Posts Tagged ‘ACL rehab’

I’m moving for the second time since I had my surgery. Not just moving apartments, but moving cities. I moved from Chicago to San Francisco at 3 months post-op and now am moving back to Chicago this weekend, 10 months post-op.

Two pieces of advice for those who move post op:

1. Seek a reputable therapist and gym membership immediately!! I waited until I “settled in” until I found a therapist out here and it was too long. Do it ASAP because good PTs are hard to find and harder to schedule.

2. Be careful with all the lifting, carrying and stair climbing. Be sure to stretch pre/post move. (Or bribe friends to help you out!) I might sound like a broken record here, but if you are lifting, be sure you are doing it properly.

Here’s some advice from About.com:

  1. Plan ahead before lifting.
    Knowing what you’re doing and where you’re going will prevent you from making awkward movements while holding something heavy. Clear a path, and if lifting something with another person, make sure both of you agree on the plan.
  2. Lift close to your body.
    You will be a stronger, and more stable lifter if the object is held close to your body rather than at the end of your reach. Make sure you have a firm hold on the object you are lifting, and keep it balanced close to your body.
  3. Feet shoulder width apart.
    A solid base of support is important while lifting. Holding your feet too close together will be unstable, too far apart will hinder movement. Keep the feet about shoulder width apart and take short steps.
  4. Bend your knees and keep your back straight.
    Practice the lifting motion before you lift the object, and think about your motion before you lift. Focus on keeping you spine straight–raise and lower to the ground by bending your knees.
  5. Tighten your stomach muscles.
    Tightening your abdominal muscles will hold your back in a good lifting position and will help prevent excessive force on the spine.
  6. Lift with your legs.
    Your legs are many times stronger than your back muscles–let your strength work in your favor. Again, lower to the ground by bending your knees, not your back. Keeping your eyes focused upwards helps to keep your back straight.

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The title quote belongs to my therapist. In PT we’ve been focusing intensely on strengthening the gluts–never gets old.
It’s all about getting the butt in shape so it will pull your body into better alignment and prevent further injury.
The butt is easier than you think to whip into shape, at least for the knee-supportive-strengthening purposes. Start with stairs and sitting/standing–two activities will do multiple times throughout the day. Since so much of rehab is a head game, and retraining your thinking about how your muscles work, get yourself to think that using your butt muscles is the ONLY way to pull yourself up from a seat and up a flight of stairs. So squeeze, pull and repeat. Try to consciously think about it for one whole day. If your butt isn’t sore by the end of the day, then try harder ūüôā

It sounds simple, but you want to focus on retraining your “head,” which will trickle into every exercise, movement and sport you do.

A long, but informational video on Glute Strengthening and Theory from Posture Exercises blog.

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I’m almost nine months post-op to the day. Over the months–the pre-op, op and post-op altogether–I’ve gained valuable fro insight from my blog readers, fellow ACL survivors, my surgeon, physical therapists, co-workers and perfect strangers who noticed my brace, crutches or limp and were kind enough to share their words of advice.

So I’ve managed to save all the advice from all of these people over the last few months. And I encourage you to add anything that’s helped you along the way, as well.

10. “Do something every day.” -my physical therapist in San Fran

Whether it’s leg lifts, clams, stretches or intense cardio, it’s important to do something towards progressing your recovery every day. We all don’t have all the time in the world, but we have to do what we can to make recovery a priority. No matter how small the #of reps. It’s better than nothing.

9. “Invest in good running shoes.” -my cousin, the triathlete

If you have a good pair, you know they make a world of a difference. Have your PT evaluate your gait and help you determine if you need running shoes for stability or motion control.

8. “The hamstrings are most important for stability.” -my San Fran ortho dr.

Make them strong–really strong. They will help compensate for a less-than-optimal knee.

