The E3 Rehab Podcast 247. Split Squat Compensations During ACL Rehab w/ Megan Graham
Apr 7, 2026
Megan Graham, DPT and ACL rehab researcher and professor, discusses her study on split squat compensations after ACL reconstruction. She covers intralimb hip-dominant strategies, how reduced dorsiflexion and trunk position alter knee demand, and interlimb weight shifts to the rear leg. Practical cues, constraint strategies, and progressions for targeting the quads are explored.
AI Snips
Chapters
Transcript
Episode notes
Patient Glute Gain Prompted The Study
- Megan described choosing the rearfoot elevated split squat for progressive overload in an ACL study because balance wasn't limiting and it could be loaded with an open trap bar.
- A patient reported her ACL-side glute grew so much from these split squats her shorts didn't fit, which prompted investigation into compensations.
Angles Can Be Misleading Without Kinetics
- Joint angles (hip and knee) looked similar between limbs, but kinetics showed a big shift: ACL-side front leg had ~58% hip, ~18% knee, ~25% ankle contribution at the bottom pause.
- This occurred because a more vertical tibia shortens the knee moment arm, reducing quad demand despite similar flexion angles.
Upright Trunk Doesn't Guarantee More Quad
- Trunk angle behaved opposite to intuition: ACL-side front leg showed a more upright trunk because participants leaned back onto the rear leg, not because upright trunk increased knee demand.
- In split squats trunk position primarily alters hip loading and can increase rear-leg load without increasing knee contribution.