T Nation

Torn ACL and PCL

This is going to sound pretty lame but I partially tore my ACL and PCL playing flag football about a month ago. My teammate and I didn’t see each other while we were going for the same guy. I wound up getting my foot trapped underneath his body and his shoulder got rammed to the inside of my knee. It hurt for a little bit but I got up and managed to get off of the field.

A few minutes later my knee felt okay so I went back onto the field and finished playing the last two minutes of the game.

The next day my knee was a little sore but it wasn’t that bad. Two days later I had my level two test for my Muay Thai class. I did the test as well as I could and I passed. If I’d known the extent of my injuries I never would have done the test but I just thought it was a muscle bruise.

Anyhow my athletic trainer seems to think that the ACL and PCL are slightly torn based off of what she felt when she was examining my knee. She advised me to start back into my lifting routine again. I need to do 1/2 squats and deadlifts.

Can anyone think of any other exercises I need to do beyond these two? I need to strengthen my leg until I’m able to have my knee taken care of.

I’m pulling out the BS card on you.

The PCL will heal AFAIK. The ACL tear can only be confirmed through an MRI and I suggest you get that done.
Depending on the grade of the tear, you will have to be careful with acts of agility (sprinting etc) and be very careful while squatting. IMO ATG squatting is safest for people with ACL troubles, and also supplement with the leg press machine. Build up progressively to heavy weights and always use constolled muscular effort.
The best exercise for anyone without an ACL (according to my physical therapist) is LUNGES. Visit a physical therapist first.
Till you get it reconstructed, regardless of the level of strength you build up, a slip on ice can cost you 2-3 weeks of recovery, and your injured leg is always ging to be weaker (the muscles generate spasms to stabilize the joint in absence of the ACL).
Also I take it your meniscii are torn, so that is just an outpatient procedure with same day recovery.
The exercise bike is your friend.use it to train high speeds, high loads etc…to help the muscles recover and/or get stronger.
Be careful with the treadmill…If you want to run and sprint, build up to high speeds gradually.
And finally the general consensus on ACl tears is that its better to get reconstruction (from a cadaver if you have a choice) if youre less than 25 or so.

[quote]tjhenry wrote:
This is going to sound pretty lame but I partially tore my ACL and PCL playing flag football about a month ago. My teammate and I didn’t see each other while we were going for the same guy. I wound up getting my foot trapped underneath his body and his shoulder got rammed to the inside of my knee. It hurt for a little bit but I got up and managed to get off of the field.

A few minutes later my knee felt okay so I went back onto the field and finished playing the last two minutes of the game.

The next day my knee was a little sore but it wasn’t that bad. Two days later I had my level two test for my Muay Thai class. I did the test as well as I could and I passed. If I’d known the extent of my injuries I never would have done the test but I just thought it was a muscle bruise.

Anyhow my athletic trainer seems to think that the ACL and PCL are slightly torn based off of what she felt when she was examining my knee. She advised me to start back into my lifting routine again. I need to do 1/2 squats and deadlifts.

Can anyone think of any other exercises I need to do beyond these two? I need to strengthen my leg until I’m able to have my knee taken care of.[/quote]

Oh, and I don;t believe your trainer recommended you to get back into a lifting program without a visit to your orthopaedist. Why lie?

[quote]tjhenry wrote:
This is going to sound pretty lame but I partially tore my ACL and PCL playing flag football about a month ago. My teammate and I didn’t see each other while we were going for the same guy. I wound up getting my foot trapped underneath his body and his shoulder got rammed to the inside of my knee. It hurt for a little bit but I got up and managed to get off of the field.

A few minutes later my knee felt okay so I went back onto the field and finished playing the last two minutes of the game.

The next day my knee was a little sore but it wasn’t that bad. Two days later I had my level two test for my Muay Thai class. I did the test as well as I could and I passed. If I’d known the extent of my injuries I never would have done the test but I just thought it was a muscle bruise.

Anyhow my athletic trainer seems to think that the ACL and PCL are slightly torn based off of what she felt when she was examining my knee. She advised me to start back into my lifting routine again. I need to do 1/2 squats and deadlifts.

