’s going to be important as we consider volume and training in general, especially in this rehab process.

One of the things that I wanted to share with is two different analogies. I’ll keep it super short. One is that, think about our energy and output as a battery. Let’s say we start the day and the workout with a full battery. It will eventually run out, and we need to recover (aka recharge the battery). In order to give our next lift, our best, think about whether you just keep doing stuff every single day. You keep emptying the battery, and you don’t give it enough time to recharge. You don’t give it enough time to be able to recover, and eventually going into each day with a half-full battery, or even sometimes it’s feeling depleted. While that can be layered into bigger topics of nutrition, stress, sleep, just overall recovery. Those obviously all play into this, but we’re talking about rehab specifically. If we’re just going hard every single day, that battery’s going to keep getting drained, and we’re not going to be able to allow it to fully recharge and recover.

The other analogy I want to share here is just thinking about training and rehab sessions as digging a hole. When you’re working on your quad and your knee, especially through a true strengthening conditioning session where you’re really pushing weight, you’re digging a hole, you’re stressing that knee, you’re stressing your body, and that hole is being dug. You’re just digging, pulling out dirt. When you recover, it’s like you’re allowing yourself to fill that hole back up with the dirt. You’re trying to get it back to where it was. And side note, this is actually where the adaptation and the muscle strength and growth actually happen. It’s not when you’re actually working them out, is actually when you allow it to recover, which often gets missed. 

If you don’t allow yourself to recover, then it is like you put some dirt back in the hole, but then you just dig a deeper hole. And if you repeat it, it’s less dirt and more dirt out, leading to a deeper and deeper hole. What’s my point here? We need to avoid junk volume in rehab and really want to make sure we train and rehab with purpose, which is going to be really key here. And that’s where the programming and structure is going to be so key in this as well. This is where rehab and S&C principles, strength and conditioning principles really do come into play. 

But first, I want to provide some understanding of what I mean by volume so that we can lay the foundation a little bit more as we go into some of these topics. Some common methods of measuring training volume include counting the number of sets to failure and the volume load. It could be sets times reps, times weight, distance, number of sprints, etc. There are different ways to calculate volume. And I’m not too crazy about needing to calculate every single thing to a tee. But of course, if we have these measurable numbers, and that’s great to track over weeks and over time to see if there’s any big jumps. Even something as simple as step count. Does that really spike up and jump? Those are going to be things that we want to factor in. 

But with that said, volume could be this catchall term. I want to break this terminology down a little bit from a training standpoint. There’s something called maintenance volume, which is how much volume you need to maintain your gains. There’s something called the minimum effective dose (MED) that is the smallest amount of stimulus needed to drive positive adaptations. If we are below this, then there will be no adaptations. Basically, you’re just doing easy stuff. You will not have any positive adaptations from it. Minimum effective dose is the minimum needed dosage to be able to make some sort of positive adaptation. Maximum adaptive volume—this is where we are training at our optimal range of volume that we can adapt to and recover appropriately to drive “optimal performance.” Now this is a moving target. This is something that will vary based on a number of factors in terms of just your nutrition, recovery, and what the focus is. I would say this is also a little bit more applicable to someone who has been training versus someone who’s going through something like a rehab process. 

The last point that I want to bring up or the term is maximum recoverable volume. This is the absolute maximum volume that your body can handle and recover from. Sometimes it’s necessary to pass this threshold from time to time. Sometimes it’s called overreaching in more strength and conditioning terminology. But this allows us to elicit greater adaptations. But the important point with this is to make sure it is not often, and usually with stuff like this, there are “deloads” that allow for that higher accumulation of volume. Allow for that super compensation, which is where basically you work. And then there’s that point of overreaching where you really stress your body, to get the training effect you want. And then you super compensate. Basically, this is for us to get that adaptation based on the strain we have put on our bodies. When it’s not monitored well, or we’re constantly over-reached without recovering, you open the door for a potential injury or for some things to start bugging out. 

And while I would say in most situations, max recoverable volume is not something that we are striving for in the majority of ACL rehab. While we are pushing some thresholds, it is just a little different with ACL rehab because in this space, with the rehab process, most of our training lives with a minimal effective dose. I would say this is where most people probably live. Not a lot of people, unless you are so to a T doing max recoverable volume and hitting that upper threshold consistently, unless you’re like an Olympian, you are someone who is so strategically focused on very high-level competitive events. It’s going to be something where you are also having such a rigid strength and conditioning program with a coach who is dialing this in day after day, week after week, very specific. We’re assuming this without there being as much of an injury to deal with. ACL rehab and most training live in the minimum effective dose. 

