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Last Season's ACL Injuries

post #1 of 16
Thread Starter 
It's Octobrrrrrr and I hope all of the ACL injuries from last season will be rehabilitated and ready for 2005/2006.

As for me today is 5 months post-op. I hope to be ready by January but at this point it's just a hope.

My injured quad is coming back very slowly. Might have to do with age.

Any advice on building quad muscle is appreciated. I'm working hard 6-7 days a week (3 days weights; 3-4 days bike and eliptical trainer). I had been told not to do leg extensions until 4 months post-op. I can't believe how weak I am with that movement now! At best I can do a 5lb single leg extension (ankle weights). I'm not even "single leg" ready for the machine yet because they all seem to start at 10lbs; truly humbling. Just to put it in perspective I can do single-injured less presses at 100lbs and other exercises with reasonable weight (considering) but extensions.... I'm a wimp.

Oh well as the season starts to turn towards winter I'm that much more motivated. Off to the gym for me.

Any other ACL'ers out there ready for the season?
post #2 of 16
What type of replacement did you have?

Personally I skipped the leg extensions because it causes shearing force on your knee. The ACL does not fully vacularize (sp?) for about 12 months so you are always at risk of popping the graft out.

A few years back I blew my ACL out in Feb, got operated on in late May, and was skiing in Novemeber.

Visibly you are not going to gain back the muscle mass for awhile. Your leg may still look smaller even when it gains full strength for a year or so.

I did a rehab consisting of biking, squats, weighted walking lunges, weighted dead lifts, and a ton of balance drills and leg and core exercises using a yoga ball, BOSU, whobble boards, bongo boards, and other stuff.

Do not forget to workout your hamstrings just as much as your quad.

I also didn't and still don't wear a brace while skiing or working out.
post #3 of 16
My surgery was March 16th, and I have been rehabing with a vengence. I spend between 30- 90 minutes daily on cardio equipment, mostly on the elliptical. I try to get it up to level 20 as soon as possible, so that I am using more hamstring. I've discovered that if I work the elliptical from a "squat" position at various intervals, I can activate the hamstrings even more.

From the elliptical I head to the recumbent bike, and pull the seat up as close as possible. This gives the hamstrings even more work. Then I spend some time on the upright bike.

After that, it's time for weight training. I am fortunate enough to own a sport training studio in Frisco, so I do most of my strength work there, on either the ball, bosu, dyna disc, or wobble board. Given the totally lame weight training equipment at the Rec Center, I can see why most people in Summit County keep re-injurying their knees. They have a leg press, and an abductor/adductor machine, a leg extension and a seated leg curl.

The leg extension should be outlawed in ski country because of the shearing forces it puts on the knees, yet I see the clueless trainers programming their post rehab ACL clients all the time.: The seated leg curl is so poorly designed that nobody feels it in their hamstrings. I usually take the stability ball and head over to the cable machine so I can do prone leg curls. Of course, nothing is as great as the stability ball hamstring curl, but that I do at my studio.

Since I also damaged my MCL, I am doing a lot of adductor work. Some of it is on the adductor machine, but I also use the cables.

In most positions, I am at full range of motion, however, I still cannot sit back on my heels.

Although I am feeling strong, my attitude remains very tentative.
post #4 of 16
Thread Starter 
Scalce - I had an allograft - achilles tendon.

I've read lots of comments about the shearing force placed on the ACL by the leg extension movement. Even though my PT and OS both feel it's ok to use this exercise I'm not going to emphasize it in my program. For now I think I'll just continue to do it at a very lite weight.

My current program is leg weights M-W-F consisting of: 15 minutes on the spinning bike, leg press, olympic bar squats, hamstring curls (seated and lying down), calf raises (seated and standing), abductor/adductor, leg extension, 10 minutes standing back and forth speed skating movement, end with 15-30 minutes on the spinning bike; S-Su-T-Th I do upper body, balance boards and ride the spinner. I live in a hilly area of So. Cal. and I plan to start adding miles on a road bike to my routine. It will at least get me outside and give me that "wind in you face" feeling again. I also think riding the hills will help the quad. I find it interesting that my hammies are getting strong faster than my quads. I've heard this is typical for an ACL rehab.

Lisa - I hear you about feeling tentative.

Thanks for the input.
post #5 of 16
Bobski, I was just wondering the same thing, as I've been dreaming ski dreams as of late, and then I wake up and think Sheesh, I don't know if I'm ready for the season yet.

My ACL surgery was done in April, hamstring graft, with repair to lateral meniscus as well. Rehab nowadays consists of 5-6 days of 45-60 minutes of varying intensity cardio work, either on the Spinning bike, or elliptical trainer. For strength, I am in the gym 3 days/week, programs consists of prone or seated leg curls, single and two-legged sets; leg press, single and two-legged sets there as well; ab-ad-ductor work, either on the hip-fly machine, cables, or seated machines; deadlifts; "monster-walk" (this is what the physical therapists called it) with tubing; the Butt Blaster, and single leg squats (when they don't hurt, which is a good day indeed!). Lots of stretching. ROM is good, but like Lisa, sitting back on my heels, or squatting down to pick something up is uncomfortable. I can run without pain about 2 minutes on the treadmill. Plyo work is virtually impossible. Balance is great, use BOSU and half a foam roll.

I have stayed away from leg extensions. My PT cautioned against it until the tendonitis goes away because of the shearing forces on the knee, as you guys previously mentioned.

