Need Advice on Torn ACL

Interesting information here lately.

I understand that athletes can perform with a torn ACl but it seems to me that they lose performance and definetly confidence.

As for deads and squats. I would say you risk inversion of the knee doing deadlifts with a torn ACL but if you can consioulsy stop before you go past a straight leg it may be doable.

GL!

JGerman, you’re right, there is some performance loss, especially agility.

Mahatma, I always had my athletes squat and do some form of DL as part of prehab to increase muscle girth.

Deadlifts will be safe b/c the active hamstring activity prevents the shin from translating forward.

Hello! Let me preface this by saying I am brand new to T-Nation, and a girl. :wink: I can offer litle or no advice about training on a torn ACL, as I am a rank beginner when it comes to weight lifting.

However, I did undergo ACL recontruction with a cadaver graft in October. Apparently I totally detached the ACL about a year before surgery, getting on a very tall horse. Got boosted up unexpectedly, my heel caught on the horse’s hip,my body rotated and my knee did not. SNAP! Swelled up like a balloon, but I was too stubborn to get down and went on a half day pack trip up into the mountains.

Swelling went down, pain was manageable so I just ignored it. What I did notice was instability in the knee. If I twisted wrong, the knee would collapse and down I would go. I learned to plant my knee just so when bucking bales, etc. I did manage to twist wrong several times, culminating in the beginning of October. I was kickboxing, twisted to the right and heard a loud snapping sound. It did not hurt, so I did it again. MISTAKE!

Long story short, I was bullied into going to the orthopedic clinic where I discovered that the ACL was completely detatched and laying transversly across the bottom of the knee, where it had been for a year, wearing down the bones. Not good. In addition, I had torn the meniscus in what they called a basket handle tear, with the cartilage flopping into the joint. That is why it was so painful with every attempt at a step.

I was in surgery a few days later. They replaced my ACL with a cadaver graft and had to completely remove the meniscus. They were going to try and repair it but it was too badly damaged. My boyfriend and I looked at the video they took during surgery and he turned to me and said, “Honey, that is NOT supposed to look like shredded wheat.” Everyone’s a comedian!

I had a complete nerve block. Push for it if you can. I felt NO pain for the first day and a half. Keep up with the pain meds. I was able to discontinue everything but ibuprophin a few days later. Also, if you can get your hands on a polar pack, it is WELL worth the expense. It is a small cooler with a pump that attaches to a pad you strap around the knee. The pump circulates cool air around the injury and greatly reduces pain and swelling.

I had a mixup in discharge orders so I did not realize I needed to be in physical therapy a day or two after surgery. I was not given a PT appt, just a post surgical visit a week later, and I did not know the difference. Suggestion #2–be sure you discuss discharge instructions BEFORE surgery and make sure you know what you need to know.

And for the major point of this response–read up on deep vein thrombosis and pulmonary emoblism–blood clots in the lungs. Not to scare you, as it is a relatively rare complication, but I almost lost my life to this condition. I had many of the risk factors–female, over 40,overweight, on birth control pills, surgery on a lower limb, immobilization of said limb, inactivity post surgically.

Nine days after surgery, I was well enough to go home. I had been staying with my boyfriend so he could help me out. I had been having some shortness of breath and some tightness in my chest. Sometimes sharp pains in my chest. I thought I might be congested and took some mucinex. I got in the truck after stopping at the feed store, and promptly blacked out. My bf tells me I stopped breathing completely and my pupils were fixed and dilated. Since we were in a running truck, he drove me directly to the ER instead of calling an ambulance.

I was breathing again by the time we got to the ER; the dr said his frantic shaking might have dislodged things enough for me to start breathing again. I spent three days in the ICU, had to learn to give myself shots in my stomach of blood thinners, and had to be on coumadin (warfarin) for three months.

Coumadin is basically rat poisin. They use it to thin the blood and prevent clots. It is not a fun drug to be on. You have to have your blood checked frequently and adjust doseages according to results. It can be dangerous if you have too high a dose and ineffective if the dose is too low.

Not to scare you, but please know the symptoms to look for beforehand. Chances are you will be fine, but I have since learned of many otherwise healthy people who have died of this condition. I still have what they call a saddle embolus in my lungs, right in the center of my chest and extending into the lungs. It affects my lung capacity but I am working to improve that. Very exasperating to feel winded so easily!

My knee is healing beautifully, btw. I have a tiny scar, maybe an inch long, and four tiny poke holes that by short skirt weather should be virtually invisible. I did go to PT three times a week to begin. They had me doing some light weights in a very short time–hamstring curls, leg press. I have very little pain now and almost 100% ROM.

There is a great book called Knee Surgery: the essential guide to total knee recovery by Daniel Fulham O’Neill. Get it if you can. It has a very complete section on getting ready for surgery and may have some of the information you are asking about. It also gives step by step instructions on how to make sure you are getting the right series of exercises to recover the best.

Good luck to you! If you need any more specifics, let me know. Oh, and the advice someone else gave–it is true that your graft is the strongest right after surgery, and gets progressively weaker as the graft breaks down and your own tissue replaces it. As you start to feel better it is very tempting to overdo and cause injury.