What is the minimum necessary to move the needle and especially when we are dealing with much more limited bandwidth for the knee, more volatility and also sensitivity given it is a joint recovering from a major surgery versus someone, like I said, who is just training to increase their performance whether that be like a bench press or they’re running a half marathon or some sort of other competitive endeavor. It’s going to be a little different in terms of the way that we are progressing in rehab, especially versus someone who is uninjured and fully performance-based. This all comes back to just being load management, and it’s even more highly sensitive for ACL rehab. As I’m sure you guys have taken away from this episode at this point, which means we have to be more strategic and much more surgical in the approach of what we do. There are basically two things we’re looking for: maximize the positive effects and minimize the negative effects. And that is going to be something we need to make sure we understand how to do practically. Let’s dive into that. 

Number one, you’ve heard me talk about a high-low approach. I’ve done an episode exactly on this, go catch that if you haven’t caught it. This is a concept originated by Charlie Francis in sprint training. Essentially, it’s been adapted into the strength and conditioning rehab realm. But the concept is you have high-stress days and low-stress days. High means it’s just like high demand on your central nervous system on your body. It’s typically like heavier lifts, power-based workouts, a lot of the dynamic stuff you might do on a field that has high effort outputs; those are high days. Your gym focus days are going to be high days. Then you have low days. These are more recovery-based days. It might be mobility-focused. You might be doing isometrics, you might even be doing some steady state aerobic work or control work. It’s stuff that you really need to do every day. You could do every day because the intensity is so low that it’s not really going to do too much to your body. And that’s where high-low comes from, is balancing these things. 

One thing that happens is that ACLers tend to live in that medium or moderate zone. Therefore,  they’re doing too much every single day. They don’t allow themselves to recover. And then they also don’t allow themselves to have really high output days. Some of those might come down to not being pushed with their provider. But it’s also something that I think just by nature of if things are spread across day to day, you’re just going to hit it at a moderate intensity.  Because it is also hitting higher intensity, most people are just not as comfortable doing it because it requires more demands. But this is truly where the value of adaptation sits. If you’re always in this moderate range, you’re not doing enough to be able to truly get the adaptations you want. And then you’re almost doing too much to where you don’t really recover either. High-low day you can always think of alternating like high, low, high, low. And that allows for this undulating pattern. Of course, there are always strategies around this, given there are seven days in the week. We could structure this in several different ways. But with that said, the general principle stays the same. We don’t want a bunch of high days back to back because then you don’t give yourself enough time to recover.

Undercook versus overcook. I did something on this recently, but I’m such a big fan of undercooking as we start. I think that it’s so valuable in this ACL rehab process because it allows us to create a safe entry point into movement and into training, especially if they’re new. We can always observe the dose response to it and then add more. Versus having to take things away and being reactive when the knee flares up, or it’s just too much to accomplish.

The next point I want to bring up is about strength in hypertrophy principles. For hypertrophy, there is plenty of research at this point. Brad Schoenfeld leads the field in hypertrophy. If you want to learn anything hypertrophy-wise, the man has really done a lot of research on this stuff and with a lot of smart people. But basically, he’s shown that if you hit 10 hard sets per muscle group per week, usually that is like the minimum effective dose for maximizing growth. Hard sets, meaning it could be within one to three reps of failure. And that’s probably the biggest thing that I see people struggle with, is that they don’t truly get themselves close to failure.

Now, if you have a very painful, swollen, sensitive knee, you don’t need to be pushing these rep ranges as much. But as soon as it’s calmed down and you can do that, then that is something we want to work towards. And our athletes work towards that in this process, and I think that’s very important to be able to do because otherwise you are just doing junk volume again. You feel like you are essentially doing work, but you’re like in a rocking horse. You’re not necessarily moving, but you’re rocking. There’s movement but there’s no progress. This is something that I think is very important with the hypertrophy research because we want to make sure this muscle can gain some size here.

Sometimes people are like, oh I’ll do a ton of different exercises. But they’ve also shown that basically once you hit 20 sets per week, there’s diminishing returns. And then that leads to also potentially overtraining and then less recovery, and that becomes an issue in and of itself. When we’re talking about minimum effective dose, if you can hit 10 heart sets per muscle group per week, and you hit that close to failure, you’re going to be in such a good spot to see the muscle grow and to recover well as well. You don’t need a ton of work to be able to get there. Now, people are on a spectrum, but the research is very clear on this. And while there are more ideal hypertrophy ranges, yes, you could say, like anywhere from six to 12, for example, you’ll see different ranges for repetitions. With that said, they’ve also shown that you can get hypertrophy with different ranges. It could be three or five, it could be 10 reps, it could be 20 reps. There still tends to be a sweet spot in that middle, I would say. But the most important thing is proximity to failure. 

