Muscle atrophy / knee rehab

as i already mentioned in another topic I had an ACL reconstruction (hamstring graft) 3 months ago. I lost a lot of muscle, especially on the injured leg (it was half as big as the healthy leg).
The last months I trained 5 days a week at a rehab center.
here’s how the schedule looked like:

-coordination/agility exercises, about 30 minutes

  • 3x10 calf raises
    -leg press 5 x 12 reps (both legs)
  • leg press 5 x 12 reps (left leg)
  • reverse hypers 3 x 15
  • hip adduction machine 3 x 25
    -hip abduction machine 3 x 25
  • 3 different exercises with therabands and swiss balls targeting the hamstrings
    -30 minutes of VMO training with a physiotherapist and massage
  • EMS (depending on how I felt, sometimes russian stim , on other days they used it to reduce swelling / recovery)

I was kinda confused when I first saw my workout plans because this was against everything I learned about training before because there was nothing like periodization and I had just 24 hours to recover from these workouts.
although i was doubtful about this whole thing it worked. my leg is much stronger than directly after surgery but it’s still relatively weak.

my problem now is that i don’t know how to proceed. my doc allowed me to ride a bike, swim, jog and to do free weight exercises.
how should i organise my workout now? and on the one hand I have a “problem” with those high reps but on the other hand I fear using more weight/less reps because I think I could damage the graft.

perhaps there’s anyone who already went through this whole rehab thing …

thanks in advance…

ps: i forgot to add that i’m not a sprinter, i play basketball.

Here is some food for thought. You would NOT have injured your self IF you were strong enough to absorb the force of whatever injured you.

The rehab cycle you laid out will not RECOVER YOUR STRENGTH QUICKLY.

If you were my patient I would want to accelerate you recovering your strength to where you were prior to your injury knowing good and well this would not prevent other injury.

Once I had your strength back to where it was prior to injury then I would introduce you to EvoSport training.

Do you have a screw in there? If so, I would be concerned about using EMS too close to the metal as it may cause local bone necrosis! Consult an expert on the topic to see where to go (this, of course, does’t mean that every other area shouldn’t be stimmed to keep up muscle mass during the rehab period).
As for the limited recovery- I’m not sure this is much of an issue for re-building the injured area, as you’re too weak there to put out enough force to require 48hrs recovery and EMS bypasses the CNS and therefore doesn’t require a day in between anyway.
How do Swiss Balls target the hamstrings?? (Please describe)
I think it’s a bit extreme to suggest that any particular type of training can prevent ACL tears- there are so many variables- but good preparation can greatly diminish the chances. Also, ankle taping is implicated in transferring shock to the knee, increasing the risk. This is finally being recognized with football.

Charlie - I have been told of some coaches who still insist on the taping of ankles.

In the NFL, the situation is muddled- which is a hell of a lot better than unambiguously screwed up. Today, a player CAN train and compete without ankle tape- BUT, if he’s injured, he’ll be fined. A lot of players are figuring out that this is the way to go.
Al Vermiel, the strength and conditionning coach for the Bulls all through their golden years and previously the S and C coach for the San Francisco 49ers during their first Super Bowl victory, argued doggedly against the policy of mandatory ankle taping over 20 years ago. Think how many knee surgeries could have been avoided if they’d listened to him then! Stay tuned for and article on this site by Al!

Great - I’m really looking forward to that article Charlie.

I never made a link between taping and knee injury, but I avoided it on other grounds.
I refused to beleive that continuous taping would help anything, least of all ankle strength in the long term.
Taping may help with injured limbs in game situations, but as a crutch for injury prevention?
The inhibition and felxibity afforded combined with the restrcition, not to mention the dangers of incorrect taping could only lead to a mirage of prociprication, achilles, ligament and cartilge problems.
That’s not to mention the great ‘hiding job’ that taping does - often masking the origins of ankle injuries which may originate in poor Hip flexibility or hamstring shortening.

first off, thanks for the replies.

you are right, many injuries can be prevented if the athlete is strong enough.
i tore my acl because i didn’t warm up properly and i was tired because i partied the night before. I know that i’m an idiot… :rolleyes:

The rehab cycle you laid out will not RECOVER YOUR STRENGTH QUICKLY.

that’s what I feared.

If you were my patient I would want to accelerate you recovering your strength to where you were prior to your injury knowing good and well this would not prevent other injury.

Once I had your strength back to where it was prior to injury then I would introduce you to EvoSport training.

What exactly do you mean by EvoSport training? Do you mean those methods of jay schroeder?

yeah, there are three scews but this are “bio screws” (i.e. no metal…).

How do Swiss Balls target the hamstrings??

Imagine plate drags with a big swiss ball.

I had the same surgery done over six months ago (January 28) and it has been a little bit frustrating. I had exams in April and did virtually nothing for the whole month. I was told that the graft would be at its weakest at around week 13, so I wasn’t too worried about it at the time. In retrospect I see now that my rehab has been less than spectacular. I started jogging in May by doing a jog for 100m then walk 100m. I would do this for 15 min, and then do my weight room exercises: 5x10 leg presses, 4x15 leg curls, 5x10 leg extensions, 3x30s calf raises and sometimes the hip extension and flexion machine for 3x30 reps on each leg. In June I started light squatting again (I had actually tried to do light squats in May but found it to be very painful) just the empty bar for 13 reps. I followed a squat rehabilitation program I saw on the elitefitnesssystems site. I know one size does not fit all but at this point I was ready to try anything as my reconstructed leg was still alot smaller than my healthy one. Last week I started doing strides for the first time and my form is really ragged, it always feels like my knee is going to buckle. But I did squat 100lbs for 5 sets of 10, a small victory. Anyway, I see now that rehab is just as tough mentally as it is physically. At my last appointment with my surgeon he said the graft was solid and that there was no movement in my knee, but I have some work to do on the quad muscle. He said not to bother with a knee brace as I shouldn’t be doing any sudden stops in sprinting anyway. “Just slowly increase your running and when you build that quad back up, that will help too” he says. Oookay. I was all set to go get a knee brace but what the hell, I’ll just run it back into shape. I know I am far behind in rehab but for the first time in months I can actually see myself sprinting again. Sorry for the long post (maybe I will start a thread in the training forum). Anyway Silky, good luck with your rehab and remember that recovery is highly individual, it sounds like you are doing better than I was at 3 months. Be careful around week 13.

Thanks for the long reply, man!
i’m in week 13 right now, i think.
you said that you did leg curls and leg extensions, which is quite suprising because these exercises are said to harm the ACL (because of the shear force) :confused:
btw, I tried jogging yesterday and it felt really weired…i guess this is just normal.


ps: good luck with your quad… :wink: