Robs ACL Allograft Exercise Journal with Timeline

[Rob_W]

On July 17, 2007 I had an ACLr Allograft and a Lateral Meniscus Trim (also a grade 2 MCL sprain when injured).

I wanted to track in one spot all of the exercises I have been assigned at PT (and a few I added on my own with an OK from my PT) and a time line of when assigned– these are all in my Post-Op diary too but they are scattered in with everything else including pre-surgery exercises: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=38125.msg308214#msg308214

Week #0:

Day 2:

Exercise #1: Quad Sets. I do these while sitting on my couch with my brace on and locked in full extension. Basically you just flex your quad muscles while feeling as if you are pushing the back of your knee down into the couch. I hold the contraction for about 2 seconds and then repeat for a total of 20 repetitions. I was told you can’t overdo this exercise so if you can do one set of 20 every hour (or every other hour) that’s great.

Day 3:

* From this point forward all exercises are done twice daily – except quad sets which I do more frequently for the first couple of weeks.

* I should also point out that for the first week I had my brace on in the locked position 24/7 except when doing the exercises.

Exercise #2: Straight Leg Raises. I do this lying on my back with my upper body sitting up a little so I am propped up on my elbows – my good leg is pulled in so my left knee points up in the air. I am not doing these exercises with my leg brace on because I do not have any extension lag (my leg does not bend when I raise it – I can keep it perfectly straight – if there was extension lag I would have to do these with the brace on and in the locked position). This exercises starts like a quad set where you flex your leg to lock it out straight. Raise the leg to about the height of the opposite knee (or whatever feels comfortable), hold for just a brief moment (I was told you do not need to leave it up in the air) and then lower back to the starting position. Completely relax the leg for a moment and then repeat (don’t just keep it flexed the entire time). I am doing 2 sets of 15.

Exercise #3: Straight Leg Raises - Abduction. This is similar to the above exercise but just lying on your non-injured side You will raise and lower your injured leg). The only difference is on this one I do not fully relax in between repetitions but continually do 15 in a row, take a break for a moment, and then do my 2nd set of 15.

Exercise #4: Heel Slides. Sit on the floor with both legs extended out straight in front of you. Take a rolled up towel and holding it by the ends in both hands loop the middle over the ball of your injured leg. With assistance from your hands pulling the towel slide your heel towards your butt along the floor so your knee starts to rise of the floor. When it wont go any further hold that position for 5 seconds and then release and slide your heel back to the starting position (getting it back to the starting position is often harder then pulling it to you – sometimes I actually had to scoot my body away from my heel to get the leg straight again). Do 1 set of 15 repetitions. As my leg got stronger (a few weeks later I would alternate between using a towel to assist some days and just using the strength of the leg to pull the heel on other days – if you had a hamstring graft that might be tougher in the beginning so the towel would probably make much more sense).

Exercise #5: Calf Strengthening with Exercise Band.This starts seated on the floor like the above exercise but loop an exercise band (elastic) around the ball of your foot and hold the ends in both hands. Pull back on it to get the tension to whatever amount you feel you can handle. Now just extend the ball of the foot away from you like you are pressing down on a gas pedal in your car and then relax and bring it back. Make sure you keep the leg straight and on the floor the whole time. Do 2 sets of 30 repetitions. This will later be replaced with exercise #16: Standing Calf Raises.

Exercise #6: Seated Calf Stretch. This starts off the same as the above exercise so you are seated on the floor with a towel around the ball of your foot and you are holding the ends of the towel in both hands. Flex the quad and press the back of the knee into the floor (like the quad set) and then pull with the hands to pull the top of the foot towards your knee. You want to make sure that you are not lifting your heel off the floor and going into hyper-extension (I was told no hyper-extension until after 12 weeks). See note at Week #5, day 35 for an alternate way to stretch the calf.

Exercise #7: Quad Set with Towel. I do my quad sets a little different when I am doing my actual set of PT exercises, but when I am just sitting on the couch I do exercise #1. Sit on the floor like the above  exercises and place a rolled up towel under your knee (not too large – it might be 1 to 2 inches tall before you compress it). Flex your quad and press the back of the knee down into the towel like you are trying to push the towel into the floor, hold for 2 seconds and then release. You might notice your knee cap move a little when you do this – and that is OK. You also want to keep an eye on your foot so it doesn’t start to lift up to high and go into hyper-extension. Do 2 sets of 20 repetitions.