The other piece that I also want to share here that has been researched pretty heavily is being able from a strength standpoint to hit three to five sets per lift, two to three times per week. Of course, the lift can vary here, but the intensity is what’s going to be really important, especially from a strength standpoint. When you’re talking about true specific peak strength to force output that you’re trying to improve, you’re likely doing less volume and higher intensity. We’re putting more weight and we’re decreasing the reps. That’s going to be something that is going to be very much driven by the intensity and specificity versus just pure volume of doing exercise for a certain muscle group. That’s going to be specific for strength. The main concept around this is it’s not about how many exercises or sets, it’s about how many effective near-failure sets per muscle group you’re accumulating weekly. It’s not about how many exercises or sets, it’s about how many effective near-failure sets per muscle group you’re accumulating weekly. 

The next point I want to share is the 80/20 principle. This is something that we do as a pure audit that will encourage you to do if you’re an ACLer, if you’re a clinician or coach listening. We make all of our mentees go through this process. But it’s the 80/20 principle, where you essentially look at your program and you cut out 80% of it and you keep 20. What is that 20% that you’re going to keep there? And that is going to be important from an auditing standpoint because then it’s going to help you cut through a lot of that junk volume and be able to be like, okay, these are my main movements. You need to be able to answer why. You need to be like, okay, right now I have a deficit in extension, so I’m doing this particular knee extension movement to help get that hyperextension. You might be like, okay, I’m having my donor site as a limiter rate limiter for me, so therefore I’m doing some specific isometrics to help that area, be able to improve from a sensitivity standpoint and tolerance. And then it might be quad strength. You might have one to two particular movements that you’re really pushing hard on a particular training day that you are trying to really move the needle with. And that’s your 80/20 right there. The rest of that stuff’s probably junk. If you walk into the gym and only have 10 minutes to do something, there you go. That allows you to understand what our priorities and goals we’re working towards, and also what movements are going to help facilitate that adaptation. 

The last point I’m going to bring up is less is more, or the addition by subtraction principle. To me, this look the same, but basically you’re trying to get more out of doing less, or addition by subtraction. You’re cutting something away and you’re actually adding to what you’re doing. Think about reducing it down to three to five key movements and hitting those super hard versus 10 at a moderate intensity. Think about doing that. You’re like, oh wow, okay. There’s like a breath of fresh air because you actually are doing less. You don’t have to go through 10 different movements. And you’re also putting so much intent behind those three to five movements versus all 10 of those movements at moderate intensity. You’ll have a better mentality around this going into the gym and knocking that out, knowing you have five things versus 10 things to do. And with that, you’ll cut the 10 things short if you do the 10 things because it’s 10 things. That is going to be something that you’re like I need to get through all of this, so let me get through all of it.

In my opinion, not great programming in most cases, especially if the goal is power, strength, or hypertrophy. We need to reduce this down to get more out of it. People think that more is better, but it’s not always the case. And I’ve seen so many ACLers move the needle by doing a lot less. We’ve had people who have been in phases where they could only do two days a week, and they really go hard on those two days a week with what we have set, and they move the needle. And we’ve seen people who have gone six to seven days a week and have been stuck for months and months. This is something that you would never expect. They also are very much there’s no way, I feel like I’m not doing a lot. And then we retest and we look at things and they’ve improved. How is that the case? It’s because we’re sticking to scientific research, we’re sticking to principles of rehab and strength and conditioning, and that is so key in this process.

Last additional point I’m going to add here. I know this episode is long, but stick with me here because I promise you, a lot of you probably listening are like, this is me, this is it, this is a lot of what is going on. I feel this, but I want to share this one last point. People want to constantly change exercises, and I think that’s just the nature of human beings. You want novelty, especially with the way that workout classes are, especially bootcamp-style classes. It’s always a new workout, different workouts, and there’s no harm in that. Don’t get me wrong. It just depends on what you like for movement and what you want. But with that said, at some time points, yes, this can be done in the ACL rehab process. But any good ACL and strength and conditioning block is going to have at least three to six weeks worth of specific set targets, but then also certain movements. We’re not going to change up the program every single week, and we’re not going to change that up just for the sake of changing, especially if someone is making progress week to week. We change because the goals may have changed based on testing. Maybe something’s come up in their lives. There are times where it’s monotony. You don’t want to do the same thing for 12 to 16 weeks. You’re going to get bored. 

