ACL Reconstruction

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Tilluin

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Tore my ACL completely earlier this year playing lacrosse (a goalie took a fall through my knee during a game) and have surgery coming up. None of my team or friends have torn their ACL before and I'm getting mixed messages regarding rehab time from my doctor, physio, personal trainer and consultant. I wondered if anyone has torn their ACL and has any tips for the prehab / rehab?

At the moment I'm hitting the gym 3 times a week doing a 40 minute bodyweight leg session (squats, wall sits, bridges, clams etc) to try and strengthen my entire legs and glutes as apparently the glutes play a large role in ACL injuries. My friend has recommended I focus on improving my posterior chain muscles as most people tend to neglect them.

Any tips on pre/rehab from anyone who's experienced it? and tips for the rest of my life - I've been wondering whether Yoga would be a good thing to take up from now on? I've been told to expect to not play lacrosse again for 6 weeks to 3 months to 6 months to 9-12 months and have no idea which to believe. I'm hoping a serious approach to strengthening will play a significant role.
 
Foggy

Foggy

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I have never heard of ACL reconstruction being a 6 week to 3 months rehab. Typically, it is expected to take roughly 1 year until you are close to normal (i.e., you can play) and up to 2 years until you are in the same place you were before.

Go see a physical therapist that specializes in rehabbing post-knee surgery.
 
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readmorepostless_sl

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I see no chance of it only taking 3 months to rehab unless they've really come up with some crazy new techniques (which maybe they have looking at recent happenings like Peterson although that was still 8 months removed from the injury). When I had it approximately 10 years ago, my leg muscles atrophied to nothing, and it took about a year to get the strength back to where it was.

In terms of post-recovery activities, I'd say the biggest thing is rebuilding a good strength base, especially for any lateral and twisting motions. I've never tried yoga, the only thing I'd caution is jumping into it too early - the tendon (or whatever they're using these days) needs time to set, if it was to stretch to early its pretty much ruined.
 
Joeboo

Joeboo

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The fastest I've ever seen a professional athlete come back from an ACL tear is like 8-9 months, and they have access to not only the absolute top, elite surgeons, but 24/7 personal rehab trainers and the bleeding edge of drug technology for recovery enhancement. Your average person(you) is looking at a year to being able to play again, and 2 years before you feel 100% again.
 
Erronius

Erronius

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Snapped mine in half a long time ago when I turned my leg 180 degrees backwards at the knee.

The best thing for me as far as prehab/rehab was pool therapy, hands down. We did 30m in waist-deep water doing stuff like jogging, flutter kicks, stuff like that. The 2nd 30m was spent in the deep end of the pool. The goal there was to tread water without using your hands for as long as possible, and the therapist would bring in a volleyball. You stood a pretty good chance of getting beaned with it if you brought your arms down into the water. If (when) you got exhausted you would just grab the side of the pool and take a breather for a minute or two then start treading water again (and in our group you were kind of off-limits to headhunting with the volleyball if you were at the side of the pool). It was way less impact than even stationary bikes and the like.

I also had my leg muscles atrophy like readmorepostless did, from when I had to keep on crutches with my entire leg splinted up after the surgery. After a while I started thinking I could hobble around the room w/o the crutches and splint until I put a little too much weight on that leg: it gave out like it was made of water and my face met the edge of the sink countertop. After that I kept the splint on and used crutches almost religiously. The worst part of the atrophy though was that I had to go in for electric shock therapy to the muscles in order to get them to work again, but after I went through that I was able to start doing the regular types of therapy.

As far as being 100% again...that happens for some people but not for everyone. I'm not 100%, and on occasion I will still tweak it and end up hobbling for a bit. I used to like running but I just don't run anymore, period. I didn't have any scoping done myself; both of my sisters also have knee degeneration (from basketball for them) and have had multiple scopes and procedures and AFAIK they have a lot fewer issues now than I have.
 
