Knee Rehab...Please Advise

I'm 5-1/2 months post surgery on ACL reconstruction using my patella tendon. I feel like I have progressed in certain areas...can do some running now with brace on, some agility drills, and have been doing Taekwondo Olympic version some...beginning to kick light to moderate on people and heavy bag...not kicking fast or hard in air or on paddle like targets. Problem is strength, weight room activities, hypertrophy, and my biodex test. Let me say I habe some tendonitis of some sort...that hasn't gone away. I can not do any leg extensions, hardly at all...even with no weight without discomfort. The Biodex machine test is what I have to pass to be "released" so to speak. My hamstring is fine, bu 70% difference in leg strength for the quad isn't good. The tendonitis shuts down my ability to move against resistance. In the gym...I was doing some Deadlifts, Sigle Leg Press, Single Leg Curl...trying Leg extensions now & then, Single Leg Calf Raises...and oulling sled backwards sometimes.

What do I need to do? I thought I was progressing ok, but the tendonitis, or whatever it is, is my critical path now...holding me back. I'm picking up the icing and stretching more...but other than that, what can I do? I dread going to doctor for 6 month checkup...I should be doing a lot more right now, but am not. Doctor is not goig to release me to do anything else...may even tell me to stop alltogether.

Knee Rehab...Please Advise

I would stay away from agility drill,kicking and even running for a while.Concentrate more on building the strength of your quadraceps especially your VMO.Backward sled dragging,peterson step up,side step ups on decline bench are great.Forget about leg extension(if you meant the machine).

Todd Wilson's picture

Knee Rehab...Please Advise

If you want to perform leg extensions, just go back to the doc and tell him to do another surgery and to take that new ACL out because you're really just going to trash it like an alcoholic will a new Corvette.

Do a search on this board and the archives for Peterson Step ups, tendonitis, knee rehab, and go to dieselcrew.com and read the articles with some of that same information.

DMSO helped me

TC:
A couple months back I hurt me knee to the point of thinking surgery would be my only option. I want to avoid any work on my knee if at all possible. In deparation I turned to DMSO to help manage the pain. I started DMSO three times daily and continued exercise paying careful attention to form during any knee movement exercise. I also do a joint mobility routine daily to keep the old hinges moving. In 10 days my knee was nearly pain-free. Smiling Until I started using DMSO (aka magic), I was having painful trips up and down stairs and whenever I bent my knee quarter way. I do have an appointment to see a doctor just ot have my knee once-overed at this point. Anyway I'm no doctor and I'm not dispensing advice, just a tail of what really helped me.
Jim

Update

Wow! (Reflecting) It’s been a while since I've been to this site. Here's an update.

Had ACL Reconstruction April 20, 2006
Have plans to visit the Doctor in a month to have my knee re-evaluated.

It wasn't until after I took Fred's advice here (in late December) that I've turned my rehab around. I stopped kicking, agility drills, running, etc. No impact to knee. I started a bodyweight program for legs mixed in with some low rep squats (real slow) and some horizontal leg press exercises. Some strength started to return to the leg...but the tendonitis or inflammation around the tendon area...stayed. Due to work, I wasn't able to be consistent with training...and each time that happened my strength level always seemed to return to zero and overcoming the tendonitis type pain started over. It was disappointing and frustrating.

In March I took a new job and moved...didn’t work out for a month. But in the process I received a God-Send. My wife had the same surgery from the same doctor (Andrews in B'ham). She was released from rehab at 7 months & she kept great notes. During the move, we found those Notes. Upon relocating, I started from scratch with her rehab notes. Basically did her workouts verbatim beginning at 1-month post her surgery. I used her weights, etc. as a competitive tool as well. Almost 4 months now, and my injured knee is close to normal.
Her rehab workout generally takes me about 3-4 hours to complete straight through.
Was doing those about 3-4 times a week. Now they have been reduced to 1 time a week, and I'm resuming more normal training. Can do Deadlifts and Deep Squats, moving well, some light kicking again, etc. The knee pain when I started about 4 months back was about a 5 out of 10 every morning when I got out of bed. I basically did a sgl leg extension off the side of the bed to check pain. Now its 0, and has been for 2-3months. What got me back going was doing isometric holds with Sgl Leg Extensions at 3 or 4 positions. Sgl Leg Extensions 4 months back I couldn't do any weight. On this particular machine, I did 70lbs couple days back 8 times on my 5th set working my way up at reps of 10. About 75% of my good leg. I know Todd says they are bad...but they are what I attribute to eventually helping me get some strength and muscle growth in the quad...

I'll begin turning away from the leg extensions now (especially since the weight is getting heavier...more force on the knee) towards more normal strength training and agility activities. I want to post my workout plans and weights I’m using, etc. to get some feedback from this board. I’ll do that later…maybe start a journal on this site on the journal section available. It feels good to be able to run again, and carry some things up stairs without fear. I’m not 100% yet…but it’s nice to know I’m past that crippled state.

Knee Rehab...Please Advise

My journal
http://drsquat.com/node/2653

Running concurrent with my rehab workout, running, and agility (I'll do this Thursday and post in journal), I plan to implement the following strength training for my lower body:

4week Cycles:

Week 1:
1
Front Squat 3x8-10
glute ham raise 4x8
calf raise 3x20
2
Deadlift 3x8
Barbell (Back) Lunge 3x8
Sgl Calf Raise 3x20

Week 2:
1
Front Squat 4x8
Explosive Back Squat (lighter weight) 2x5
glute ham raise 4x8
Calf Raise 4x20
2
Barbell (Front) Split Squat 3x8
Romanian Deadlift 4x8
glute ham raise 3x15
Sgl Calf Raise 3x20

Week 3:
1
Front Squat 4x5
1-1/3 Back Squat 2x8
Leg Curl 4x6
Calf Raise 3x20
2
Platform Deadlift 4x5
Barbell (Back) Lunge 2x8
Sgl Calf Raise 3x20

Week 4:
1
Front Squat 4x4
1/4 Back Squat 2x4
Leg Curl 4x5
Calf Raise 4x15
2
Deadlift from blocks 4x4
Regular Deadlift 2x4
DB Lunge 2x8
Sgl Calf Raise 3x20

After the 1st 4 weeks, I should be adding a steady dose of basic plyos and more agility and running. Would think I could do this cycle for a few months, should bring me up to some minimum strength standards (1.5 times bw squat, etc.) To date I have done 115 on the front squat for 10 reps, and 135 for 8 reps on the deadlift.

Please tell me what you think.

Knee Rehab...Please Advise

What about terminal knee extensions. THey are really helping my knees.

http://asp.elitefts.com/qa/default.asp?qid=33895&tid=115

Knee Rehab...Please Advise

Phil, have a video of those, or a series of pictures showing the ROM? Looked at the link and there is just a static picture. I don't see how you can flex your knee and still keep your heel on the ground.

Knee Rehab...Please Advise

I don't have a video. I got the exercise from elite fitness. Post on the website for a clarification.

Knee Rehab...Please Advise

I did these early in rehab. Kind of forgot about those. I have been doing a ton of resistance band exercises, I'll add these back in.

Brian,
Basically your foot stays anchored and you let the band unlock your knee...then you tighten the quad stretching the band at the same time. The PTs never told me to keep my heel on the floor. Shouldn't be difficult to do though. This was never a difficult exercise, even the 1st week after surgery. Probably why I forgot about it.

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