When we think about true physiological adaptations, we’re looking at six-ish weeks. It could be four weeks, let’s just say from the four to eight week window, when we’re like, okay, if we’re doing said movements, where does the adaptation start to occur? We start to see those adaptations start to occur after the four-week window, up until the six-week window, and beyond. It just depends on what you’re working on. But with that said, that is just basic human physiology from a training standpoint. If you change it each week, you won’t know if you’re really improving, especially for heavy strength lifts. That’s why we typically work in four to six-week blocks, still progressing things like the movement variations. You might have something that challenges it a little bit more. Let’s say you’re doing a drop jump, and then next you’re going to do a single-leg drop jump. But if you’re doing a certain squat variation or a split-squad variation, we may make it harder by different ways of increasing the variation of it, the sets, reps, intensity, the velocity, or the speed of it. But that’s just a side note here, as I think it’s important to mention. 

I’m sure I’ll do an episode on this at some point, but this is something that I think is super key and can be super helpful in this process because a lot of times people want things to change very regularly, maybe once a week or every two weeks. And the thing is, with ACL, especially when you truly get into the gym training, we don’t want to change too much too often because then that’s going to create a lot of moving pieces, which makes it harder to track progress. But then also if something flares up, for example, if you’re constantly changing the variables, you’re not gonna know what flared it up.

If I have the same program from week three to week four, and all I’ve done is maybe increased the RPE or the intensity of it, or maybe added like a few reps to it or one more set, it’s very unlikely the knee is going to respond negatively to that because it’s such a small increase, but we’re still getting an output from it. If the person goes and their knee flares up, we can track and be like, maybe this was because you went and walked 10,000 steps, and you’ve only walked up to 4,000 steps the week before.  We can start tracking these things and be able to be a bit more detective-like, but then also keep the ship moving along in the right direction.

In summary, this has been way too long an episode on this. I’m so sorry. I did not expect it to go this long, but you know what? I just wanted to talk about this principle. I see it so much within the ACL space and something I am not going to say I’ve never been guilty of. But at the same time, once you learn, you make updates and you change. We always make sure to find the sweet spot for our ACLers of what we’re looking for adaptation-wise, time-wise, and making sure they’re not doing a bunch of junk volume. 

I look at junk volume as someone having the emergency brake on while you are driving. It’s just slowing down your progress, slowing you down on this journey. I’d rather you do three exercises really well with high intention, output, and intensity than 10 exercises moderately. We want to eliminate the junk volume by anchoring two principles. I promise, as much as you think you can outsmart it, you will not. It’s the reason why these principles have stood the test of time. We cannot outsmart the human body, unfortunately. This is where I think having an audit of your ACL program, the structure and the movements, the reps and sets, intensity, all that matters so much within each phase of this process. Auditing it just to make sure, is this meeting what I need from a minimum effective dose standpoint, or am I going to the max unrecoverable volume where you’re just like hitting such an end, where you’re like, this is not even allowing me to progress. That’s something that I think is important to audit as time goes on in ACL rehab. 

I hope that this was helpful. Get rid of your junk volume, be more strategic. I would almost encourage you that if you are working on exercises, if you try to do five of them really well with high intention, proximity to failure, getting closer to failure, and fatigue in that muscle, in that movement, versus doing 10 where you just do a bunch of reps and then you’re like, all right, cool, I’m done. You’re checking the box. In reality, exercises are just a vehicle for adaptations. There’s no perfect exercise. There’s not one bulletproof exercise, although knee extension is probably close to it. But with that said, exercises, the rep sets tempos. It’s all just a proxy for putting stress on your body. It’s been built into a system of exercise prescription where you do sets, tempo, reps, certain intensities, and hoping for a specific output. But at the end of the day, your body doesn’t know any different; whether it is a split squat or a squat, it just knows that it is doing this movement. We need to lean into this stuff and do. The movements, do ’em very intentionally at high outputs when it’s needed, and also make sure we’re not doing too much, also not too little, especially not too much where it is very much limiting your ability to recover and also be able to progress forward.

I hope that this is helpful. If you have any questions about this, if you feel like you’re a junk volumer and you’re worried about it, send us a message. I audit people’s programs. I give feedback on that stuff. I’m happy to take a look. Our team is happy to take a look, so you can reach out via email, via Instagram, wherever that might be. But other than that, I will catch you guys next week. This is your host, Ravi Patel, signing off.