Week #1:

Day 7:

Exercise #8: Push ups. I checked with my PT to see if these would be OK and he said they would. I do 2 sets of 20 pushups twice per day with my regular pt exercises. I keep my left knee on the ground (good leg) and I keep my brace on in the locked position raised off the floor (I started doing them without the brace on Day 17).

Day 11:

* I checked with my PT if I could start using my home gym for upper body exercises twice per week and was given the OK. So I do incline bench press, lat pull downs and bicep curls twice per week. On the days that I do the incline bench press I do not do any push ups.

Day 12:

* I started going for short 10 minute walks today (with crutches and unlocked brace).

Week #2:

Day 14:

Exercise #9: Tibialis Anterior Strengthening with Exercise Band.This one I only do at PT, not at home, but you can if you want - it strengthens the muscles in the front of the shin. It is similar to the calf strengthening exercise but you anchor the band on the far side of your foot so you get the resistance as you pull your toes toward your knee. I was told to do as many as I can until it burns. This will later be replaced with exercise #19: Heel Walking (which hits the same muscles and is easy to do at home).

Exercise #10: Quad Sets with E-stim. This is one that I can only do at PT - Basically just quad sets but hitched up to a mini electric stimulation hand held devise. Two pads are attached to my leg (one close to the knee and one further up the thigh). I was told to do 30 reps of flexing the quads as hard as I could. The machine tells me when to flex, and if I contract hard enough it will add some current to flex me even harder – I hold this for 5 seconds and then it has me rest for about 5 seconds. It keeps adjusting up or down in intensity to match how hard I can flex.

Exercise #11: Stationary Bike. Quarter or half turns to start. I started today just rocking the pedals back and forth. On Day 16 I got my first full revolution by day 21 I was riding normally again. I do the stationary bike 5 times a week. At home I use a recumbent, and at PT I use an upright (I also started riding my actual mountain bike on day 46.

Day 16:

* Started on 1 crutch today and also did my first full revolution (backwards) on the bike today.[/i]

Exercise #12: Seated Leg Press. This is another I can only do at PT. I used both legs and started with 30 pounds. I think my good leg was doing all the work and my injured leg was just along for the ride.

Exercise #13: Straight Leg Raises - Adduction.This one you lie on your injured side and your good leg (which is higher up) then steps on front your injured knee so the foot is flat on the floor just in front of the knee. You now flex the injured leg and lift it off the floor towards the ceiling (most people can only lift it a few inches at first) then relax and lower back to the floor. 2 sets of 15.

Day 19:

* I am starting to do many of my PT exercises with my good leg also now (not every session but every now and then).

Week#3:

Day 23:

Exercise #14: Terminal Knee Extensions. Anchor a band to something stationary in front of you and then around your leg so that it anchors to you at the height of your knee, just behind your knee. Now back up until it is taught. Next bend the injured knee forward without moving the foot and then straighten the leg back to 0 degrees extension. I did 2 sets of 15 of this and by the end of the last set my knee was feeling pretty worked (had some pain with this but it seemed OK). I was told the weight distribution should be about 95% of my weight on my uninjured and 5% on my injured leg.

Exercise #15: 3 Way Balance Exercise. For this next exercise I stand just on my injured leg with the knee at 0 degrees extension (or close to it). I stay balanced on this leg for 30 seconds. The first 10 seconds my good leg is extended straight out in front of me, then straight to the side for 10 seconds, and finally straight behind me for 10 seconds (for all of these the good foot is about 1 foot off the floor). That would be 1 set and I do 5 sets total. This was much easier than I thought – I was able to keep my balance and my leg felt strong throughout (maybe 23 years of martial arts has made a difference).

Week #4:

Day 28:

Exercise #16: Standing Calf Raises. I was told to replace calf strengthening Exercises #5 with this one. Just standing on the floor and using both legs slowly go up as high on the balls of the feet as you can, then slowly lower back to the floor. 2 sets to failure, or 2 sets of 30. This replaces exercise #5: Calf Strengthening with Exercise Band.

