T Nation

ACL Reconstruction and Powerlifting

Injuries and Rehab
#1

During spring break I was involved in a car accident and tore my ACL in the process… I’m scheduled for reconstructive surgery on May 17th. I talked to my doc about it and she walked me through the phases so I pretty much have a grasp on the process.

However I’m looking for more specific info mainly related to powerlifting. I know pull-ups and dips are the obvious stuff I can do but other stuff like bench press totally eluded me until I wrote this post. Without an ACL, I can no longer bench powerlifting style :frowning: i can’t do heavy squats nor deadlifts and I guess I can’t do barbell rows, standing shoulder presses, or standing good-mornings either.

I’m just looking for individuals to share their experiences and details on their road to recovery. inputs from people who suffered a similar fate are greatly appreciated.

#2

what are you talking about? Scott Cartwright tore his ACL not too long ago. I don’t think he got surgery but I could be wrong. Anyways, he has definitely been squatting benching and deadlifting.

#3

You will be able to do them when you get better and your range of motion, strength and balance return. Ask your surgeon and PT when you will be able to return to them.

We used to get ACL reconstructtion patients to squat and deadlift light at about 3 months post surgery, depending upon how they were progressing and surgeon approval.

#4

I had acl reconstruction surgery last year. It’s a slow road back and if you don’t take your time you can easily re-injure yourself so be patient. As for squatting and deadlifting without an acl if you feel stable enough go for it, just start off light and pay very close attention to your form.

Also, I have to add the doing any sort of weight training for my legs has turned out to be the best thing fr my knee. The added muscle gives the joint added stability which is sorely needed after an acl tear.

#5

Check out Jeremy Frey’s lot over at elitefts.com he recently tore his ACL and got it repaired.

#6

Cartwright was “only” a partial tear. If you have a full tear, then surgery is your only option. I agree with checking out Frey’s log. The guy is super smart about training, so he’d be a great person to follow.

#7

Agree with checking out or contacting Jeremys log. Also, we had a guy at our gym who had a complete tear of his ACL in High School. It has been 6 years, but he is 100% fine with training now.

Jason

#8

thanks for the response guys… this whole thing has been a huge headache for me. hopefully i will be able to be 100% too after the surgery (and a long period of rehab)…

#9

I tore my ACL and had surgery about 15 months ago. I definitely agree that weight lifting is probably the best thing you can do for it, but make sure you have completely healed. I will be honest and tell you that I haven’t done back squats since I got hurt, but I am going to try those soon. Leg press, lunges, front squats, etc. have all been just fine. Listen to the doctors and actually do the physical therapy and it will help you recover much faster.

#10

I also had my ACL reconstructed about 7 months ago. You absolutely can still bench, Kara Bohigian set a WR while rehabbing hers. This is me 4 days after mine, http://www.youtube.com/watch?v=3CCk4hf2fv0 . You can do everything upper body fine, just sit down. I did lots of 1-legged leg press, leg extensions and curls till I was cleared to start squatting again. I think it was around 4 weeks.

Just take your time and take it easy.

#11

[quote]awwww_fuq wrote:
During spring break I was involved in a car accident and tore my ACL in the process… I’m scheduled for reconstructive surgery on May 17th. I talked to my doc about it and she walked me through the phases so I pretty much have a grasp on the process.

However I’m looking for more specific info mainly related to powerlifting. I know pull-ups and dips are the obvious stuff I can do but other stuff like bench press totally eluded me until I wrote this post. Without an ACL, I can no longer bench powerlifting style :frowning: i can’t do heavy squats nor deadlifts and I guess I can’t do barbell rows, standing shoulder presses, or standing good-mornings either.

I’m just looking for individuals to share their experiences and details on their road to recovery. inputs from people who suffered a similar fate are greatly appreciated. [/quote]

Is it solely an ACL tear? Any other ligament involvement? Any meniscal damage? Are you getting a patellar graft, hamstring graft, or cadaver graft done? Depending on which graft is performed (and assuming it is only an ACL tear) will determine your return to participation (RTP) timing.

Hamstring graft generally means no hamstring strengthening for 3 month post-op. Patellar graft will limit quad activities for a little bit and usually leads to patellar tendonitis issues down the road. Both hamstring and patellar grafts are generally 6 months post-op until the physician will clear you for full RTP, but this number can sway depending on your recovery rate and how you are progressing through rehab. Cadaver grafts are usually 1 year until RTP and there is always the chance of the body rejecting the graft.

Best advice I have for you is to follow your therapist’s/physician’s advice and to make sure to regain full ROM, especially into knee extension. If you don’t gain full knee extension back, there is a chance of a “Cyclops Lesion/Cyst” forming, which is basically a ball of scar tissue that forms in the back of the knee and will permanently limit knee extension. Also, at about 1-2 months post-op, you will begin to feel like a million bucks and think you are ready to go out and play in athletic competition and test your knee out. DO NOT TEST IT OUT. The strength of the graft in your knee will fluctuate and at that point in time, even though you feel great, the graft is most vulnerable to re-tearing. It is a slow recovery so don’t rush through it, but don’t feel like you cannot do anything at all. You have 3 perfectly healthy limbs to train with, so enjoy a lot of upper extremity work and single leg lower extremity work.