Can anyone think of any other exercises I need to do beyond these two? I need to strengthen my leg until I’m able to have my knee taken care of.[/quote]

[quote]PinkMist wrote:
I’m pulling out the BS card on you.[/quote]

Congratulations on attaining the position of patrolling these boards

Well, I would have already seen an ortho specialist but I changed jobs and I missed the window for open enrollment with their insurance company. So until I’m able to enroll I can’t afford to do anything beyond what I’ve already done. Also, I can’t see a doctor because if there are any records of my knee already being injured I’m going to get denied by the insurance company for a preexisting injury.

The tears aren’t complete but it’s allowing for some slop in the joint that makes it somewhat uncomfortable. My Muay Thai instructors are aware of the injury and they’re tailoring my program to work around the injury as best as they can. My main concern is I do not want to quit this program if I’m able to help it.

Thanks for your advice.

[quote]rbpowerhouse wrote:
The PCL will heal AFAIK. The ACL tear can only be confirmed through an MRI and I suggest you get that done.
Depending on the grade of the tear, you will have to be careful with acts of agility (sprinting etc) and be very careful while squatting. IMO ATG squatting is safest for people with ACL troubles, and also supplement with the leg press machine. Build up progressively to heavy weights and always use constolled muscular effort.
The best exercise for anyone without an ACL (according to my physical therapist) is LUNGES. Visit a physical therapist first.
Till you get it reconstructed, regardless of the level of strength you build up, a slip on ice can cost you 2-3 weeks of recovery, and your injured leg is always ging to be weaker (the muscles generate spasms to stabilize the joint in absence of the ACL).
Also I take it your meniscii are torn, so that is just an outpatient procedure with same day recovery.
The exercise bike is your friend.use it to train high speeds, high loads etc…to help the muscles recover and/or get stronger.
Be careful with the treadmill…If you want to run and sprint, build up to high speeds gradually.
And finally the general consensus on ACl tears is that its better to get reconstruction (from a cadaver if you have a choice) if youre less than 25 or so.

[/quote]

What exactly would I gain by lying on here? I’m a new guy and I don’t have anything to prove to a bunch of people that I’ve never met before and likely never will.

She never told me to go straight back into a lifting program heavily. She said I needed to strengthen my leg back up so that the muscles would help hold my knee together until I’m able to see an ortho specialist and get an MRI. The longer I sit around without doing anything the more my joint’s strength will deteriorate. With less strength and two torn ligaments it’s easier for my knee to hyper extend which will just make the injuries that much worse.

With all of that out of the way are there any other exercises you guys can recommend for strengthening my quads and hamstrings?

[quote]rbpowerhouse wrote:
Oh, and I don;t believe your trainer recommended you to get back into a lifting program without a visit to your orthopaedist. Why lie?

[/quote]

I have always heard that no matter if a partial tear or complete as far as an ACL goes it makes no difference… it has to be reconstructed if you are as active as you say.

My son tore his during high school football and used a cadaver and had a retear… so we opted for using his own patellar tendon for his revision and we are pleased… good luck and be careful not to cause further damage in the meantime

Get an MRI to confirm. I would not trust a partial tear diagnosis.

When I ruptured mine the pieces were all over the inside of the knee and it swelled up so badly I could not move it.

I don’t believe a partial ACL tear will ever heal so you can get it fixed now or just play on it until it fails. Good luck.

Ok, I assumed she asked you to get back into a HEAVY lifting regime, my bad.

I would say, focus on strengthening your hamstrings (say leg curls) in addition to lunges.
Do you have full ROM in your knee joint yet? IF so, then work into bodyweight squats first and then barbell. Stretch the quad, hams, gastroc and soleus before each workout.
If you don;t have the full ROM yet, focus on lunges. add weight with dumbbells. And for God’s sake, go easy.
If you have good ROM you may also want to do leg presses.

And strenghten your shin muscles by walking on you heels for 30 seconds at a time.

[quote]tjhenry wrote:
What exactly would I gain by lying on here? I’m a new guy and I don’t have anything to prove to a bunch of people that I’ve never met before and likely never will.

She never told me to go straight back into a lifting program heavily. She said I needed to strengthen my leg back up so that the muscles would help hold my knee together until I’m able to see an ortho specialist and get an MRI. The longer I sit around without doing anything the more my joint’s strength will deteriorate. With less strength and two torn ligaments it’s easier for my knee to hyper extend which will just make the injuries that much worse.