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Tilluin

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The mixed messages about recovery time are definitely confusing. Especially since the consultant I saw was top of his field at the hospital and when I mentioned my season starts in September he said I'd be ready to play then, but there is no way that's right. I'm 26 so was hoping to be in my prime, lacrosse wise, over the next 2 - 4 years not rehabbing! The pool therapy sounds like a great idea, I'll get on that. Are there any vitamins / products I should be taking to enhance my rehab programme?

I'm definitely not ready to see that much muscle wastage, apparently taking prehab seriously can negate some of the post-surgery wastage but I'm hoping it doesn't happen to that level Erronius. Sorry to hear yours never got back to 100%.
 
Erronius

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Well a lot of it might come down to how badly torn your ACL is and what kind of procedure you get. Both of my sisters for example had tears in theirs along with rips and flaps in their meniscus that had to be sewn/cleaned up, and one sister had a large piece of debris (for lack of a better word) removed from her knee that was the size of a nickel or whatever (iirc). They only got scoped and their recovery time was much quicker and easier than mine was - with my surgery they just cut my knee open and started drilling/cutting/etc.

Thinking about this again this morning, I'm probably a worst-case scenario and more of an outlier so don't let it bother you (my surgery was in an Army hospital with Army doctors, LOL). I wasn't given any MRIs and I wasn't scoped - they knew what they were planning on doing beforehand I guess, and they actually inserted screw-anchors and rebuilt my ACLs using strips cut from the tendon/ligament that holds the kneecap. I alsoDID NOThave my MCLs looked at in my surgery at all (no idea why not), and I suspect that they were damaged as well (I had some other issues with my meniscus but I don't remember off the top of my head what it was). I get some side to side or left/right movement in my knee to this day on occasion, more of a wobble, and I'll probably have it looked at eventually.

September though, that still sounds awfully optimistic to me.
 
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skrala

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8-12 months is reasonable, there's no way I'd say less than 6 unless you're flying to Germany for a Kobe Bryant procedure every other week. I had mine done a few years ago, I was cleared for all sports in 8 months but it was well over a year before I felt confident in my knee. It's more mental than physical at the end imo, and I've heard that from others as well.

As for prehab, get your hamstrings and quads as strong as possible. For me the hamstrings were the toughest part to get back, I still don't have the flexibility I did before and I get a lot of hamstring pulls that I never got prior to surgery.
 
Astennu

Astennu

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ACL tears suck. They are so random and everyone reacts to them differently. I did mine nearly 19 years ago now. I was just playing a casual 2 on 2 basketball game in the gym waiting for others to get there for a real game. Drove by my guy, planted my right foot and snap. It was so loud it echoed in the gym when the ligament popped. I ended up tearing meniscus too, so I couldn't really pre-hab at all since my range of motion was nil and I couldn't reliably stand on it. I had similar to what Erronius described--took part of my patella tendon and built a new ligament, attached with screws.

Biggest thing is don't be slack on any part of the rehab. A lot of it sucks and is definitely painful, at least it was that long ago. I remember the morning after surgery at my first rehab appointment they made me stand and put pressure on it. Mother fucker that hurt. The surgery is less invasive now and the rehab is more aggressive. It was a full year before I was ready to get back into sports, and, like others mentioned above, the mental part is initially hard to overcome. I'd say I got back to my pre-surgery self after 18 months, including not worrying about tearing it again anytime I exerted at all. Just don't try to do too much too soon. Even if you think you are ready you can unknowingly favor your other leg and end up messing that up, or your back, or any number of other injuries that come with it.

But once you screw it up it's never completely right. As I've gotten older I can really tell the difference between my knees. I had to get a tune-up about three years ago from the wear and tear. Best of luck with it.
 
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Tilluin

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Thought I'd update as I'm now almost 7 months post-op. I was on crutches and off work (I'm a primary school teacher so had to wait longer due to the constant moving etc) for 3 weeks. I was initially petrified to move my leg and didn't do too well with my range of movement exercises but a kick in the ass from my physio in week 2 set me straight. She picked up on me not walking correctly with crutches and bust my balls about doing things properly and not being afraid 24/7. Just what I needed thankfully!

