T Nation

Training After ACL Surgery

Hey all, new to the forums as a poster but ive been reading this site for a very long time.  Reason for this post is my legs are very weak and i still feel some minor discomfort in the left knee after tearing the acl... playing football of course :) 

Anyways, my squats are very weak and im getting paranoid when attempting them. Now my question… is there maybe a lunging routine I can try for a few months slowly building up some strength in that knee, or would you guys recommend going straight into squats and sucking it up.

My bench is over 220, I can curl 140, bent over row is about 225, im not weak ( only been training for the past 3 months, took 5 years off) but my squat is embarassingly low, can anyone help me get my legs to where i want them? thanks. Stats incase anyone cares, im 27, 5’11", 195 lbs

[quote]perpetualpump wrote:
would you guys recommend going straight into squats and sucking it up. [/quote]
From my experience, no.

First, sorry to hear about your knee - and I wish you well in getting back on it.

Second, when did you have the operation?

About me: I had a terrible skiing accident 5 years ago; 8 months after ACL reconstruction, I had to look down at the scar to remember which knee.

I was very fortunate - I know plenty of skiers who never quite made it back to normal. It takes a lot of attention to a complex of factors to get it right. The hardest thing - to tell the truth - was fighting my own impatience.

IMHO, the reason why you’re “paranoid” when squatting is because your knee doesn’t quite feel your own yet. At least that’s how I felt.

The way I proceeded was: good supps (including lots of high quality fish oil), some kind of functional movement in my ACL knee very frequently, including lots and lots of balance board work (sans pink dumbbells, of course :-))

Each time I got on the balance board my knee felt a little more like my own.

Then I slowly worked into split squats - simple, controlled, not a lot of the acceleration/deceleration that lunges would entail. Then took it from there into front squats/supported single leg squats, etc.

thanks for the advice man, greatly appreciated. I had the surgery about a year and a half ago. But the actual injury occured a year prior. Due to helath care and me moving around from work, there was soo much time in between, i actually tore it a second time and by the time my surgery cam around, i had lsot half the muscle mass in that leg. Not only am I paranoid but my left leg has no strength at all anymore adn maybe half the muscle mass as my right leg.

I ll try to incorporate ur ideas into a routine, its jsut I have no strenght in that knee, i cant go 3 inches down on a left leg squat, its pretty sad actually :slight_smile:

Pleeeeeaaase take it slow and don’t be embarrassed about your current lack of strength. You’re simply going to have to put in the time with the light stuff - just don’t do it when the chicks are there :wink:

Do whatever you need to do - this is your knee for the rest of your life. If you focus on it, I have no doubt you’ll get back to normal.

Given where you are, I’m quite sure you’re going to run into secondary compensation problems: for example, given the amount of time it’s been injured, you’re probably limping, which is scr*wing with your back and probably other things. When you start to get strength back, no doubt your glutes on the bad knee side will be inhibited and weak, so your IT band will be tight and you’ll have tracking problems with your patella. Etc…

Do yourself a favor and purchase Robertson’s Bulletproof knees - I don’t have it, but it’s the kind of thing I wish I had access to when I was where you are.

So hang in there and please post and/or email/pm me if you ever have any questions.

Cheers & keep thy chin up.

Thanks bro. I’m going to take it slow and see where I’m at in a few weeks. Ill keep ya posted

Hey man, I had ACL/PCL/MCL reconstruction two years ago, and same as you, I was terrified to squat. Heck, honestly, I was scared to even step off a curb for the first six months, for fear of landing on it wrong and tearing it again.

I wouldn’t worry too much about squatting now. I would do some unilateral exercises for your knee (leg extensions, leg curls, leg press for your reconstructed knee).
Focus on that first, then start with quarter squats, then slowly work your way to full squats. I know you said you had surgery 1.5 years ago, but you want to make sure it’s strong enough to properly squat.

For me, personally, unilateral exercises helped my leg the best, and make sure you hit the leg curl pretty good, get your hamstring up to par.

Hope that helps.

And another thing, take it easy. Don’t rush into it too fast. There is nothing wrong with using light weights initially to gain mobility and stability. You have to start somewhere. Just make sure you use proper form, and you should be okay.

Fish oil and glucosamine-chondritin pills helped me out greatly, they are good for joint flexibility, as well as overall health. You can try Flameout by Biotest available here on this site, or check at GNC or any health food store.

And like I said in the last post, make sure you hit your hamstring good. Leg curls and Romanian Deadlifts should help you with this.

Feel free to PM me if you have any other questions.

thankw to u too bro. Ya its a matter of uncertainty. its unchartered territory. Ive been working for a busy furniture store here in canada as a delivery guy so ive been walking with heavy objects for the last year but as soon as i do a lift with weight at the gym, it feels awkward.

Just on first glance u can tell my muscle mass on that thigh is half of that on my right. I was a basketball player as well as football and i coudl dunk a 10ft hoop at 5’11" and being white :slight_smile: off of my left foot, it was my power leg adn now well, ya I dont have to explain how it is any further :slight_smile:

I greatly appreciate everybody’s comments. Unilateral seems very interesting regarding this. I just hit a PR on the bench last night, 230, but i dont think i could squat 150 :slight_smile: time will tell huh guys :slight_smile:

[quote]perpetualpump wrote:
I just hit a PR on the bench last night, 230, but i dont think i could squat 150 :slight_smile: time will tell huh guys :)[/quote]

well think of it this way - at least you can brag that your so freakin’ strong that you can bench even more than you can squat. (if anyone asks you for details, just be a little vague :wink: )

hahaha good stuff :slight_smile: I guess i should also mention i can deadlift over twice of what i can squat :slight_smile: i just set a pr of 320 in the deadlift, thast with that knee being soo weak, i cant wait to see what i could do with some stronger legs

[quote]perpetualpump wrote:
i coudl dunk a 10ft hoop at 5’11" and being white :slight_smile: [/quote]

So I guess you debunked the myth: white men CAN jump.

