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mindspin70 09-11-2012 11:46 AM

ACL Rehab Question
I completely tore my ACL about a month ago at an INT wakeboarding competition on Lake Acworth going for an indy grab I've done 100's of times. I guess I just landed wrong and BAM, ACL snapped.

I had surgery exactly 2 weeks ago (hamstring graft) and the doc said everything went great (no other damage). Just started PT today and I'm not feeling terribly confident in my therapist. I was asking the doc all kinds of questions about the type and frequency of stretches and exercises and his only response was "It's in the hands of your physical therapist now." He handed me a PT prescription sheet that said "ACL Protocol" and told me the physical therapist would know what to do. Problem is, I go to the PTist today and he asked me what the doc said to do :banghead:

I've been Googling the hell out of it and found all kinds of results for ACL protocol that say to take off the immobilizing brace and do some passive knee bends, straight leg raises, quad isos, etc.. as soon as a week after surgery. I've been kinda scared to take the brace off, but it seems like it's going to make my recovery take longer the longer I wait to start gently exercising/bending it.

I was wondering what other people's experience was with PT after an ACl reconstruction. What kind of exercises did they have you doing and how soon after surgery? I know there's no way to rush it, but I want to be as on schedule as possible.

augie_09 09-11-2012 12:05 PM

maybe find a new PT. Are you at a Sports specific PT or the old people PT?

I've never had a knee injury PT but have had shoulder and feet. Both had me doing things that I didn't find online. they also could measure my range of motion and strength and show me my progress week after week. plus a journal of exercises and equipment to take home with me.

jrw160 09-11-2012 12:49 PM

I had hamstring autograft acl reconstruction almost 4 years ago. I was in physical therapy the day after surgery, and they had me bending it and doing exercises twice a day. I don't remember wearing the immobilizer very long. I think I switched to my cti brace a couple of days after surgery.

kristian 09-11-2012 12:57 PM

Same as above. Had a brilliant surgeon and a great PT. Started physio the day after surgery. The first few weeks is really slow going and can be frustrating.

If you're not happy with your PT find another one. One that specialises in sports and muscal skeletal.

Therapy10 09-11-2012 1:00 PM

I'm a PT and sometimes different surgeons have different protocols i.e. no weightbearing for 4 weeks vs weight bearing immediately so that may have been what he/she was asking. Unfortunately there is a wide variety in quality with therapists, for me I would recommend a sports specific clinic or someone with the OCS (orthopedic clinical specialty) certification but I'm biased.

The following is not intended to be medical advice and only my experiences!!

Here is the spiel I tell everyone after ACL surgery: there are three cornerstones to a good rehab process 1) quadriceps strength 2)ROM 3) swelling control with the quad strength being consistently the variable identified with being able to return to sport function at a high level. Initial exercises should include knee range of motion exercises (heel slides with a strap for example), quadriceps set (contract the muscle of the anterior thigh as much as possible-you can't strengthen the muscle if you can't control it and control is reduced postoperative in most cases), weight shifts (getting the body used to bearing weight on the leg--only if cleared for full weight bearing), and you should been set up with electric stimulation for quad contraction (think ivan drago in Rocky V) which helps speed up strengthening. Control swelling with ice and elevation. Do the exercises multiply times a day and put your best effort into rehab process and you'll be back fairly quickly--look at Adrian Peterson!

Hope this helps

kristian 09-11-2012 1:13 PM

Sorry, can't seem to get the PM working so I'll just post it here:

Had the wife (who's a physio therapist with the Aussie winter team among other teams) do a quick bit of research. She did find a guy in Macon who should be able to take care of you.

Rehabilitation and performance centre in Macon
Therapist named Sammy Bonfim

Therapy10 09-11-2012 1:24 PM

For the area listed in your profile I'd go see this guy if it were me and I didn't know anyone personally Chris Alford, PT, DPT, SCS, ATC, CSCS

mindspin70 09-11-2012 1:49 PM

Awesome info, thanks a lot! I talked to everyone I knew that had any sort of orthopedic issue and they all said my surgeon was one of the best around, so I feel good about the quality of work I have done internally. I'll check out Alford and Bonfim for sure. Alford is 5 minutes away and Bonfim is only about 30.

The guy I'm seeing right now is the Head Athletic Trainer for our local University (where I work). I don't think I'm getting any sort of special deal, he just happened to be in the doctor's office when I asked the doc who I should go to for PT. We have been doing measurements and he hooked me up to the "Ivan Drago" machine today, so maybe I'm just worrying for the sake of worrying

I'm kind concerned that some of ya'll were doing exercises right after surgery and I'm still immobilized. Guess I need to get on the phone and schedule some consults!

deminimis 09-15-2012 8:42 AM

Stationary bike was key to my recovery. Was using an old Schwinn. Started with the seat in the highest position. Was on it constantly. Would lower the seat and lower the seat and lower the seat until it bottomed out each time to increase the knee's ROM. Just park the bike in front of the TV and get obsessive about it. Good luck.

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