Day 30:

* Started doing the single leg press today with just the injured leg. He had me put my foot up a little higher than normal to shift some of the work off my quads and onto my glutes.

Exercise #17: Step - Lateral Step Ups. These next 2 exercises I did in pre-surgery to get ready. I stand on a step (short one) and balance on my injured leg. I then slowly lower myself so my left leg (good leg) touches the floor, and then back up again to the starting position. I found initially I could only lower myself and inch or 2 before it started to hurt and I would come back up but as I got stronger I gradually increased the height of the step. He had me initially only do 1 set of 15 but soon got up to 3 sets of 15.

Exercise #18: Step - Front Step Ups. This time I put the step in front of me. Starting from the floor I would just step up onto the step and then back down again. Initially I was told I could do it all just using my injured leg, or I could pause on the step by putting my left leg down. As I progressed I was told to just tap the step with my good leg while at the top and really focus on squeezing the thigh muscle. I did 2 sets of 15. At 7 weeks I was told I could stop doing this exercise. At 8 weeks I started doing this at PT again, but we increased the height of the step to at least double a normal step (more like a short bench). I was told to start with my injured leg on the step and using an explosive movement drive all the way up (I could also assist with a push-off from my good leg), and then a controlled motion all the way down (I never touched my good leg to the step). At 9 weeks I was told to start holding a 10 pound dumbell in each hand when doing the high step ups.

Exercise #19: Heel Walking. Basically just walk around on the heels of your feet with the toes pulled up as high as you can get them. You do this until the front of the shin is feeling a good burn. This replaces exercise #9: Tibialis Anterior Strengthening with Exercise Band.


Week #5:

Day 35:

* Increased standing calf raises to 3 sets to failure and I can also start doing them on a step. In addition I can do those 1 legged or both legs depending on how it feels.

* I can also start stretching my calf the way I was doing it pre-surgery - he had me put the ball of my foot on a telephone book and then lean forward so my hands and/or forearm are on a table and just relax into the stretch (he didn’t want me to just stand on a step and sink because he said too many other muscles are involved to keep balance and keep you from sinking to far down). This replaces exercise #6: Seated Calf Stretch.

Day 37:

Exercise #20: Bridging. This exercise is a basic bridging exercise to work the hamstrings and glutes. Lie on your back and then pull your feet towards your butt so your knees are pointing up (like the end of a heel slide). Now just raise your hips off the floor, pause when as high as you can go, then lower – 2 sets of 15 reps. I was told initially don’t worry if my good leg did more work – which it did – my injured knee and quads also really felt this one (almost like a stretch). This will later be replaced with exercise #25: Physioball Bridging (or if I am tired I still do this one).

Exercise #21: Proprioception Balancing. Stand on just my injured leg and close my eyes. See how long I can balance without opening eyes, touching the other foot down or touching anything with my hands – if any of that happens re-start the timing. Then do the same with the good leg. I went back and forth for about 3 to 5 minutes and would say at this point I was balancing for about 30 to 40 seconds on each side. I have not talked to my PT about this yet but I think I will do my first balancing exercise in one of my daily pt sessions and then this one in my 2nd daily pt session – but not both each time.

Day 41:

Exercise #22: Step - Step Downs. I started on the step and basically just stepped down like going down a flight of stairs (leaving my good leg up on the step), and then stepped back up. I did this about 30 times today and was told to gradually work up to 3 sets of 15 (I was basically doing these at home already but just on a shorter step). You really want to focus on your control as you lower yourself. I was told to imagine an egg on the floor and you want to lower youself slowly so you don't just fall off and crush the egg (in the beginning that will be very difficult but that is what you are working towards).

Exercise #23: Standing Hamstring Curls. This exercise is a standing hamstring curl with a 5 pound weight on my ankle. I did 3 sets of 15 and these were pretty easy. At 7 weeks I was told on one day do this with exercise 25: Physioball Bridging, and on the next do just exercise 31: Chair Walking – no need to do all 3 on the same day.