[quote]perpetualpump wrote:

I greatly appreciate everybody’s comments. Unilateral seems very interesting regarding this. I just hit a PR on the bench last night, 230, but i dont think i could squat 150 :slight_smile: time will tell huh guys :)[/quote]

Yeah, time will tell, but don’t rush it. I can only squat 175 for 5 reps before my knee starts really hurting, and I weigh 315 at 6’4, and it’s been over 2 years since I had my surgery, so everyone has a different timetable.

that’s one thing i’ve been curious, is if the pain ever completely subsides. Is it one of those things that your always going to have on the back of your mind while using the knee in any kind of strenuous activity? Theres days where I don’t feel it at all and then i get cocky with it and before I know it, i wake up and i feel some pain in the knee again.

Theres soo much action int he knee, i can never tell exactly what the problem may be. especially after a surgery liek that where everything is rebuilt, without exrays or mri’s or doctors telling me ona daily basis, i cant tell each problem just by feel. Maybe if i had a better understanding of what it shoudl feel like, maybe i woudl have a better plan of action here.

Oh well, ill hit the weights slowy here, see where I go from there. Its weird not being abel to jump 2 inches off that leg when i use to get half my arm over the rim and im only 5’11" :slight_smile:

tmoney, the pain you’re still having while squatting - do you know what the problem is, precisely?

Are you still making progress???

Perpetualpump - you can definately get to the point where the knee functions normally.

I kept running into pain as well - but found the root of the problem often was inhibited glutes on the injured side. This meant I had a tight IT band = patella doesn’t track correctly (pain right under the patella - sort of deep pain).

I think the glutes where inhibited on the injured side because of relative inactivity/weird movements on that side due to injury and opp.

Other than that, the initial inflammation/pain lasted for some time as well - let’s face it, your knee doesn’t like to have sharp things stuck into it.

I have to go but I’ll try to think of other problems I ran into - it might be of some help to either of you.

[quote]katzenjammer wrote:
tmoney, the pain you’re still having while squatting - do you know what the problem is, precisely?

Are you still making progress???[/quote]

I don’t know what the pain is specifically, so I don’t want to guess. I feel it in the front and outside of the knee. I pretty much stopped squatting because of the sharp pain, and I switched to the Cybex Squat Machine. I know it’s not the same as barbell squat, but it’s less painful on my knee.

I have made progress and strength, but still not 100%, but it’s something I have to keep working on.

[quote]perpetualpump wrote:
that’s one thing i’ve been curious, is if the pain ever completely subsides. Is it one of those things that your always going to have on the back of your mind while using the knee in any kind of strenuous activity? Theres days where I don’t feel it at all and then i get cocky with it and before I know it, i wake up and i feel some pain in the knee again.

[/quote]

From what my doctor and physical therapist told me, the knee will never be 100% again, and the pain will get worse and worse as you get older, and never completely subsides.

katzenjammer - thanks man, always good to get advice and learn form someone who has gone through the same thing. You obviously have a vast knowledge of the knee, i didnt even know what a patela was, still don’t :slight_smile: Mayb ei shoudl do some more research. But ya, anything u can help us with, that would be great.

tmoney - that’s what I feared the most was never being 100%, but no time for complaining, just get it to the point where your happy with it. Best of luck to you sire, i know ive got a long road ahead of me in terms of the liftings, slow and steady wins the race i guess. Mind you, i think if the rabbit wasn’t soo cocky, he woulda killed his ass :slight_smile:

[quote]perpetualpump wrote:
Mind you, i think if the rabbit wasn’t soo cocky, he woulda killed his ass :)[/quote]
Hah! Yeah, I didn’t have my accident during a race or anything all that spectacular - I was simply showing off for blond on a bump run. I tried to get her number while they were carrying me away in the stretcher…

That oughta show me, eh? Next time get the number first! :slight_smile:

[quote]perpetualpump wrote:
i didnt even know what a patela was, still don’t :slight_smile: Mayb ei shoudl do some more research. But ya, anything u can help us with, that would be great.
[/quote]

I’m just a bleeping amateur too - I’d purchase Mike Robertson’s Bulletproof Knees on this site if I were you. He might have some articles on the knee too. He’s apparently the knee injury guy. I’ve never seen his book, but he’s extremely good in general and I imagine the book is worth every penny.

The patella = kneecap. The IT band spans the outside of the thigh - you might try foam rolling it to see if it helps. Warning: it’s likely to be painful, but over time the tissue will adjust. Of course, the underlying reason for the IT band being so freaking tight should be addressed as well.

The reason I mentioned balance board work is that the knee is very complex little joint with lots of tendons/ligaments/muscle having to fire in symphony and with great precision. The balance board board work re-trains all these aspects of the knee to fire in concert.

In other words, it’s not only strength that’s missing, but neuro-muscular coordination.

I’m convinced all the balance board stuff really got me on the right track.

I’ll check my journals to see what else I learned back then…