Rehab for ACL and meniscus surgery -Week 6

Posted on February 13, 2012

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I saw my surgeon at the end of the 6 week mark. So far, so good. My x-rays came back solid and I passed the Lachmann test. Both very good signs.

I was concerned about some popping I was having in the knee but other people who had the surgery, as well as my surgeon, confirmed this was typical.

At this point I only have about 5 more weeks until the majority of the healing is done. This doesn’t mean I’ll be ready for sports -that’s a long ways off- it means that the ACL graft will be solidly set in place and my meniscus will be fully repaired. After that it will be another 3 months or so of strengthening the leg to get it where it needs to be.

My surgeon did mention that there was a little more fluid in there than he would like. Possibly associating this with me pushing things too hard. I told him that I think it might be more a result of how much I stand throughout the day. He agreed that was a possibility. Because of this though I started wearing my ACE bandage more often. This has seemed to get rid of pretty much all the fluid. So that was a minor issue.

Week 6 marked some other pretty big changes:

Post-op Day 36-42 (Week 6)

Routine schedule:

Day 36: ROM, Proprioception, Strength,

Day 37: ROM, Conditioning, Proprioception

Day 38: ROM, Upper body

Day 39: ROM, Proprioception, Strength,

Day 40: ROM, Conditioning, Proprioception

Day 41: ROM, Upper body,

Day 42: ROM

> The routine schedule changed a fair amount in week 6. Lower body strength training is decreased from 3x a week to 2. Because my legs are getting stronger now, 3 times a week is a bit much. The sweet spot for strength training a muscle group is once every 5 days. So twice a week still adheres to this.

Proprioception is still performed one day while fresh (strength day) and one day while fatigued (conditioning day).

Upper body training has finally made its way back in too. It’s been left out up to this point for a couple of reasons: I didn’t want to risk messing my knee up by carrying heavy dumbbells or just doing something dumb while lifting my upper body. Next, your body can only recover from so much. I didn’t want to take any energy away from healing my knee. Adding a bunch of upper body strength training would take energy away from healing my knee. While my knee isn’t fully healed, I feel 6 weeks in is a good compromise here. I can only become so emaciated before I start to lose my mind.

 

Range of motion exercises (15 reps of each exercise. Should be done often enough throughout day to accomplish goals! There is no magic number.)

-Extension: To 0 degrees or 5-7 degrees of hyperextension.

> AHH! FINALLY! This has finally become not an every damn hour type of deal. Towards the end of week 6 this got better. I started to wear my ACE bandage a bit more –to try and push some of the left over fluid out- and I think this really helped. All of a sudden I have full extension damn near all the time.

 

-Passive knee extension with quad squeezes

-Flexion: Active flexion allowed only to 90 degrees. BUT, no RESISTED flexion allowed. Full passive flexion allowed as tolerated.

> I just about have full passive flexion now. This was really easy. No where near as difficult as regaining extension.

 

-Patellar mobilizations

-Sitting hamstring stretch

-Tibial rotations. Palpate hamstrings and tibia to make sure these are moving and movement is not only occurring at the ankle.

-Plantarflexion / dorsiflexoin

-Clamshells

-Straight leg raise

-Hip flexion

-Hip adduction / abduction

-Lying down knee extension 90-0 degrees

Strengthening (Barefoot)

Day 36:

A1) Squat to 60 degrees (30lbs)

A2) RDL (45lbs)

B1) Single leg leg press to 60 degrees (42lbs)

B2) Glute Bridges

C1) Single leg calves (42lbs)

C2) Isometric heel slides @ 30, 60, 90

 

Day 39:

A1) Squat to 60 degrees (35 lbs)

A2) RDL (50lbs)

B1) Single leg leg press to 60 degrees (47lbs)

B2) Glute Bridges

C1) Single leg calves (47lbs)

C2) Isometric heel slides @ 30, 60, 90

 

Conditioning

-Elliptical -Backwards only -> 30 minutes each day.

-Pool –Walking in all directions

Proprioceptive training

Weight shifts on bosu ball w/eyes closed.

-Single leg standing straight and bent unsupported.

-Ball toss on bosu ball

-Single leg standing w/knee straight on bosu ball

-High knee stepping sideways over cones.

Meds

Ibuprofen if needed (Ideally after exercise.)

Nutrition

Calories = Bodyweight x 15 + 20% on strength days.

Calories = Bodyweight x 10 on other days.

Protein always high.

> Because I’m starting to actually be able to lift a little bit of weight and I started lifting my upper body again, I upped the calories on the strength days to help promote some muscle gain.

I also forgot to mention that I’m still taking glucosamine and chondroitin, vitamin D, and fish oil.

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