7. “Don’t let your knees go¬†over your toes!” -my Jillian, the trainer from “Biggest Loser” (she yells @ me when I do her “30-day Shred” workout video)

No matter what the lunge, stretch or squat may be, it’s important to keep yourself aligned to prevent injury and pain!

6. “Work your core.” my¬†Chicago PT

Same thing with the hamstrings, you gotta work your core to keep you stable and strong and prevent any other injuries.

5. “Clams are your best friends.” -My San Fran PT

They strengthen your glutes and work that IT band. Two major, major factors in determining your rehab success back to normal activity.

4. “It it’s too painful, stop.” -My surgeon’s nurse

3. “Some weeks are better than others.” -My surgeon

Sometimes you feel you can run a marathon and sometimes you hobble home from the gym, either way, you have to accept that this is how life will play out from now on. But, because of this experience, you are more cautious of your activities and more grateful for the opportunity to move your body every way you can.

2. “Performing less¬†exercises¬†with good form is better than doing a lot of reps in bad form.” My Chicago PT

Have your PT assess how you are performing the exercises. Practice makes perfect, but the practice has to be perfect form. It’s better to focus on the biomechanics of doing the exercises correctly than trying to do the most reps you can. Once the form is proper, then you can do all the reps you like.

1. “P-A-T-I-E-N-C-E.” My mom

No one said it’d be easy. Before you physically go into this process, you have to mentally prep yourself for the time it’s going to take and the time you will have to devote to getting yourself back to “normal.” Just remember we are all different. We are heal at different times. And we all return to sports at different times. The text book recovery for ACL reconstruction is 6-8 months. But you and your knee are unique like everyone else. Don’t let the textbook tell you when you feel like yourself, and take your time. It’s better to be fully prepared to compete, then rush into anything and risk further injury, or a re-injury.

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This whole time that I have been rehabbing, I’ve had my sights set on making my big sports comeback on the ski slopes. When I tore my ACL last Jan., I did it one week before a ski trip to Whistler. (Ouch!) I had to sit on the bench for the that one. I even booked my ski trip this year eight months post-op, hoping that would give me ample time to get fit. But sometimes, no matter how far in advance you plan and no matter how much prep work you do, your plans just fall through. Mine did.

I saw an orthropeadic surgeon a few weeks ago, and she told me I shouldn’t ski. What?! You mean to tell me that all my rehab and all my PT over the past months and all those times I unwillingly drug myself into the gym when I just wanted to collapse wasn’t good enough?!?!? Are you telling me that my knee is STILL in need attention and that I’m STILL not back to normal?! Ugh! FML!

Talk about disappointment in the midst of an already brutal, and sometimes seemingly elementary rehab process. Hearing that news sucked. But it wasn’t as bad as I thought, seeing as how I already heard that similar news about a year ago when I first tore my knee. If my knee isn’t getting stronger, at least my skin is getting tougher.

My first thought was, “What did I do wrong?” Then the guilt started creeping out. I should have gone to the gym more. I should have scheduled more PT sessions. I shoulda, coulda, woulda… This whole ordeal has taken enough of my time, stress and frustration. I had to give myself a break. After all, I have a life, and so do you. We can’t all make one singular ligament the sole focus of our crazy busy lives. We don’t all make a living playing professional sports, so sometimes the incentive to work the knee every day is non existent and just a hassle–at least it can be for me, your average former high-school athlete who wants to keep sports a part of her life for the rest of her life.

Before my doctor came to her conclusion about ruining my ski trip, she made me do the one-legged jump test. (You probably shouldn’t try this until you are ready to get back to sports.)

