[Patrick L]

Last summer I blew out my right knee riding street and tore both my ACL and Meniscus. I had surgery and went through physical therapy and everything has been going well as I have been able to snowboard everyday without much trouble since December and ride my fixie. However the other day I went out for my first light trail ride since last May and had to cut it quite short as the pain overtook my desire to ride. Last month i started a primitive work out routine of running, riding on the trainer, and lifting with a kettle bell and have seen some weight loss results but not much else. I know rebuilding the muscle in my knee will be key to getting back in shape for this next DH season but I'm not quite sure what all I should be doing other then squats as I have never really worked out before other then riding the bike and the snowboard. So simply put, what should I be doing to get my knee back in shape?



Thanks,
Patrick

 

[Capricorn]

trust me on this: follow the regiment recommended by your physio. I blew my ACL and meniscus as well (some of it had to be removed cos i fudged it up over 3 years before i could afford the surgery).

Also, take considerable time to build muscle that supports your knee. As you probably already know, weak supporting muscles and/or being overweight while pushing the limits of your under-maintained physical abilities resulted in the knee blowing out in the first place (i'm not ruling doing something genuinely stupid as a reason either ). Get those hamstrings back into shape!

The physio's exercises will be boring, and mindnumbing, but the results will speak for themselves. I dont know of any more exciting options in terms of proper rehab for your knee and supporting muscle structures, so if there another forum member whois well clued up in these areas, I too am interested.

But dont wait until then. get to your physio and suck it up. It's really the best for you and your knee in the long term. Having an ACL reconstructed is almost a no-brainer. but stuffing up your meniscus, or both of them as I did, is a whole different ball game.

 

[Patrick L]

well here comes in another dilemma; the only advice and routine my physical therapists gave me were different variations of stretching to get my range of motion back, they didn't give me any muscle building exercises, and insurance will not pay for any more PT. what was your exercise routine?

 

[RUFUS]

I gotta run out the door but here is what I do in the gym to get my knee back into shape.

First off you need to worry about rebuilding your thigh muscle, quad) and your hamstring. Stretching is key and mandatory.

These are not in order.

I alternate wearing my knee brace, one day with it on then one day with it off until the knee builds back up and then I go without it.

Do 40-50lbs on the leg extension machine. One of only two machines that I use. Bring it up with both legs, drop one leg and then do 10-15 reps with one leg. Do not go past 110* from a straight leg position. That means, straighten you leg all the way out then slowly bring it down to about 110*, DO NOT go to 90*. Do that for each leg. I do 3-4 reps per leg.

Next I use the 45* leg press machine. Pretty much a squat machine at a 45* incline. I do 180lbs in weights, (my body weight and do squats. Usually 10 reps for 3-4 sets.

Next I do 1 leg squats with 25lb dumbells. Stand with one 25lb dumbell at each side, lift one leg then do a squat. I do 10-12 reps and 3-4 sets.

Next I do a bulgarian split squat. this exact one. http://www.nsmb.com/3493-train-for-the-season/

I then do a regular straight bar squat with about 95lbs of weight. Slow and steady reps paying particular attention to form and correct technique. If my form starts to get crappy then I stop and take a break. Do not do any workout if you can't do each rep perfectly.

I gotta run but I will edit with my hamstring workouts as well as what else I do.

 

[I Are Baboon]

Just so we're clear here, you had ACL reconstruction and your doctor(s)/therapists didn't give you a full list of stretches and exercises for endurance, range of motion and muscle building?

I tore my ACL, LCL and meniscus last March and had surgery in May. I was given so many exercises to do that I can't remember them all. I'm already running faster and further than I did prior to the injury.

 

[Total Heckler]

Take your time with the rehab. They are only giving you range of motion exercises because that's all you are ready for (in your PT's opinion). After you regain your ROM back, you start on strengthening. Be patient. Its worth it in the long run.

 

[Patrick L]

correct they did not give me any exercises other than stretching. I have full range of motion and my PT said i didn't have to go to it anymore, I haven't been back since last november. My surgeon said back in november also that its fine and i don't need to see him anymore and he said i could start snowboarding starting december.

 

[Al C. Oholic]

your routine sounds good except for possibly the running. i'm not a physiotherapist, but i know that both my surgeon and PT recommended i stop running as much as possible and find other cardio. This could be because of the fact that i've done both my ACL's and both medial and lateral meniscus in both knees. in fact, my surgeon cleared me to take off my brace to walk yesterday.
If they removed any of your meniscus like they did mine (60% of the R and 50% of the L) then running could be detrimental to the cartilage, depending on your weight (i weigh 210), and cause osteoarthritis.
so to get a good workout AND work the leg muscles, I recommend starting swimming laps if you can afford a gym. weight lifting can be great as long as you're careful on your knees (ie use your brace for squats). and one thing that i found helps the stabilizers the best is find a trampoline, a medicine ball, and a wall. don't jump on the tramp, just put it near the wall and practice standing on the injured leg and bouncing the medicine ball back at yourself, catching it from different angles. STRETCH OFTEN, and ice after every workout

 

[Al C. Oholic]

Be patient. Its worth it in the long run.

Also great advice. keep in mind that there's a huge difference between what you CAN do and what you SHOULD do. no matter what graft you got, you won't be fully healed until give or take six months. No matter how strong you feel, ESPECIALLY if you got an allograft like I just did, the graft needs six months to revascularize, and will not be able to take abuse until then

 

[TreeSaw]

your routine sounds good except for possibly the running. i'm not a physiotherapist, but i know that both my surgeon and PT recommended i stop running as much as possible and find other cardio. This could be because of the fact that i've done both my ACL's and both medial and lateral meniscus in both knees. in fact, my surgeon cleared me to take off my brace to walk yesterday.
If they removed any of your meniscus like they did mine (60% of the R and 50% of the L) then running could be detrimental to the cartilage, depending on your weight (i weigh 210), and cause osteoarthritis.
so to get a good workout AND work the leg muscles, I recommend starting swimming laps if you can afford a gym. weight lifting can be great as long as you're careful on your knees (ie use your brace for squats). and one thing that i found helps the stabilizers the best is find a trampoline, a medicine ball, and a wall. don't jump on the tramp, just put it near the wall and practice standing on the injured leg and bouncing the medicine ball back at yourself, catching it from different angles. STRETCH OFTEN, and ice after every workout

I too was told minimal running (which was great by me since I don't often get chased by a bear ). I used a Bosu ball for some strengthening of my knee muscles as well...much harder than it looked for sure. I'd drop in to your PTs office or give them a call and ask if they have any strengthening sheets that you can take with you. Mine gave me a few and they always have them on hand. Also, make sure you follow a routine and rest. Strengthening muscles means allowing them to rest & rebuild too and never forget stretching.