At 4-5 weeks I started group physio sessions at my hospital once a week for a month and did the activities I learnt there in the gym 1-2 times a week + daily leg raises, knee bends etc. I started running on the treadmill around 3 months and at 5 months started interval training doing 2 minutes at 8kmph then 1 minute at 10kmph. I started to throw in small box (yoga step) jumps 2 foot to 2 foot and progressed on to bad leg to bad leg. At 7 months I'm now doing interval on the treadmill of 10kmph for 2 minutes then 14kmph for 1 minute for around 20 minutes, curling around 85lb on my operated hamstring, raising about 70lb on my bad legs quad and single leg (bad knee) pressing 150lb. My physio has said I'm roughly 4-6 weeks ahead of schedule and everyone else in my group workout class from the start of my rehab which is my comparison. I'm working on speed/agility work and quad/ham strength mostly now and have been cleared to return to lacrosse training once a week which I am to take slowly and progress as I feel ready through certain drills. My biggest barrier at the moment is self-doubt - everything that used to be natural has become a thought out process where I actively try and protect my knee through a lack of urgency or not pushing myself like I normally would. I'm hoping the return to practice will help me with that.

I'm due to be signed off at the 9 month stage and will be returning to full contact lacrosse at 10 months. It has been frustrating, infuriating, laborious, stressful and I'm pretty sure I've been hard to live with for my girlfriend but there is starting to be some light at the end of the tunnel. If anyone else is about to have ACL surgery do lots of prehab it helped me with muscle growth and my initial bad form with rehab exercises was covered by my strong prehab. I'm conscious of what could cause it to happen again though as my physio is assuring me that as long as my quads, hams, glutes etc are strong enough I will be as good as new but I'm still struggling with the confidence.
 
Joeboo

Joeboo

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Good to hear man, glad you're almost done with the ordeal.

I thought I had really screwed up about a month ago. I wasn't doing anything out of the ordinary, my wife and I were going shopping and we parked in the parking lot. My side of the car had a little hedge-row of bushes between me and the sidewalk we needed to be on to walk over to the store. Well, instead of walking around the back end of the car and to the actual entrance to the sidewalk, I decided to just oh-so-athletically jump over the bushes, saving myself that LONG walk around the car. I jumped, cleared the bushes, and when I landed I felt and heard an audible POP in the back of my calf, and I crumpled like I had been shot. Just excruciating pain, my wife had to help me stand up, and hop back to the car, couldn't put any weight on my calf.

I figure I'm totally boned, throught I had torn my achilles or something, since it was on the back of my leg between my ankle and knee, I knew it wasnt a knee ligament, my knee was fine. This was on a Saturday, so I decide I'll just lay on the couch and ice it until Monday when I can call the doctor. It actually didn't hurt if I didn't move. And while no visible bruise ever formed, my whole calf was so tender that tears would well up in my eyes if I barely even poked it, goddamn it hurt. Well, thank god by monday I could actually walk again(very slowly, with a limp) so I decided to tough it out and see if it got better. Slowly got better over the course of like 2 weeks, and I'm finally back to where I feel 100%

I still don't really even know what it was, I definitely heard an audible pop, so I wouldn't have thought it was just a muscle strain/sprain, but here I am with no ill-effect about a month later, I'm totally fine. Weirdest damn thing ever. I thought for sure I was going to break my 36 year lifelong streak of no surgeries, lol.
 
Gravy

Gravy

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By 36? You really don't know how to hurt yourself.

By 36, I had had 3 hand surgeries, 2 knee surgeries, multiple broken bones set, and one heart stint. I am the Master of Disaster.

Tilluin, it's great that you did all that prehab. My latest knee guy told me that if my legs weren't so well developed, there's no way I'd be able to stand. Keep up the strength training and flexibility exercises.
 
Joeboo

Joeboo

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I've never even had stitches. Worst injury I've ever had were a couple severe ankle sprains playing basketball and football in Jr High & high school. But to be fair, my lifestyle of office jobs + video gaming since then really hasn't put me in a lot of likely injury situations.
 
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