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Going for ACL Reconstruction. Tips?

also most people will be doing co-contractions of the knee, among other things, pretty early on in the piece - (usually) between 2-4 months is where you really start to smash the hammys to get some mass \strength back, but if you haven’t done any by that stage you’re rowing down shit creek without a padddlleeeee.

I agree with you krsoneeee and wasn’t trying to say hamstring grafts are a waist at all. I’m kind of 50/50 in terms of which one I would suggest to people. A lot depends on how their tear occurred.

If it was a non-contact ACL tear, most of the time I’d prefer patellar due to the fact that with non-contact ACLs it is usually due to a hamstring weakness or other muscular imbalance associated with the posterior chain. The reason I suggest the patellar graft is that case is that you can immediately start training the hamstrings post-op if you wish and can fix the problem that caused the ACL tear.

But again, it comes down to what sport the athlete plays, which position, their compliance with rehab, etc. I have worked with a lot of doctors and there is a mix to which surgery they prefer to do. Each of them has said that their reason for doing the surgery they prefer is due to what they would taught during med school.

yeah its hard ay - could have the most balanced athlete in the world and theyll still do their acl - the human knee was designed very poorly! haha

What are your thoughts on calf training post op? I think its pretty important but a lot of people dont seem to put a lot of effort into it.

Calf training is one of the first things I implement for a number of reasons. One, people are restricted with knee ROM due to pain, swelling, and the post-op state of the knee, so calf raises are a great way to begin activating some of the surrounding musculature.

Also, it helps with removal of swelling by activating the venous blood system. I usually start with higher repetitions to develop a proper endurance base and then progress from there.

Rehanb_bl,

Just curious as to what you decided and if you’ve set a surgery date. There is a lot of good information in this post and I hope it’s helped. Good luck on your recovery.

i am still waiting to see the surgeon which should be this week to discuss the options, athough the video that I posted is looking very attractive , the place where i am going does double bundle which is a good thing for my athletic career.

hey OP, i am one month post op ACL reconstruction w/allograft and mensicus trimming. the only problem that I had was the iso quad contraction exercise that they make you do in the beginning. every time i flex my quads i automatically flex my hams in conjunction, causing a really sharp pain on the side of my leg.

i felt like my tendons were about to snap. the doctor said its because of the way i trained my body, meaning how weightlifting had programmed me to use as much muscles as possible when i contract. they didn’t addressed this hindrance until 3-4 weeks into the program but when they did (with electrotherapy) it helped tremendously.

i don’t know whats your athletic background is like but if you encounter a similar problem, ask for electrotherapy on the get-go to save time and pain.

other than that, the first three days are worst. after the initial week, things will start looking up. you’ll lose the crutches in 1-2 weeks and by week 3, you should be able to walk, albeit in an extremely limpy state.

don’t give up hope though! by week 4 i was able to deadlift 70% of my pre-surgery max, even though i did’t get the okay from the doctor yet… i told him about it and then i got the okay to do closed-chain exercises.

OP - once you’ve locked in your surgeon and surgery date, make sure to pay attention to the insurance issues. Depending upon your plan, you may be obliged to contact your carrier and provide them with the procedure codes prior to surgery in order to receive coverage. Usually the surgeon’s office will contact the carrier directly but it’s better to be safe than sorry when it comes to paying for surgery. Standard practice for carriers is to receive notification from the surgeon and to provide coverage for crutches and an ice machine for anywhere for 1-3 weeks. If your doctor prescribes a CPM, that should be covered as well.

Awwwwwwwwwwwwwwwwww- I had the same surgery and same tendon pain. I’m one week behind you (surgery June 15) and started the electro-stim a little before you did and it totally makes a difference. How the hell are you deadlifting so much, so soon? God bless, but just sayin’.

Not sure if this helps, but - again - I’ve been walking/lifting with a torn ACL (and torn medial meniscus) since mid-April. I still lift 4 times per week with 2 upper days and 2 lower days. Here is what I’ve been able to do with no pain:

Deadlifts (4x8)
Dumbell split squat, 1 foot elevated (4x8)
1-leg leg press (3x6-8)
1-leg leg curl (3x6-8)
Smith machine calf raise (3x20)
Seated calf raise (3x20)

I tried back squatting one day and regretted it the next day. I had tremendous pain around where the meniscus tear is and had a sharp pain every time I went to stand up from a seated position. It took ~2 days to go away.