Exercise #24: KAT Balancing. This exercise is the same 3 way balance exercise #13 I have been doing (hold good leg out in front, to the side and then behind me for 10 seconds in each position) but I did it standing on a piece of equipment called the KAT. It is basically like a balance/wobble board but you have a little hand squeeze thing to pump up the base to set the amount of wobble it has. This too was pretty easy. I do this at home on a wobble board. At 13 weeks I started balancing on one leg (on the wobble board) and my PT I would basically play catch with a weight ball.

Week #6:

* I was told at this point I should be doing 3 sets of each exercise (or more if indicated) of all my different exercises but that I could drop down to just 1 session of exercising per day (and to push myself hard when I feel strong).

Day 44:

Exercise #25: Physioball Bridging. This exercise is bridging on the ball (which I had already started to do on my own, but this version is more difficult). I would lie on my back with my heels up on the ball. The firsts step is to raise your butt so there is a straight line from your shoulders on the floor, to your butt and through to your heels (you should look like a straight plank of wood). Next you pull your heels to your butt bending at the knees and driving your hips straight up (at the top of this position you want a straight line from your knees to your butt and through to your shoulders on the floor) – this motion will roll the ball towards you, you then extend the feet away from you (this rolls the ball away from you) and you are in the straight plank position again, and then relax back down to the floor. The goal is 3 sets of 15 (although on my first day trying this on the 3rd set I got to the point where I just bridged to the plank and back down again). This replaces exercise #20: Bridging (although when I am tired or sore I still do the straight bridging). At 7 weeks I was told on one day do this with exercise 23: Standing Hamstring Curl, and on the next do just exercise 31: Chair Walking – no need to do all 3 on the same day.

Exercise #26: Balancing - Dumbell Pickup. This is another new balancing exercise (I was told to just do one balancing exercise per training session and just pick from the various ones I have). Stand on bad leg, hold a weight in opposite hand (just 2 pounds) and then bend forward and set the weight on floor, hover for a moment, then pick up weight and stand back up. I can rest in between or do as many as I want without putting my good leg down (I was also told to mix up trying to bend my leg to lower myself which works the knee more, or just bend more at the hip which works the hamstring more.) Another way to do this is start with the weight in your hand, bend down and place it on floor, stand back up, pause for a moment on one leg, then bend down, pick it up, stand back up and pause again on one leg (that would be 1 rep, and since it is 2 motions you would just do 5 reps for each set).

[Rob_W]

Week #6 (Continued):

Exercise #27: Balancing – Corner Touching. I was also told that I could start doing a balancing exercise that I was doing pre-op where I place two books on the floor about 2 feet in front of me, and spaced about 3 to 4 feet apart (so they are out at 45 degree angle from me). I then stand just on my injured leg and bend down and touch the book to my right with my right hand (I am told to put it as far away as I possible can so I really have to reach for it), then I stand back up (not touching the other foot to the floor), and then I do the same but this time my left hand touches the book way to my left, I then stand back up (again without ever touching the other foot to the floor). I then repeat this 9 more times on the injured leg (without ever touching down). That is one set, and I am to do 3 sets on each leg (so a total of 30 reps on each leg). Those were the reps I was doing pre-surgery so I imagine I can do less now to start and check my balance during the sets if I need to. At 8 weeks I was told to start doing 2 sets of 20 reps each (and each set I touch each book 10 times).

Exercise #28: Rowing. I actually started this at Day 25 as a quick warm-up for my knee before I got on the stationary bike (about 3 minutes), but at this point I will start substituting at least one stationary bike session per week and row for about 20 minutes (I currently ride the bike 5 times per week for 20 minutes each session - as of 9/1/07). I was doing this same thing pre-surgery.

Exercise #29: Physioball Squats. I have not officially started these in PT yet but was given the OK to do them. I was told to limit my squatting types of exercise (this includes leg press) to no more than 3 times per week. Since Igo to PT twice a week and do the leg press in both sessions that means 1 day a week on my own I can do a squatting type of exercise if I want. Start standing with your back to the wall and a physioball between you and the wall (basically leaning on it slightly with your mid-back). Stand with your feet about shoulder width apart and slowly start to sink down bending at the knees. Make sure your knees to do not go forward past your toes (general rule for all squatting exercises). When you get to the bottom of the motion reverse direction and push back up (make sure you are pushing with the whole foot and not just the ball of the foot). The distance you travel down than up will depend on how long you have been doing the exercise - in the beginning just a few inches will probably be all you can do. Like most of the other exercises your goal is 3 sets of 15.

