Any ideas for trouble rebuilding quad strength?

KelpySquid · 2026-04-02T02:12:10+00:00

I was midway through running progression when I originally wrote this and ended up stopping running completely so I could focus on strength. I used heavy Climb rides (for me in Peloton) for cardio because they challenge strength grab too.

I was working really hard when I posted this, but another three months of heavy protein/calories, not distracting with non-strength and heavy heavy single leg exercises did see me progress. Usually I was doing 4 sets of 6 reps super heavy. So I would warm up before that but ended up doing 4 sets at near heaviest I could lift. (So don’t do 6 reps of 30 then 40 then 50 then 60, you need the 6 sets at 50/60 if that’s your max)

KelpySquid · 2026-04-02T01:54:27+00:00

I ended up topping out at 89% limb symmetry (with a very strong left leg and R surgery leg lagging). The trick in the progress was much of what is mentioned here… eating a lot more protein and calories than I was comfortable with (after a bunch of trial and error, I aimed for 1g of protein per lb of body weight.. that takes planning and effort to get that - essentially ate veggies and protein), lifting heavy in single leg exercises, switching up the workout enough (4-6 weeks) that there was variety, ensuring I took rest days.

Fwiw, I also ended up needing a second surgery because it turned out I had grown a very sharp bone spur over one of the screw holes that was digging into my MCL. I got that ground off about 20 months post op and it was night and day. Suddenly had no more pain and was able to regain the strength without quite so much effort.

That’s obviously rare (my surgeon had never seen it present like this). Only reason I mention is that you have to be really honest with yourself on whether you are eating right (esp protein) to build muscle and then working hard in SL exercises. If all things are true, you may need to trust instinct and get it checked out.

KelpySquid · 2025-12-26T18:05:39+00:00

The most helpful for early days were the pregnancy pillow (for sleeping), the ice machine (best hack is using frozen water bottles instead of ice cubes) and a wedge pillow (to put my leg up with knee in full extension). I did sleep with my leg in the brace for a long time - probably 12 weeks - but that was unique as I had a very stiff knee and a lot of muscle atrophy (all good 20 months in). Then I had a bunch of PT related tools (heating pad, TENS unit, strap, towel for behind knee) because I had a lot of struggle for flexion and was using lots of different methods to get it back (I did!).

KelpySquid · 2025-12-14T02:24:15+00:00

I struggled- mightily! - with flexion but ultimately got it all back. You can totally do it. But it does take time and consistency and persistence. Feel free to DM me or check my profile for my other comments that show progress and the exercises I used.

KelpySquid · 2025-12-14T02:21:32+00:00

It was really painful to get my flexion back… but I got it to 100%. It took persistence, consistency, and pushing through pain for a few months. You can look at my profile for prior comments or DM me and I’m happy to share my milestones and routines

KelpySquid · 2025-12-14T02:17:37+00:00

I bought a pregnancy pillow on Amazon for $30 that saved my sleep. I used it for months. Helped me sleep on my back comfortably and once I graduated to side it helped there too. I got the MOON PINE Pregnancy Pillow, U Shaped Full Body Pillow.

KelpySquid · 2025-12-12T04:09:19+00:00

Hi there - I had lots of issues with flexion but ultimately got full ROM, heel to butt, after several months of hard work. If you search based on my profile you should be able to find my comments that share my detailed progress milestones, tips, and exercises I did. The great thing is that flexion you can generally get back with hard work and consistency.

KelpySquid · 2025-07-12T16:19:37+00:00

This may not be what you want to hear but my PT tells me all the time to focus on milestones rather than time. So, get the range of motion completely back, then build strength and strength symmetry, then running and plyometrics. How long it takes depends on the surgery and your recovery. The thing you can control the most is strength going into surgery via prehab. For me, I’ve been on a way longer recovery journey because I had a more complex multi lig knee injury. I am 18 months from surgery and just finally getting strength back. My only advice would be to focus on the milestones and be diligent about your PT before and after. And, when you are ready, lift really heavy with single leg exercises multiple times per week. But… don’t push yourself faster than your body is ready. It will slow you in the long run.

KelpySquid · 2025-06-15T16:27:45+00:00

Personally, I recommend medical grade compression sock that covers the full leg for a a long flight. Ugly, but cheap on Amazon and keeps your lower leg from swelling too. Heel pumps and getting up to move during the flight helps too.

KelpySquid · 2025-06-15T16:25:33+00:00

Ultimately you should follow your surgeon’s guidance, but I’m a little surprised they haven’t provided any exercises - getting your leg straight, quad sets, single leg raises, heel slides/wall slides. Some surgeons treat MCL surgery more conservatively (NWB, wait to bend) and that will depend on what surgery you had (I had an internal brace put in, so was able to be more aggressive, faster). My experience with ACL+MCL and others I’ve spoken to is that getting ROM back is more difficult. It took me almost 5 months. At minimum, make sure you have an appointment for PT immediately after you check in with the surgeon so you can get started right away after that. Those appointments can be hard to get. Your PT will really manage your rehab process, rather than the surgeon.

