OBJECTIVE: To investigate the effects of linear periodization (LP) resistance training after anterior cruciate ligament reconstruction (ACLR). SETTING: Physiotherapy clinic. PARTICIPANTS: Male recreational athletes who underwent ACLR. MAIN OUTCOME MEASURES: Knee extensor and flexor isometric strength, hop tests performance, patient-reported function (International Knee Documentation Committee, IKDC), and psychological readiness (Anterior Cruciate Ligament- Return to Sport after Injury, ACL-RSI). RESULTS: Twenty-two participants (mean age 27 +/- 6 years) were randomized to either a LP program or the traditional '3x10 reps protocol'. The LP group demonstrated greater knee extensor strength gains compared to the 3x10 group (p = 0.03): 51% (95% CI 28 to 73) versus 26% (95% CI 11 to 40). No statistically significant difference (p = 0.11) in knee flexor strength gains was observed between the LP group (45%; 95% CI 18 to 71) and the 3x10 group (23%; 95% CI 7 to 39). Six months after ACLR, the LP group exhibited a greater knee extensor limb symmetry index (97 +/- 10% versus 85 +/- 11%, p < 0.01) and higher ACL-RSI scores (68 +/- 18 versus 53 +/- 14, p = 0.04). No significant between-group differences were found in hop performance or IKDC scores (p > 0.05). CONCLUSION: A resistance training program incorporating block-structured LP is more effective than the traditional '3x10 reps protocol' in enhancing knee extensor strength and psychological readiness during ACLR rehabilitation.

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