The following improvements to performance must be made before returning to competition:

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• Muscle hypertrophy

• Strengthening the tendons and ligaments

• Improvements to the blood flow around the injured area

• Greater elasticity of fibres

• Greater joint mobility

• Confidence in movement

• Balance and stability

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This stage in the rehabilitation process has no specific time limit. Each athlete will experience recovery in different lengths of time. Therefore, the extent of total body fitness exercises they undertake will vary in relation to other athletes recovering from ACL injuries.

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Low intensity total body fitness exercises may include:

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•  Light weights to strengthen the upper body

•  Controlled swimming exercises (low - impact activity)

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These exercises are targeted at athletes who are still working toward their full range of motion and strengthening the muscles that surround the knee. Total body fitness should be progressive so to avoid further stress and trauma to the joint and surrounding muscles. As the joint strengthens and the range of motion increases, higher intensity exercises can be introduced.

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High intensity total body fitness exercises may include:

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• Stationary cycling

• Stationary rowing

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These exercises involve the flexion of the knees. They are targeted at enhancing the range of motion whilst simultaneously working to increase cardiovascular endurance and upper body strength. Rowing and cycling should be introduced toward the end of this stage of rehabilitation due to their increased impact on the knee joints.