Backpacking Fitness

Injured ACL? You Might Be Able to Skip Surgery With These Exercises

How focused exercise helped one hiker return to the trails without going under the knife.

I tore my ACL in my last week of law school. The entire class gathered on the beach along the coast from St. Andrews, Scotland, for beers, ice-cold swimming, and barefoot soccer. I was in my stride as I guided the ball past a defender and on toward the driftwood goalposts. I pivoted suddenly against a locked knee, felt a pop, and crashed to the sand. 

I spent a week on crutches before working with my physical therapist to regain stability in my knee, but progress was slow and a month later it was still a challenge just to walk the cobblestone streets in my hometown of Edinburgh. Previously I had bounded up the snowy peaks in the Scottish Highlands; now I felt as though my knee would collapse at any moment. I was in my mid-twenties and I could barely summit a flight of stairs.

According to my PT, since there was no sign of improvement, surgery might be my only option. But surgery is no small decision. After deeply considering the physical toll surgery could take, its inconsistent outcomes, and the long recovery time, I was keen to explore alternatives. That’s when a personal trainer friend introduced me to Foundation Training—a series of bodyweight exercises that takes the load out of your joints and transfers it to your muscles. Dr. Eric Goodman, the creator of Foundation Training, describes it as a system that accessorizes our normal exercise routines to train our muscles to work better together. 

The practice is widely applicable to almost any injury—from an ACL to a PCL, lower back, shoulder, or neck injury. Goodman created Foundation Training in 2007 to heal his own chronic back pain, having declined the spinal fusion surgery prescribed to him by his doctors. 

“It gives your body a muscular contractibility that is shared among muscle chains, instead of isolated to individual muscles,” he says. “And that is a very healthy shift for most people.” That shift that Goodman describes is about working smarter, not just harder, by adjusting the way we move our bodies to maximize our most efficient muscles.

I figured I’d give it a shot. I had nothing to lose and I was eager to get back to mountain sports, so I threw myself into Foundation Training—working at first with my trainer to ensure my form was correct and then continuing with instructional videos from Goodman and his team online. Every morning while my coffee brewed, I hit the mat and practiced movements designed to strengthen my hamstrings. I discovered that if I wanted to support my knee, I would first need to learn to hinge effectively at the hips and build strength and coordination in my feet.

After six weeks, I felt stronger and was moving more confidently. I was breathing deeper, standing taller, and walking better. In 3 months, I hiked Ben Vorlich, a breathtaking mountain trail above Loch Earn, some 9 miles long at an elevation over 3,200 feet. It felt exhilarating to charge up a trail, unhindered by my injury. I was retraining my movement patterns to shift weight from my knee, and it felt good to remind my body what it was capable of doing. I listened to feedback in my body and adjusted my movements to optimize my ascent. 

Foundation Training isn’t just reserved for major injury recovery. Think of it as the owner’s manual for everyday maintenance of your body—whether you’re a pro athlete or a weekend warrior. Even when I’m backpacking or on a dawn patrol ski mission with friends, I start every morning with my Foundation Training exercises.

I still do the same set of exercises every morning. Progress comes with frequency, intent, and repetition. I integrate the practice into all of my pursuits—hiking, skiing, and trail-running. With regular training, you can learn how to address surprise aches and pains on the trail. 

“What will you do one morning if you’ve slept awkwardly on a rock and you literally can’t walk?” Goodman asks. “How are you going to get your body back to a strong, healthy position? This is a good tool for that.”  

I managed to avoid surgery with Foundation Training, but every case is unique. First, discuss your situation with a medical professional who understands your injury and get an opinion that counts. Foundation Training is not a panacea. If you’re the kind of person that will practice the movements until they start working their magic and then never touch them again, surgery may be a better route. “Strength is a day-to-day process, and it is the daily challenges and endeavors that we apply to our body that determine our direction of strength,” says Goodman.

On the other hand, people who like the idea of committing to a daily set of exercises focused on muscular realignment may thrive with a Foundation Training routine, Goodman says. “It’s like you’re performing a microsurgery on yourself every morning, but with movement.”

Foundation Training exercises use bodyweight only (no equipment required) to correct muscular imbalances caused by a sedentary lifestyle (like a desk job) or, as in my case, injury. Many resemble yoga poses, using gravity to stretch and strengthen key parts of the body. 

Besides the physical element of recovery, the mental element is key. We’ve all experienced the kind of pain that all but consumes our focus, and Goodman is no exception: “I’ve been there many times in my life, where the sensation of pain dominated every other neurological endeavor in my body, and it was brutal,” he says. 

Committing to recovery is challenging: Doctors can’t prescribe dedication. We have to dig deep and find that within ourselves. In my case, I found it rewarding to put hard work into my recovery to be able to avoid surgery. When it got painful—and it often was—my drive to get back to the mountains kept me moving forward. 

Those mental and emotional elements are key, Goodman agrees. “When you get out of pain, you feel good,” he says. “When you get yourself out of pain, you feel great. The people that make that dedication to themselves, they are different. And they feel better for it.”