Exercise #30: Foam Roller. I was given the OK to start using my foam roller. I use it currently for the IT band, but will gradually start using it for the hamstrings, quads and inner-thigh (I also use it for my entire back and lats too). Keep in mind if you have never used a foam roller it can be pretty painful the first week or two, but the pain will quickly diminish and things will start to feel really good as you use it more. Here is a link that I stole from Feeny's exercise thread that might be helpful to any who have never used a foam roller: http://www.youtube.com/watch?v=t32xJspx50o&NR=1

Week #7:

* I was told at this point I should be doing 3 sets of each exercise (or more if indicated) of all my different exercises but that I could drop down to just 1 session of exercising per day (and to push myself hard when I feel strong). I was also told that he should have told me this at week #6 so I put this note there also.

Exercise #31: Chair Walking. Sit down on a rolling chair and just using your injured leg extend it as far forward as you can reach, and then put it on the floor and pull so you roll the chair forward. Do about 20 reps of that in one direction. Turn around so you are facing the other direction and use your good leg to pull yourself back. I am starting with 3 sets in each direction (so 60 reps with each leg). I was told on one day do exercise 23: Standing Hamstring Curl and exercise 25: Physioball Bridging, and on the next do just this exercise – no need to do all 3 on the same day.

Exercise #32: Prone Quad Stretch (with Belt - optional). This description is to stretch your right quad. Lie on your back as close to the edge of a table (or bed/couch) as you can get without falling off to your right. Pull your left knee towards your chest and hold it with your left hand. Drop your right leg off the side of the table and loop a belt around the foot/ankle and grab that with your right hand. Now just pull with your hand so you pull your foot towards your butt and get a good stretch in the quad (position your knee so you feel like you are stretching the quad more than just working ROM in the knee). Hold for a minimum of 30 seconds. He told me this is about the best stretch you can do for your quads. At 10 weeks he started having me just grab my ankle with my hand and not using the belt - everything else remained the same.

Week #8:

Exercise #33: Lunges with Dumbbells. This is an easier version of the lunge because you start in the lunge position and just fall and rise in this position (rather than stepping into it and out of it). He had me work it with my injured leg forward for every set, and not my good leg forward yet. Make sure your lead knee does not bend forward past your toes. Lower yourself to as far as you feel comfortable. He said at this point it was probably more of a balance exercise than a quad strengthening exercise due to these modifications. The goal is to work for 3 sets of 15.

Exercise #34: Balancing – With Exercise Band. Anchor one end of the exercise band to something about waist high (you could tie it on a bed post or something). Back away so there is tension in the band. Hold the band with the same side as the injured leg. Now standing on just the injured leg bend forward and reach towards where the band is anchored (this will start to take tension off of the band), and then straighten back up and at the end of the movement you do the ending motion of a row pulling your hand towards your waist with your elbow sticking out behind you and your closed fist palm is facing up. The goal is to work for 3 sets of 15.

Week #9

Exercise #35: Walking. I have already been doing this but he did check to see if I have been walking 2 to 3 times per week for about 25 to 30 minutes.

Exercise #36: Walking – Backwards on Treadmill. He started me on backwards walking on the treadmill today. He said it was great for the hamstring and I also felt it quite a bit in the muscles in the front of the shins (tibialis anterior). I did 5 minutes today (I only had 5 minutes left in my session so not sure if I will normally go longer). I also do not have a tread mill at home so he said I would just do it at my weekly visit for now.

Exercise #37: Plyo Mini Hops. This is a plyometric exercise designed to enhance the explosiveness of the muscles and builds speed and strength (great for sports). Start with your hands above your heads. Now just pop off the floor slightly using primarily your calf muscles (it looks like a little mini bounce and you probably go about 1 inch off the floor) and do this continuously through for 30 reps. Make sure you keep the knees soft (keep a slight bend in them at all times). He had me do 3 sets of 30 and told me to do this twice per week. This is my first impact exercise.