With all of that out of the way are there any other exercises you guys can recommend for strengthening my quads and hamstrings?

rbpowerhouse wrote:
Oh, and I don;t believe your trainer recommended you to get back into a lifting program without a visit to your orthopaedist. Why lie?

[/quote]

Exactly, “THE ACL CAN NEVER EVER HEAL…”. You tear it even a bit, onl a matter of time before it goes fully.

[quote]edboze wrote:
I have always heard that no matter if a partial tear or complete as far as an ACL goes it makes no difference… it has to be reconstructed if you are as active as you say.

My son tore his during high school football and used a cadaver and had a retear… so we opted for using his own patellar tendon for his revision and we are pleased… good luck and be careful not to cause further damage in the meantime[/quote]

If you have an athletic trainer do you have access to ESTIM? If so see if he/she will allow you usage prior to reconstruction. By using ESTIM set at 10/10 - 10sec contraction followed by 10sec rest - you can get direct VMO contraction with less risk of further damage.

I’ve got pretty decent range of motion. I would say it’s probably 90% of what it used to be. What I have noticed though is the reduced stability in that leg. At my Muay Thai class last night we were doing straight knees into the pads. I was able to do a right knee perfectly while I was supported with my left leg. I tried to do a left knee and I knew it wasn’t going to work so I stopped.

I’m not being easy on it but I’m definitely being smart about it all. I’m not going to attempt something that I think may further injure my knee.

Like I said though, as soon as I’m able to get my insurance through work then I’ll go get the MRI and figure out exactly what’s wrong. I still have 7 months before I’m able to do that so I don’t have much of a choice but to strengthen it and be careful.

What sucks about all of this the most is that I was really starting to make really good progress. I started lifting heavily last June for the first time since high school. I bulked up to 190 and I was making pretty good gains.

I started doing kickboxing and I shed 20lbs in 3 months without losing anything in the gym. I just hate the fact that I was getting into the best shape of my life and then this happens.

Thanks for all of your advice everyone.

I agree with the other responses…you should get an MRI. There is no way for a doctor to confirm through an examination alone that your ACL is or isn’t torn. Even if it’s a partial tear, it’s likely that it will tear eventually. Good luck.

[quote]ascshotput wrote:
If you have an athletic trainer do you have access to ESTIM? If so see if he/she will allow you usage prior to reconstruction. By using ESTIM set at 10/10 - 10sec contraction followed by 10sec rest - you can get direct VMO contraction with less risk of further damage.[/quote]

What is the benefit of specificly working the VMO with an injury to the PCL and ACL?

Seeing as he’s an athlete and one that does a fair amount of unilateral leg movement (Muay Thai), it isn’t unreasonable to question VMO strength. Weakness in the VMO can cause improper knee position, greatly increasing the chance of injury. So, by “turning on” or contracting the VMO passively (via ESTIM) one can both strengthen it (if it is weak) as well as prepare for atrophy from reconstructive surgery without weight bearing exercise.

I agree with the previous posters, definitely get an MRI.

I tore my ACL/PCL/MCL completely, and even after many many hours of therapy, my physical therapist didn’t recommend any exercises for me, he told me to ask my doctor.

My doctor said do quarter squats, and buy ankle weights and increase the amount of weight every week when I walked.

As a previous poster said, my knee is 99% healed, but it still hurts every now and then, and will for the rest of my life, and it will get worse when I get older. I suggest you get it fixed as soon as you can.

You’ll be surprised, but MOST ACL tears go undiagnosed and people never ever become aware that they’ve torn it. If you choose to avoid surgery, build up the VM , do leg presses and work into quarter or ATG squats.

My personal opinion is that parallel squats are a little more awkward and ATG squats are painless (for me) as long as I don;t bounce on my knees.

[quote]tmoney1 wrote:
I agree with the previous posters, definitely get an MRI.

I tore my ACL/PCL/MCL completely, and even after many many hours of therapy, my physical therapist didn’t recommend any exercises for me, he told me to ask my doctor.

My doctor said do quarter squats, and buy ankle weights and increase the amount of weight every week when I walked.

As a previous poster said, my knee is 99% healed, but it still hurts every now and then, and will for the rest of my life, and it will get worse when I get older. I suggest you get it fixed as soon as you can.[/quote]