ACL rehab month 5, and a temporary change in direction

Posted on May 23, 2012

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Month 5 marked me running forward for the first time. This went pretty well. I was able to go a bit faster than a jog, but anything faster than that and my knee let me know it wasn’t ready.

I had no issues after running. No flare ups, no lasting pain, etc. It’s just while running my leg wasn’t strong enough to go beyond a certain speed.

Lateral movement went really well though. Other than some stiffness I am able to laterally shuffle, stop, cut back and forth pretty damn well.

Week 20 marked me hitting a wall. A wall me, and the people around me, have seen coming for a while now.

In the words of a friend, “You look like you need to not think for about a week and go drink around a 1000 beers.”

Me (Laughs)

Friend “No, seriously. Go do that. You look awful.”

…I am burnt out…

In the last 6 months I have: gone through surgery, been doing this rehab just about every single day, gone through a break-up and adjusted to single life, written my first book / product for this website, my business and work life doubled, this blog’s traffic quadrupled (thanks for reading!), and not taking more than Sundays off in 8 months. I hate to complain…but screw you, it’s my blog and I’ll cry if I want to.

I decided to scale my rehab back at this point. Two main reasons: 1) I am going to be traveling for a good amount of time in two weeks, and then I have family visiting for a good amount of time a week after I get back. It is going to be hard for me to keep up this schedule over the course of the next 6 weeks or so. Plus, mentally I just don’t want to right now. Working out period has become a chore. I dread it. I’m exhausted.

2) I feel like I could be moving better at my leg (and my back, which has become a recent issue) and have little things to work on. I wrote about this here: Thoughts on hamstring curls. Before I decide to really push the running (basically full throttle and full on sports), I want to improve on this. My biggest fear of this whole process is trying to do too much too soon and have a fucked up leg the rest of my life. Walking is more important 20 years from now than flag football is 2 months from now.

Between me being burnt out and this type of exercise/movement work being low intensity, there is a nice confluence of taking a break and focusing on this at the same time. Therefore, until about mid-July I will primarily just be doing the massage and range of motion work listed in each week. And attempt to not think about this much beyond that. No heavy strength stuff, no intense running, no comparing myself to Adrian Peterson and how fast he is coming back, etc.

Ironically, I decided to start doing this during my most recent visit to my surgeon, where he remarked to me, “You look very, very good. I’m really happy with your progress.”

He reminded me how it’s still very early in the process for me, many people don’t return to full activity for a year (while I know this, it helps hearing it from someone else), and many people don’t feel really normal again until 18 months. He gave specific scenarios of NFL guys he knows whom, even for people who are rehabbing and getting paid to do so, still don’t feel normal ‘til the 18 month mark.

 

Post-op Day 114-120 (Week 17)

Routine schedule:

Day 114: Massage, ROM, Proprioception, Strength,

Day 115: Massage, ROM, Conditioning (Running first), Proprioception

Day 116: Massage, ROM, Upper body,

Day 117: Massage, ROM, Proprioception, Strength,

Day 118: Massage, ROM, Conditioning (Running first), Proprioception

Day 119: Massage, ROM, Upper body,

Day 120: Massage, ROM

Massage Work 

Foam Rolling / Tennis Ball: Adductors, Glutes, Quads, Calves, Peroneals, TFL, Lumbar spinal erectors,

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

-Passive knee extension with quad squeezes

-Flexion: Full flexion allowed as tolerated.

-Patellar mobilizations

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

-Clamshells

-Straight leg raise

-Plantar flexion / dorisflexion

-Hip flexion

-Hip adduction / abduction

-Best damn IT band stretch

-Bridge hold with alternating leg kicks

-Toddler squat

            –This consists of me simply attempting to sit in a full squat, like a toddler would. This started out pretty hard week 1. I wasn’t able to fully sit and achieve complete knee flexion. After a few weeks I’m pretty much there, and it feels good. It’s a great mobility exercise. 

-Single leg hamstring curl

-This has turned out to be really important for me. See this article here for why: Thoughts on hamstring curls .