Best of luck.

-LH

#12

[quote]LevelHeaded wrote:

Is it solely an ACL tear? Any other ligament involvement? Any meniscal damage? Are you getting a patellar graft, hamstring graft, or cadaver graft done? Depending on which graft is performed (and assuming it is only an ACL tear) will determine your return to participation (RTP) timing.

Hamstring graft generally means no hamstring strengthening for 3 month post-op. Patellar graft will limit quad activities for a little bit and usually leads to patellar tendonitis issues down the road.

Both hamstring and patellar grafts are generally 6 months post-op until the physician will clear you for full RTP, but this number can sway depending on your recovery rate and how you are progressing through rehab. Cadaver grafts are usually 1 year until RTP and there is always the chance of the body rejecting the graft.

Best advice I have for you is to follow your therapist’s/physician’s advice and to make sure to regain full ROM, especially into knee extension. If you don’t gain full knee extension back, there is a chance of a “Cyclops Lesion/Cyst” forming, which is basically a ball of scar tissue that forms in the back of the knee and will permanently limit knee extension.

Also, at about 1-2 months post-op, you will begin to feel like a million bucks and think you are ready to go out and play in athletic competition and test your knee out. DO NOT TEST IT OUT. The strength of the graft in your knee will fluctuate and at that point in time, even though you feel great, the graft is most vulnerable to re-tearing.

It is a slow recovery so don’t rush through it, but don’t feel like you cannot do anything at all. You have 3 perfectly healthy limbs to train with, so enjoy a lot of upper extremity work and single leg lower extremity work.

Best of luck.

-LH[/quote]

sorry for the long delay, finals week…

yes, its a sole ACL tear in my left leg, no other damages. I’m currently set on get a graft from a cadaver because the idea of losing/exchanging something else from my body is not too appealing. however, in reality i’m not grounded in my choice either… they all have negative aspects. thanks for the response. i’m gonna try really hard to muster out the patience to let my leg fully heal.

[quote] Matt wrote:
I also had my ACL reconstructed about 7 months ago. You absolutely can still bench, Kara Bohigian set a WR while rehabbing hers. This is me 4 days after mine, http://www.youtube.com/watch?v=3CCk4hf2fv0 . You can do everything upper body fine, just sit down. I did lots of 1-legged leg press, leg extensions and curls till I was cleared to start squatting again. I think it was around 4 weeks.

Just take your time and take it easy.[/quote]

is it difficult to pull your torn leg back further? i usually pull mine way back near where my shoulder region is. it seems like you’re arching fine though. i was attempting to bench with a cast on the other day and i kept slipping (haven’t gotten surgery yet, just experimenting). are you just getting a bench workout in or are you going somewhat heavy? have you tried maxing out on the bench, or attempted dumbbell bench since the surgery? thanks.

#13

One piece of advice - you can absolutely come back stronger than before, IF you rehab properly! It’s not a race to see how fast you can get back to your previous bests - it’s how well you can rehab so that you can lift as long as possible at a high level!

I see too many guys rush to get back, and all they’re doing is laying down dysfunctional patterns in the process.

Make sure you get your knees symmetrical first and foremost (flexion and extension). Along the way, you can get hip/ankle mobility normalized side-to-side as well.

Once there, motor control is imperative. I find a lot of people don’t focus on the smaller stabilizing muscles of the hips, and this (combined with strength imbalances between legs) results in a shift when squatting.

Basically, do everything your PT tells you and get yourself as symmetrical as possible. Once there, build back up slowly - use the time to refine and dial in technique, and you’ll come back stronger than ever.

Good luck!
MR

#14

[quote]awwww_fuq wrote:
is it difficult to pull your torn leg back further? i usually pull mine way back near where my shoulder region is. it seems like you’re arching fine though. i was attempting to bench with a cast on the other day and i kept slipping (haven’t gotten surgery yet, just experimenting). are you just getting a bench workout in or are you going somewhat heavy? have you tried maxing out on the bench, or attempted dumbbell bench since the surgery? thanks.
[/quote]

I couldn’t pull my leg back in that video because it was 4 days post-op, and it hurt like a motherfucker. I can set up just fine now. I was just getting a workout in, taking it easy. I didn’t try going heavy or anything close to max till I was getting close to being cleared by my surgeon. That surgery sucked, I didn’t want to have to do it again.