Stand with about 3-4 feet of clear space in front of you (hard surfaces work great)

Start with your non-surgery leg (I’m doing my best not to say “good/bad knee”)

Jump forward as far as you can. Stick the landing. Repeat with your surgically enhanced leg. It’s not that easy, huh? I didn’t do so hot. I didn’t jump very far and my landing was not stuck–I took an extra step like a nervous gymnast. The good thing was I had the confidence to attempt it–I did it without thinking twice. Just goes to show you how powerful confidence and attitude can be during rehab. That’s honestly what got me through this bit o’ bad news and allowed me to reset some goals and reevaluate my overall process and program. Now, instead of attempting the bunny hills next weekend like I would have, I plan on skiing in March at the level that I left off on; my therapist said she could even get me trained for jumping. We’ll see about that. I’m sure I’ll slowly immerse myself back onto the mountain, but this time I’ll certainly be stronger than expected. No use half-assing it. I’ve waited so long so, so hopefully I’ll be ready to conquer the mountain, as opposed to just bunny-hillin’ it.

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So I recently moved to a new city, San Francisco, where I don’t know a lot of people. That alone can be a little tough, but even worse when you are trying to find a new physical therapist and fellow ACL friends to share stories with each other. Lucky for me, my boyfriend’s cousin’s sister-in-law lives out here, and she recently tore her ACL. So we decided to meet over drinks to talk about our busted knees. I had my surgery (patellar tendon reconstruction/lateral meniscus repair)¬†on May 20. She had her surgery (cadaver graft)¬†at the end of June.

So here’s how two different sugeries and two different graphs are¬†doing at two different points in their recoveries:

Cadaver Graft,¬†6 weeks out…Kate, my friend, walked into the bar¬†like it was nothing.¬†No crutches, no brace. Not even a gimp. If you didn’t know she had surgery, you couldn’t tell anything. Prior to her surgery, Kate enjoyed an active lifestyle of hiking, biking and skiing. (She tore her ACL skiing in Tahoe.) Now, she isn’t quite running just yet, but she uses the excercise bike and is building her strenght back up. She¬†will be back on the slopes in no time for the season.¬†She took off work for three weeks.

Me…still not running, but moving around just fine. I don’t even think about me knee anymore. I can sit cross-legged again, do light yoga and kneel on my knees. The scar¬†hasn’t gone clear yet, but it is certainly starting to fade into oblivion. It will be gone in no time. I, too, plan to hit the slopes this season–that’s my current goal. Perhaps Kate and I will do an ACL ski trip, and this time she will conquer Tahoe, no fear at all. Details to come….

Any other ACL skiers out there? Perhaps we can all plan a ski trip together–a celebration of progress, if you will.¬†

Pic from tahoesbest.com

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For the past two months, all of my¬†PT sessions have started out on¬†the excercise bike. This has not only warmed up the muscles, but given me added confidence so when I’m outside of my PT’s watchful eye, I can actually complete these activities. The road to full-sports recovery may be long, but biking is just one of the many activities I first (and confidently) came back to. But as we all know, doing the same activity over and over again can get boring. So…just when I got bored with the bike, someone¬†(one of my relative’s in laws) came up with the Conference Bike. Talk about a Continuios Passive Motion Machine!

Yeskneecan ride the¬†Conference Bike with six other people! It’s the closest I came to¬†“participating” in group sports in a long time. All riders pedal and one person steers. We worked up some speed and managed to go up some light hills. If you ever see one, I highly recommend checking it out! Or, if you are in the San Fran/Bay Area and want to rent it out for an event–or some productive group therapy, just let me know! My relative, Terry, is one of a few lucky owners of this bike, and he’d love to spread the fun around.

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This past weekend I was in San Francisco. I’m actually moving there for work next weekend. When the work opportunity first presented itself, I was about one month post-op and still in a knee brace. I went to visit and couldn’t walk around because the hills in that city are just so impossible. Well, after this weekend, I am happy to report that at two months post-op, I had no problem traversing up and down the hilliest hills of San Fran–Pacific Heights, Nob Hill, Telegraph Hill, Alamo Square, Chinatown and all little neighborhoods in between. For the record, the knee didn’t hurt the next day, even after a hilly 4 mile climb.

Yes Knee Can! Picture from http://members.cox.net/travelreflections2/sf/SFHillsViews.htm


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