Strengthening (Barefoot)

Day 114:

A1) Rearfoot Elevated Split Squat 2-3 x6-8r  (20s x6r)

-I moved this to earlier in the workout as I’m giving it more priority.

A2) Glute Bridges weighted 3 x6-8r

-Due to having quite a bit of difficulty doing the Bridge w/Alternating leg kicks (see above), I eventually took these bridges out in favor of the single leg bridging. My right leg (and external oblique) still needs more work than my left.

B1) Box Squat to 90 degrees 2-3 x10-12r

B2) Hamstring curls 3 x10-12r

B3) Single leg calves 2 x10-12r

Day 117:

A1) Squatting to 90 degrees 2 x6-8r

A2) Bridge w/Alternating leg kicks

B1) Side to side to 90 or as tolerated 2-3 x10-12r

B2) Hamstring curls 3 x10-12r

B3) Single leg calves 2 x10-12r

 

Running / Conditioning

-Running –Backwards and side to side with stopping but forwards with NO stopping

-Biking

-Elliptical –Forward and backwards

 

-Pool –             –Running all directions w/Stopping

            –Plyos both legs all directions

            –Plyos single leg all directions

 

Proprioceptive training

Weight shifts on bosu ball eyes closed.

-Single leg standing straight and bent unsupported w/ball

-Single leg straight and bent on bosu ball w/ball

High knee stepping sideways over cones with ball. Forward and back with ball.

Plyos with both legs; all directions

-Plyos; single leg; backwards and side to side

 

Meds

Ibuprofen (Ideally after exercise.)

Nutrition

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

Calories = Bodyweight x 10 on other days.

Protein always high.

Glucosamine and chondroitin, fish oil and vitamin D for supplements

Post-op Day 121-127 (Week 18)

Routine schedule:

Day 121: Massage, ROM, Proprioception, Strength,

Day 122: Massage, ROM, Conditioning (Running first), Proprioception

Day 123: Massage, ROM, Upper body,

Day 124: Massage, ROM, Proprioception, Strength,

Day 125: Massage, ROM, Conditioning (Running first), Proprioception

Day 126: Massage, ROM, Upper body,

Day 127: Massage, ROM 

Massage Work

Foam Rolling / Tennis Ball: Adductors, Glutes, Quads, Calves, Peroneals, TFL, Lumbar spinal erectors,

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

-Passive knee extension with quad squeezes

-Flexion: Full flexion allowed as tolerated.

-Patellar mobilizations

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

-Clamshells

-Straight leg raise

-Plantar flexion / dorisflexion

-Hip flexion

-Hip adduction / abduction

-Best damn IT band stretch

-Bridge hold with alternating leg kicks

-Toddler squat

-Single leg hamstring curl

Strengthening (Barefoot)

Day 121:

A1) Rearfoot Elevated Split Squat 2-3 x6-8r (20s x8r)

A2) Bridge w/Alternating leg kicks

B1) Box Squat to 90 degrees 2-3 x10-12r

B2) Hamstring curls 3 x10-12r (Seated x55lbs)

B3) Single leg calves 2 x10-12r

Day 124:

A1) Squatting to 90 degrees 2 x6-8r

A2) Bridge w/Alternating leg kicks

B1) Side to side to 90 or as tolerated 2-3 x10-12r

B2) Hamstring curls 3 x10-12r (Seated x55lbs)

B3) Single leg calves 2 x10-12r

 

Running / Conditioning

Running –Backwards and side to side with stopping but forwards with NO stopping

-Biking

-Elliptical –Forward and backwards

-Pool –             Running all directions w/Stopping

            –Plyos both legs all directions

            –Plyos single leg all directions


Proprioceptive training

Weight shifts on bosu ball eyes closed.

-Single leg standing straight and bent unsupported w/ball

-Single leg straight and bent on bosu ball w/ball

High knee stepping sideways over cones with ball. Forward and back with ball.

Plyos with both legs; all directions

-Plyos; single leg; backwards and side to side 

Meds

Ibuprofen (Ideally after exercise.)