Today, however, I tried box squats for the heck of it and they seemed to go alright. I did them in place of the DB split squat and had no trouble banging out 4x8. I had never done box squats before though, despite lifting legs very intensely for the past 4 years. My 1RM pre-injury for a box squat was 295, and I used 185 for my sets on the box squats. I’m not sure how box squats translate to 1RM, but the 185 I used was challenging, but not impossible. I’ll let you know if they irritated my knee tomorrow.

I’ve found that I’ve been able to do squats and deadlifts fairly heavy (dl 405 for 5-8, squats of 315 for 6) without and pain, i’ve even been able to do some a skips and such without any problems.

The issue is lateral movement If i concentrate hard on keeping the knee in the right position i’m good but anything unexpected it shuts down. Right now I’m just trying to add some mass to my legs before the surgery

I tore my ACL and slightly tore my miniscus and MCL. I tore it playing D2 football. For Surgery they went in and trimed the ones that were only slightly torn and replaced my ACL with a piece of my petella Tendon. Rehad was fine but slow, i did everything that my trainer told me to do and i was back to normal in about 6 months. Needless to say i lost most of my strength in my legs but quickly recovered it after rehab. Its been about two years since then and my Knee is fine, its stronger then my other knee but then again it was my good knee to begin with.lol

well I had regained a lot of strength full rom and almost full strength. The doc said it was more than likely a partial tear and that I could transition back into sports slowly with a brace. Yesterday at rugby (during the pre practice touch rugby game) I stepped funny and went down.

So back to square one, I heard the dreaded POP again and knew this time it was a complete tear and if not the majority of it. Luckily my MRI is next week wednesday and then hopefully I’ll have an appointment with the surgeon soon after.

After seeing the surgeon today, the verdict is a torn ACL (as expected). The spanner in the works however is my meniscus. The medial meniscus has flipped over and is stuck along the centre groove. I am on an urgency list to try and save the meniscus asap.

Hey rehan, wondering where you are in terms of recovery and whether you’ve had surgery yet. I had my ACL reconstructed on August 10 and am about six weeks out. Hope things are going well with yours.

Triple C I had my surgery the first of september. I am 3 weeks out and walking in a almost normal manner (even though today i stretched/tore my hamstring). They had to remove large parts of both my meniscii so it is definitely a sucky situation. Although everyday is getting better. I hope to get back to training soon, my muscle mass on the affected leg is pathetic right now. Luckily my doctor got me in quick and did an excellent job for my situation .(Dr. Robert Litchfield, surgeon of the canadian olympic skiing team). How is your rehab going? I am looking forward to sprinting again.

Hey I had the same issue with my hamstring at around the 3-week mark. My doc said that what I did was normal and not to worry. Apparently (assuming you had a hamstring graft?), some of your hamstring will develop scar tissue and grow some adhesions during the first few weeks. The doc said I probably tore one of those adhesions, and the pain is very similar to a pulled hamstring. It hurt like hell and limited my rehab for about 6-7 days, but it eventually got better. I felt like as soon as it healed, I was able to activate much more of my hamstring.

The atrophy on your leg is for real, and there’s really no way to avoid it. That muscle is not hard to get back once you get into the real part of your rehab, though. I had to wait 4 weeks to get on the leg press because they repaired my meniscus, but now that I’m able to do that, my quad’s coming back.

Really sorry about your meniscii. That is brutal. Was that caused by the injury or something you’d been living with beforehand?

it’s good to know that you’re not having any problems. I injured myself playing rugby. It was a non contact injury which really sucked. The only thing I am worried about is returning to my previous lifting ways without putting to much wear and tear on my knee ( i can imagine 500+ deadlifts do the articular cartilage any good). The issue with the hamstring makes sense. Was the idea to allow these adhesion to develop or to keep the semitendinosus loose (i.e. foam rolling)? I feel flabby as hell but i know that i will be able to pack on a lot of muscle as soon as my lower body is good to go

From what I understand of the surgery (at the least the method they used on me), the semitendinosus is the tendon they remove to create the new graft, and it does not grow back. It was the opposite side of my hamstring (outside) where I had all the pain.

I didn’t ask if those adhesions were supposed to grow there but from what my doc told me, it just sounds like the natural process your hamstring undergoes to reconstruct itself without the semitendinosus.

I stayed away from a foam roller over the first four weeks, but started working with it after that. My calf got pretty tight (stretch it daily, I’d recommend), and I had a lot of pain (mostly just stiffness) when I extended my leg all the way. My PT knew what the problem was instantly, and after a round of massage and stretching, the pain completely disappeared.

Now I foam roll it 3 times per week and stretch 3-5 times per day and haven’t had any issues since.