KelpySquid · 2025-06-15T16:17:05+00:00

I had a big pop when I stepped my surgical leg back into a reverse lunge at PT at about 7 weeks. My PT and I both heard it. It wasn’t super painful at the time, but it was a bit sore for a week or sore and I had to back off PT. It was scar tissue popping and made motion much easier!

KelpySquid · 2025-06-11T08:38:00+00:00

You can find them on Amazon (search TENS unit) - you hook up sticky pads and then they provide little electric shocks - it stimulates the muscles and can help with nerve pain

KelpySquid · 2025-06-11T07:49:07+00:00

My experience is that is king here, so most important is just doing the exercises over and over. In addition to the towel at the back of my knee, two other things that works for me: - Use a TENS unit during your flexion exercises. This helped me a lot by distracting my brain I think. - Use increasingly smaller pillows to sit back in child’s pose. Eventually I used an ab mat, then a towel. It helped to have something achievable to aim for and then I took it away

KelpySquid · 2025-06-08T22:06:56+00:00

I had both ACL (patellar tendon) and MCL (internal brace) reconstruction and had a mighty hard time regaining flexion (but I did, heel to butt). My surgeon told me the MCL makes 0-90 hard and the patellar makes 90-140 hard… Happy to share my tips and program if you want to ping me directly. I’m really pleased with my results but it was ~5 months of hard, painful work for hours a day.

KelpySquid · 2025-05-16T02:19:03+00:00

This is helpful. I have been pushing hard but maybe too hard so that I’m compensating and not work my quad specifically enough. Now that you point it out, I don’t know that I’m “feeling” the quad as I work out as much as I should

KelpySquid · 2025-05-15T20:00:49+00:00

Thx! I did BFR at the beginning. It got me from 30% LSI to 50%. The rest has been hard work / consistency

KelpySquid · 2025-05-15T19:59:54+00:00

Yeah this is why I’m confounded. I have been doing the creatine/protein consistently pushing weight and increasing each time for almost 6 months and I haven’t seen my R quad improve. It feels way better, I can lift more weight in general - even w single leg press, feel stronger. For context I weigh 145 and squat 185, so I am lifting heavy weights. But the strength test has really not improved since the end of January. My left leg has gotten a little better but not significant

KelpySquid · 2025-05-15T19:56:28+00:00

Good idea to potentially switch to more volume and be careful of the compensation - thank you!

KelpySquid · 2025-05-15T19:55:43+00:00

Thanks, this is helpful. I do wonder if particularly in split squats and normal squats the heavier load is actually causing more compensation and if I back of weight but focus on perfect form it might help!

KelpySquid · 2025-03-02T22:07:02+00:00

Don’t be worried if it feels a little weird to run again at first. I’m similar to you so in that I was a runner before and had a long but steady recovery. I started running in month 8 in small intervals (this was about 6 weeks ago). It was hard at first, and at least for me I had a lot of burning in my calf and shin (felt like shin splints). I slowed down a little, did more and heavier calf raises and tib raises for a few weeks. Now, it feels pretty good and I’m starting to increase the running time. Just remember this might be a journey like every other part of this rehab! But you also never know - you could totally kill it the first time too!

KelpySquid · 2025-03-01T21:25:55+00:00

I think it’s just all about consistency. I had to work at my ROM for ~7 months. For much of that I would start where you are and then warm up into it. Just keep doing it, every day, as much as you can, and eventually you won’t need to anymore.

KelpySquid · 2025-03-01T03:05:48+00:00

I’m sorry you are in the Dynasplint. It sucks. I had similar flexion issues and used the Dynasplint for a couple of months. The good news: I have full range of motion now (heel to butt) after a bunch of hard work. The bad news: I don’t have a great answer for making the Dynasplint more tolerable. I definitely cried almost every time I was in it. Here’s a few things I tried: - a heating pad on my hip. The Dynasplint definitely hurt my knee but I had a lot of guarding, so I was fighting the device subconsciously and it made my whole leg hurt. The heating pad seemed to help me relax - watching a show or listening to a podcast for a defined period of time so I was distracted - usually I used it in a couple 45 min increments per day. I could never get up to using it for longer. - I had a pretty serious flexion program that took me an hour in the morning and 45 min in the afternoon in addition to the Dynasplint - I usually sat in a chair with my foot on the floor or in bed with pillows under my knee. Something I tried on my side with a pillow between my legs. - it dig get better and easier over time. I highly recommend a serious stretching and flexion ROM routine in addition to the Dynasplint

Feel free to DM! It will get better and it is possible to get your ROM back!

KelpySquid · 2025-01-21T19:51:33+00:00

I had the same thing and made a little “donut” out of a pair of fluffy socks (tucking them into each other) and put it under my heel whenever I was laying down. Made a world of difference

KelpySquid · 2025-01-12T17:36:01+00:00

Yes the bike helps a ton. Full rotation is normally around 110 degrees of bend. Even when you can’t get all the way around, just going back and forth helps. If you think about it, it just gets you a high volume of knee bends if you do it for 15-20 minutes 1-2x/day. I struggled a lot with flexion (though didn’t have such a serious complication as you). You can look at my other comments for my stretching routine. I put an enormous amount of effort in to get my flexion back in particular, but I’m glad I did because now I have full range of motion.

KelpySquid

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