I think key elements in ACL post-rehab (after being cleared from the medical professional) would include exercise regressions/progressions and loading. Individuals are generally advised to engage in strength training approximately 6-8 months after surgery (Augustsson, 2013). I believe that regressions are an important component at such a point. If, for example, I wanted to work on a knee dominant pattern leading to power based exercise, I would likely begin with:
Stability/Strength
Hip Bridges (bilateral)
Hip Bridges (torso elevated + weight)
Hip Bridges (single leg)
Hip Bridges (single leg + torso elevated + weight)
Narrow half-Kneeling (pad below knee)
Narrow Half-Kneeling Anti-Rotation (pad below knee)
Tall Kneeling Anti-Rotation (pad below knee)
Split Stance Anti-Rotation
Bilateral Deadlift
Suitcase Deadlift
Single Leg Deadlift
Assisted Split Squat
Assisted Split Squat + Counter Weight
Assisted Split Squat + Weight
Sliding Reverse Lunge + Weight
Rear Foot Elevated Split Squat + Weight
Single Leg Squat + Assistance
Single Leg Squat + Counter Weight
Single Leg Squat + Weight
Lower Extremity Power (Sagittal Plane)
Box Jump + stick the landing (bilateral)
Jump + stick the landing
Jump
Single Leg Box Jump (low height) + stick the landing
Single Leg Jump + stick the landing
Single Leg Jump
Lower Extremity Power (Frontal Plane)
Bounds + stick the landing
Bounds
Medial/Lateral Hop + stick the landing
Medial/Lateral hops
The strength progressions move from simple/supine positions to bilateral to unilateral leg motions to static half kneeling to dynamic half-kneeling to bilateral hip motions to unilateral leg hip motions to knee dominant to knee dominant and load to single leg knee dominant. I make sure people are single leg knee dominant (or at least rear foot elevated/split squat) before working really hard on plyometrics. My reasoning is that I want to control external loading through slow controlled motions before introducing ballistic motions that produce loads that are multiples of bodyweight.
**These were the regressions and progressions performed on myself after ACL surgery**
References
Augustsson, J. (2013). Documentation of strength training for research purposes after ACL reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy. 21(8), 1849-1855.
-Michael McIsaac