Nutrition

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

Calories = Bodyweight x 10 on other days.

Protein always high.

Glucosamine and chondroitin, fish oil and vitamin D for supplements

 

 

Post-op Day 128-134 (Week 19)

 

Routine schedule:

Day 128: Massage, ROM, Proprioception, Strength,

Day 129: Massage, ROM, Conditioning (Running first), Proprioception

Day 130: Massage, ROM, Upper body,

Day 131: Massage, ROM, Proprioception, Strength,

Day 132: Massage, ROM, Conditioning (Running first), Proprioception

Day 133: Massage, ROM, Upper body,

Day 134: Massage, ROM

 

Massage Work

Foam Rolling / Tennis Ball: Adductors, Glutes, Quads, Calves, Peroneals, TFL, Lumbar spinal erectors,

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

-Passive knee extension with quad squeezes

-Flexion: Full flexion allowed as tolerated.

-Patellar mobilizations

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

-Clamshells

-Straight leg raise

-Plantar flexion / dorisflexion

-Hip flexion

-Hip adduction / abduction

-Best damn IT band stretch

-Bridge hold with alternating leg kicks

-Toddler squat

-Single leg hamstring curl

 

Strengthening (Barefoot)

Day 128:

A1) Rearfoot Elevated Split Squat 2-3 x6-8r (25s)

A2) Bridge w/Alternating leg kicks

B1) Box Squat to 90 degrees 2-3 x10-12r

B2) Hamstring curls 3 x10-12r (Seated x60lbs)

B3) Single leg calves 2 x10-12r

 

Day 131:

A1) Squatting to 90 degrees 2 x6-8r

A2) Glute Bridges weighted 3 x6-8r

B1) Side to side to 90 or as tolerated 2-3 x10-12r

B2) Hamstring curls 3 x10-12r (Seated x60lbs)

B3) Single leg calves 2 x10-12r

 

Running / Conditioning

Running –Backwards and side to side with stopping but forwards with NO stopping 

-Biking

-Elliptical –Forward and backwards 

-Pool –             -Running all directions w/Stopping

            –Plyos both legs all directions

            –Plyos single leg all directions

 

Proprioceptive training

Weight shifts on bosu ball eyes closed.

-Single leg standing straight and bent unsupported w/ball

-Single leg straight and bent on bosu ball w/ball

High knee stepping sideways over cones with ball. Forward and back with ball.

Plyos with both legs; all directions

-Plyos; single leg; all directions

 

Meds

Ibuprofen (Ideally after exercise.)

 

Nutrition

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

Calories = Bodyweight x 10 on other days.

Protein always high.

Glucosamine and chondroitin, fish oil and vitamin D for supplements

Post-op Day 135-141 (Week 20)

Routine schedule:

Day 135: Massage, ROM, Proprioception, Strength,

Day 136: Massage, ROM, Conditioning (Running first), Proprioception

Day 137: Massage, ROM, Upper body,

Day 138: Massage, ROM, Proprioception, Strength,

Day 139: Massage, ROM, Conditioning (Running first), Proprioception

Day 140: Massage, ROM, Upper body,

Day 141: Massage, ROM 

 

Massage Work

Foam Rolling / Tennis Ball: Adductors, Glutes, Quads, Calves, Peroneals, TFL, Lumbar spinal erectors

 

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

-Passive knee extension with quad squeezes

-Flexion: Full flexion allowed as tolerated.

-Patellar mobilizations

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

-Clamshells

-Straight leg raise

-Plantar flexion / dorisflexion

-Hip flexion

-Hip adduction / abduction

-Best damn IT band stretch

-Bridge hold with alternating leg kicks

-Toddler squat

-Single leg hamstring curl

 

Strengthening (Barefoot)

None

 

Running / Conditioning

-None

  


Proprioceptive training

-None

Meds

Ibuprofen (Ideally after exercise.)

 

Nutrition

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

Calories = Bodyweight x 10 on other days.

Protein always high.

Glucosamine and chondroitin, fish oil and vitamin D for supplements

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