Physical Therapy after ACL Recon
 

Tore my ACL after casing the wake in August. Had ACL Reconstruction on 9/17/12 (used hamstring graft and they also stitched up a couple small meniscus tears).

I have full extension and can bend it up to like 130 degress. Still stiff after sitting for a couple hours, but I can more or less walk without a limp.

Those with ACL Reconstructions, about how long did you do PT sessions? So far I've done 20 PT sessions over the past 2 months since surgery (2-3 times per week). Should that be enough or should I expect to do PT for several more months? My insurance will cover up to 20, but if I need to continue to attend PT then I'll suck it up and pay for it. Otherwise, I'll just go to the gym.

Also, for those rehabbing on their own after you're done with PT, what are the best exercises? My quad teardrop is mostly back, but my outer quad is still concave. My other (good) leg quad is bigger than ever. Kind of depressing! Anyway, I've been riding a stationary bike for 45 mins at a time on level 10 which pushes my legs pretty hard. Then I do 3 sets of 15 leg dual leg and then single leg leg presses. Then I do some hamstring machine curls, and sometimes calf raises. Anything else I should start doing at the gym?

I have torn the ACL in each of my knees and had reconstruction both times (both basketball injuries, one is 2001 and another in 2005). They used the patella tendon as the graft. Do not neglect your range of motion in the quest for strength. Its really tempting because you want to recover quickly but its likely most important for a full recovery you get as much of your range of motion back as possible.

If you are riding the bike that will help a lot. I felt like my milestones were 1) after I could ride the bike I improved quickly 2) After I was cleared to jog I had my second major leap as I could incorporate another activity that was weight bearing.

With the bike, I felt like interval training (if you are cleared by doc and physical therapist) improved my strength better than riding for a steady period of time. I think i did 30 second sprints as hard as I could with decent resistance then easy for a couple minutes and kept repeating. I don't remember how far along I was before it was safe to do interval training. Check with your doctor and physical therapist.

With weight lifting, I did ridiculous amounts of leg presses. Just keep backing off the weight and continue doing them to get a burn. Once I was fully cleared , I had a rough time after my first knee reconstruction getting my "explosiveness" back. One of the few things that helped was a huge sand dune that I would run up. It helped get back the explosiveness and to develop the little muscles to support the knee. I did use a knee brace while doing it.

One thing that helped on my second surgery was an ice machine. It helped immediately after the surgery where there is a pad put under the gauze and wraps and it circulates ice cold water constantly. It helps reduce swelling. If you are having swelling issues after working out, the machine helped a lot and I was able to use it at work by filling it up and plugging it in. It was expensive though. I think it was around $200.

Regarding continuing to pay for PT. If you are diligent and can do it on your own, you should be ok. You may want to set milestones when you should be cleared for additional activities and see the therapist then and see if they agree with your progress.

Good luck with your rehab. I used to be a decathlete in college and difficult workouts never were a problem for me. Rehabbing from the ACL injuries is really tough. Its takes a lot of patience and persistence. Patience was the hardest part for me.

I think you are good to stop going to PT, but be sure to continue to work it out 3 times a week. I only went to PT for the amount my insurance would cover and just got the trainer to write me out a couple of weekly exercise plans + show me different exercises to try at the gym.

I would try running then box jumps and one-legged hops forward/back and side to side. (Wearing a brace of course)

when i tore my acl i did about 3 or 4 PT sessions and just figured out what i needed to do and did the rest on my own, just mainly rode a bike every single day. stretching, and balance exercises at home were good too

I haven't rehabbed an ACL but other good exercises to build the memory muscles back up and balance/proprioception is lunges,.. do them every single way... back lunge, side lunge, front lunge with twist of upper body, front long leg crossing in front of the back leg, back lunge cross... many of these are difficult without an injury but it'll build your muscles and balance incredibly...

Anything one legged... one legged bird dogs I believe theyre called are good and hard, balance ball/bosu ball stuff, riding an indoboard to warmup and balance train a bit... All good things. Push yourself so you're 10x better than before you injured yourself is how I figure any injury... if I only regain to where I was then I am more prone to injury than I was before I injured myself, if I get in better shape and stronger, then I might be at the same level of prone-ness to injury as initially... My $.02

In addition to continuing your physio exercises on your own and starting to build in a more rigorous weight program as you progress remember to stretch, stretch, and stretch some more!

I was riding (standing up behind the boat and doing surface tricks) after 6 months and actually attempting to wakeboard after 8. The mistake I made was not stretching enough. The knee is strong as ever but the hamstring sure likes to cramp up and stay tighter than I'd like it to!

Tore my ACL MCL and meniscus. As for your ACL, some of this may not be new to you so take from it what you can....

I did a hamstring graft as well. You should never do any forward sitting leg extensions again as it only puts stress on your ACL. Leg presses are awesome as you already know from PT. don't do any leg presses with both feet, only do single leg for the next six months and your 100%. When you do your single leg leg presses make sure your hip is in a strait like with your knee and ankle to foot. And with your single leg leg presses if your doing ex: 50lbs 12 times for four sets on your bad leg then mimic those same sets with your good leg even if it is way to easy (cuz remember its not the one that needs work so you just need to maintain it).

Laying face down reverse leg curls will strengthen the knee (single leg again) and rebuild your hamstring. And then for range of motion your not trying to see how hard you can push the stationary bike but find a decent resistance and hold that at moderate jog pace on the bike with the seat almost all the way down to help make more range of motion and increase vascular flow to your knee to speed recovery

You're going to a PT much more than I ever did. I went like once a week for the first month, then once every 2 weeks. I did resistance exercises daily though, moving up bands, along with stretching and working on full extension. After the first 2 months, I started doing monthly visits, and got less and less frequent. Now I'm doing leg work 1-2 times a week, but I'd like to be doing more.

One tip for when you move onto body weight squats in the future, that I've found great, is using stairs as a squatting exercise. So any time I have to go up stairs, I'll go up 2-3 at a time on my bad leg, Starting static and keeping my form right, focusing on keeping my knee out. On the way down, I do a 1 leg squat, with my other leg outstretched, and then fall onto the next step/2 steps. Its making me work my leg much more with just day to day effort.