Listen to Mike Robertson too, he helped me out a ton. Pick up his bulletproof knees, lots of good shit in there to fix you up. Make sure you concentrate on getting your extension back, my PT’s didn’t really push on that one with me and I had to go through a lot of bullshit later when it was a fuckload harder than if we would have stressed that early on. FULL and SYMMETRIC extension, not just straight.

Good luck and remember to think in the long run. Sure taking a few weeks or months to get your knee better sucks, but in a lifetime what is a couple months or weeks? Well worth it to do it right. This is one of my big problems lol.

#15

OP, i decided a while back to start a blog-like thread on a forum i frequent.

http://www.honda-tech.com/showthread.php?t=2770106

it’s overly detailed, but after surgery (and sometimes before) you tend to have some down time so i’m hoping someone somewhere will take the time to read it and i can actually help them in some way.

i am getting cut tomorrow, 5/12, and found your thread while researching what people are doing in terms of lifting while their leg is basically immobilized.

anyway, i’ll be updating my blog thread thing with that info once i get back into the gym, hopefully on Monday. i go to a very progressive gym with alot of current or former high level athletes who have experience with working out under such conditions so i hope to post what i do and maybe help you along the way.

best of luck y0!

#16

builthatch, i’m reading your blog right now. i bookmarked it for future reference too, so i can have something to read when i’m bed-ridden haha.

matt, sorry to bombard you with more questions. hope you can answer just one last one. i was checking out your youtube and you were looking strong in your squats. were there major strength losses after your rehab was complete? was it easy to build back up to the level you were before? any lack of ROM? my cousin had an ACL reconstruction five years back; he complained about how he can’t rock bottom squat because when he attempts to go below parallel, one knee is noticeably higher than the other. when he attempts to asian squat, he can’t level both of his knees… the reconstructed knee is about 1-2 inches above the other.

mike, i’m gonna take it as slow as necessary. don’t ever wanna go through this ordeal again. i’m also pick up your book… seems like a lot of people hold it in high regard. now i’ll have something to look forward to while i’m handicapped haha.

#17

Very cool man - thanks and best of luck with your progress!

MR

#18

[quote]awwww_fuq wrote:
matt, sorry to bombard you with more questions. hope you can answer just one last one. i was checking out your youtube and you were looking strong in your squats. were there major strength losses after your rehab was complete? was it easy to build back up to the level you were before? any lack of ROM?

my cousin had an ACL reconstruction five years back; he complained about how he can’t rock bottom squat because when he attempts to go below parallel, one knee is noticeably higher than the other. when he attempts to asian squat, he can’t level both of his knees… the reconstructed knee is about 1-2 inches above the other.
[/quote]

I’m not all the way back to where I was yet. I told myself I’d stay raw till I got back to 405 and then start putting gear back on. Didn’t take long at all, but I’ve been working hard as hell during my rehab too so it came back pretty quick.

No issues with ROM anymore. I had some trouble where it was not hyperextending to the same degree as the other knee so I was going to the chiro at least once or twice per week and doing tons of Graston and ART and working the extension till it was symmetric. Flexion will come pretty easy, but it will hurt like a motherfucker. You gotta gut through it and push and it will get back to normal. The only thing that still sucks is trying to kneel on that knee, and I’m working on that too.

Hope that helps

#19

Also, if you have any interest I have my entire rehab documented and I can send it to you. I know I was pretty freaked out and seeing how someone else went through it would have really helped.

Let me know if you want that.

#20

been there, done that…a couple of times. First time I tore my ACL I wasn’t into lifting yet, but I rehabbed by myself and probably did too much too soon. I was 19 and couldn’t differentiate the good pain from the bad.

Over the years the graft stretched and my acl was basically worthless. I was still able to squat 545 in single ply poly walked out and 600 in the monolift (walk out was hardest part due to lack of knee stability). Then I got it fixed again and it was GREAT. That was March 2006. By Nov 07 I was back to squatting 365 x 2-3 with just a belt and pulling 500 with just a belt…then I tore my acl and shattered my tibia wrestling.

They had to put in a metal rod and a bunch of screws, that got infected. I was on crutches for 5 months and had 4 surgeries on the leg in 13 months. Before they took the hardware out in Dec of 08, I was back to squatting 225 for a set of 5 (very carefully). Doc damn near shit when I told him. Squat and DL are no longer a priority for me as I am chasing a 405 raw bench. Eventually I want to get back to a 500lb pull and would like to squat 315x10. This is with no ACL and a stretched MCL.

Advice for rehab: Start flexing your quad as soon as you are conscious. Do the stupid stuff the PT tells you to do, and then start working on range of motion ASAP. Avoid leg extentions at all cost. Exercise bike is good to start and then start working on squats, good morings, deadlifts, and leg curls. You will be shocked at the atrophy…but if you work hard you can get it back. really work on getting your legs balanced again strength wise, or you will have more problems down the road (at least I did).

What kind of graft are you getting? I had the patellar tendon done the first time and hated it. 2nd time was hamstring and that was great!