I am concerned that my strength has not returned, or is taking its sweet time, to say the least. The quad is still small and sad looking, and worst of all, doing squats and lunges still make the knee hurt, due to patellar tendonitis. The hardest part is taking the professional's advice, which was "don't do the excercise if it hurts your knee", and "the reason your knee still hurts is because your quad isn't strong yet." Lose-lose situation, sounds like to me, so I bear the pain if its not too bad. Then I go home and worry that I've overdone it again.:

The season is approaching, and I'm thinking that I'll be taking it easy a bit more than I'd like to, but at least I'll be on snow. Sitting home would be unbearable.

Cheers to all of you, and keep on keepin' on!
post #6 of 16
Good to hear from you again, Sheskis. Although the season has already begun in Summit County, I am holding back. The fact that two, top level skiers, examiner level instructors have already suffered injuries on the slopes makes it an easy decision.

I've discovered a quad exercise which is safer and more effective than the leg extension. If your gym has a pull-up/chin-up machine, you can put one foot on the pad, and extend the leg. It's a closed chain exercise, which means there will be less shearing force on the leg. Since you are standing up, it's more functional than the leg press. If you have a dyna-disc, you can put it under your foot to enhance balance.

Unfortunately, the hamstring equipment at the rec center is totally lame-all they have is a seated leg curl. I've been using the cable machine, plus lots of variations on the stability ball leg curl. At my studio, I've been using the pro-fitter with a small medicine ball between the inner thighs. This adds adductor strength, to prevent re-damaging the MCL.

Good luck everyone!
post #7 of 16
Hey Lisa,

Can you clarify this excercise? Are you talking about the assisted pull-up/dip machine? You are saying stand on the top step and place one foot on the platform where you usually put your knees (or on some machines, the bar that you stand on) and press down with your leg?

Today is Leg Day. Perhaps I'll try this out!
post #8 of 16
Yes! At first, hold on to the sides for balance!
post #9 of 16
I, too, had my acl done in april , hamstring graft,and am experiencing the same things as sheskis, right down to the dreams. Oct 15 my doctor cleared me to return to all activites, but then I got sick and missed six days of rehab. upon returning to the gym I was noticebly weaker, ppain on squats, step ups, running. a return trip to Dr. confirmed this. I was actually weaker on nov.11 than on oct 15, and I was getting that compression of the knee cap causing pain. on Monday I start more agressive "sport specific" PT. I feel your frustration sheskis, it seems to be a vicious circle.
post #10 of 16
After reading some of the posts I'm feeling quite lucky. In March I had an ACL replacement on my right knee and meniscus tear and repair on the left. I just finished my second day on skis with no ill effects. In fact after all the rehab, this has been the strongest I've been on opening day in a long time. My thoughts on getting back on skis came from Satchel Paige when he said it's mind over matter: If I don't mind it doesn't matter. When you get that wind back in your face and that white carpet is laid out in front of you it comes back quickly why you enjoy this sport.

post #11 of 16
Thread Starter 
Arrgghh... 3 feet of snow this week at my regular spot and my operated leg has a quad that is still 2 inches smaller than my good leg.

Oh well, it looks like I'll be living vicariously through my kids for a bit.

I bought a road bike and am getting some wind in my face on it. But even with lots of work the quad is gaining strength at a snail's pace.

So I'm praying for a deep snowpack, long spring season and strong quad by March.

I'd love to hear from you folks as you get back out there this season.
post #12 of 16
Bobski, take a deep breath! I hear ya, though. On my first day back on skis, I was lucky. There was only a teensy 18" base, and 1 run open (the Canyons). Even more lucky, my son decided to take up snowboarding (again), this time, no lesson, just to see if he "could remember how to do it, Mom". Half day, went nice and easy, be a cheerleader for my kid, worked on tipping those suckers on edge on a beautiful sunny day.


The suffering was worth it.

Oh, and the ice and Advil aftewards, that was there, too. Oh well, what did someone say about living with it? I think I'm gonna make it.
post #13 of 16
5-6 months not long enough for acl reconstruction to return to skiing in my opinion. The graft isn't strong enough yet. Skip leg extensions!! It's a dinosour with no athletic carry over value. Waste of time. Perform many one leg squats and backward lunges and read Lisamarie, she knows her stuff!
post #14 of 16
My doc let me start skiing last March at 5.5 months post op from an allograft ACL reconstruction. My knee is feeling pretty good. I managed to injure my MCL on that knee this summer in a mountain biking accident, but it's feeling okay now. I stuck to groomers for a couple weeks and then went to some untracked powder. This winter I'm still taking it a little easy - mostly just being careful to listen to my body and quit when my legs feel tired.

I'm skiing fairly well, but that last bit of confidence to really go for it when the snow is cruddy just isn't there yet. And my leg doesn't feel as strong as it used to.

The other thing I have difficulty with is deciding how to work strengthening and exercise into skiing. I'm up skiing 5 days a week for anywhere from 1.5-6 hours, and I find it hard to figure out where to fit gym time into the schedule. I'm always worried that I'll be tired for skiing. Logically, I feel like I should hit the gym after skiing to be safe... but it tends to just not happen. I have an xerdisc that I use at home to do some balance work, and I did a little hamstring work a few days ago, but that's about it.

Any ideas?
post #15 of 16
The problem is that you feel great 5 months out after acl repair, but the graft isn't done friming up and getting stronger. Infact some experts say it is at it's weakest point 6 months post op.
post #16 of 16
Part of the problem is knowing the information that ski=free has given out. In the back of your mind, you are well aware that the graft is not completely healed, so you tend to be more tentative. But if tentative keeps you from being stupid, it's a good thing. Read my "Live From Davos" report is the Resorts forum. I rented skis that I was having trouble with, and my knee started to feel as if it was being tweaked. As a result, I called it a day and went back to change skis. Granted, that's easy to do if you already live in ski country, but nonetheless, it may have saved me from becoming one of those people who have consecutive ACL surgeries!
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