Can You Suggest Rehab Exercises After ACL Surgery?

Greetings all. On June 4 I had ACL replacement surgery on my left knee. After the surgery I attended therapy for several weeks. It was, in my opinion, quite beneficial. Therapy is now finished, and it is now almost four months out from the surgery.

I believe that I have graduated beyond the surgical tubing exercises and assorted low-impact exercises that composed therapy.

I am a competitive swimmer, and my number one concern is getting to where I can sprint all-out without pain, and to regain explosive strength in my hips to power my stroke.

As you might imagine, my left quadriceps is noticably atrophied. Right now I am swimming 3-4 days per week. As of yet I am not able to sprint regularly without causing the knee to swell and hurt, so I have done several weeks of tempo and intensive tempo.

I’d like comments on what I am doing for lower body in the weight room. I am doing the following twice per week for the left leg only.

[b][b]4 sets of 15-20 Peterson step-ups, raising the height of the step as I can. I have read that this exercise targets the vastus medialis.

4 sets of 5-6 split squats, leading with the left leg. Either bodyweight or ten pounds.

3-4 sets of 6 one-legged Romanian deadlifts, for the hamstrings.[/b]

I’d like to know whether all this is desirable.[/b] Thanks for all your help!

By the way, should anyone wish to see a competitive swimmer’s training regimen, click here:

http://www.charliefrancis.com/community/showthread.php?t=3227

Mike,
How is your ROM in flexion and extension? At this point you must have full knee extension and flexion equal bilateraly. How is the quad, hamstring,calf, adductor and glute mass? Do not run or jump until you have equal mass bilateraly. Other exercise you can try. I like to split training up into two different days at this point focusing on single leg movements. I suspect your muscle mass may be lacking due to the low volume of reps in your training. I prioritize training depending on what surgery the athlete had. Autograft patella tendon - quads. Autograft hamstring - glutes/hamstrings. Allograft - Balanced depending on present levels of mass/strength.

Exercises you can do are as follows:
Glute/hamstrings
Single leg good morning.
" RDL
" deadlift
" reverse hyper
" back extension
" hip extension on floor
" glute/ham raise on Swiss ball
" hamstring curl

Quads
Single leg squat
Peterson step up
split squat
*Can vary with a step under working leg or step under support leg
Single leg knee extension
Step up variations

Finally, EMS!

  1. Questions …

Should the application of EMS top the joint area be partciular and designed to stimulate only certain muscle sites in order to avoid unecessary direct trauma to the actual operation site?

Is there a danger that EMS too soon post op may have a neg. effect?

Xlr8 - re: your recent knee trouble - did you use EMS?

Thomas, thank you very much for you detailed analysis! The autograph was from the patella tendon. And as you pointed out, the quadricep is quite atrophied, though nowhere near as bad as two months ago.

In range of motion, I can extend the knee almost to total lockout. Perhaps I am missing less than one degree at this point. But I can easily lay the leg out flat to stretch. I cannot bend the knee up to my glute, however.

There is still some edema on the knee that has not gone away, and I wonder if that is what is keeping it from bending completely. The edema obscures, somewhat, the muscle where the quad attaches to the knee.

The left leg is still noticiably smaller than the right. As per your instructions I will refrain from running.

I’ll also up the number of reps as well, though I am unsure how much higher in the split squat I can go, as I am only using bodyweight.

Thanks again. Any other thoughts appreciated.

Mikeh

Mikeh,
You may want to check this :

http://www.elitefitnesssystems.com/documents/squatrehabprogram.htm

Thanks, I will!