Week #10

Exercise #38: Straight Leg Lowers with Exercise Band. I don't really have the setup to do this at home so will just do it weekly at PT. It's almost the opposite of a straight leg raise. Lie on the floor with your head close to the wall and your feet furthest away. Attach an exercise band to your ankle and then to the wall behind you above your head (high up on the wall). Start with your leg straight up in the air (and some tension in the band). Now quickly lower you leg to the floor, and then slower back to the starting position. You should keep a slight bend in your knee. Do 3 sets of 15.

Exercise #39: Side Lung. Start with your feet together. Assuming you injured your right leg, step out to your right a little bit wider than shoulder width and go into a slight squat on that side (left leg straight and right leg bending feeling as if you are starting to sit down into a chair). Make sure as you go down your right knee does not go further to the right than you right foot. Now push off of the right foot so you go back to the starting position with your feet together. Do 3 sets of 15.


Updated Routine at 10 Weeks:

This will be my core routine for a while.

Biking: 5 times per week for 30 minutes
Walking: 2 times per week for 30 minutes (5 minutes of backwards walking per session)

Do the following PT routines at least 5 times per week total (alternating between #1 and #2) - Take up to 2 days off for rest if needed from PT exercises. For example, Monday PT Routine #1, Tuesday PT Routine #2, Wednesday Rest, Thursday PT Routine #1, Friday PT Routine #2, Saturday PT Routine #1, Sunday PT Routine #2.Details for each exercise can be found in above posts.

PT Routine #1:

1. Straight Leg Raise
2. Straight Leg Raise - Adduction
3. Straight Leg Raise - Abduction
4. Standing Hamstring Curl W/Ankle Weights
5. Lunges W/Dumbells
6. Side Lunges
7. Plyo Mini Hops (as of 15 weeks I was told to pick 2 plyo exercises each session - but only twice per week)
8. Standing Calf Stretch
9. Hamstring Stretch
10. Prone Quad Stretch

PT Routine #2:

1. Step - Lateral Step Ups
2. Step - Front Step Ups
3. Step - Step Downs
4. Wobble Board Balancing
5. Balancing - Dumbell Pickup or Balance - Corner Touching
6. Standing Calf Raises
7. Physio Ball Squats or Standing Squats
8. Standing Calf Stretch
9. Hamstring Stretch
10. Prone Quad Stretch

I was told that this will be my core workout for a longtime, but that I could substitute in similar exercises when I wanted to. For example, instead of doing Lunges W/Dumbells I could do Walking/Twisiting Lunges with Medicine Ball. Another example might be skipping the Standing Hamstring Curl and doing the PhysioBall Bridging that hits the hamstrings...


Week# 11

Exercise #40: Plyo Squat Jumps: Start with your feet about shoulder width apart. Lower yourself into a partial squat position. From this low point swing your arms towards the ceiling (bent elbows) to help slightly with momentum and jump up in the air (only a few inches to start). When you land you want to have soft knees (bent knees) and decelerate into the starting position. He said at this point there is no need to rush to the next jump (reset yourself in between each jump). 2 sets of 10 no more than twice per week (maybe even just once per week to start).

Exercise #41: Walking/Twisting Lunges W/Medicine Ball: I did these holding a 10 pound medicine ball in front of me. Step out into a lunge with your left leg forward and twist the ball (turning your upper body) to your left (keep your left knee pointing straight forward). From hear rise up and step out with your right doing the twist to your right. I did 3 sets of 10 steps to start.

Exercise #42: K.A.T. Balancing W/Exercise Band: Anchor an exercise band to the wall in front you you and hold one side of the band in each hand (the middle is anchored - or just wrapped something stationary) and you want so tension in the band. Stand on a wobble board with your injured leg. Now, with your hands down by your sides, just pump your arms forwards and backwards (about 6 to 12 inches) as you balance. Do the pumping motion about 50 times, and do 3 sets of this. Now turn around and do the same thing so the exercise band is anchored behind you.

Week #13

Exercise #43: Plyo Lateral Jumps: Start standing on one leg and jump laterally (maybe a couple of feet) and land on your other leg, pause for a moment, and then jump back to where you started. Do 2 sets to start where you land on each leg 10 times in each set. Make sure that as you land you have a soft knee (it is bending to help you decelerate). Don't rush these - when you land do almost a quarter squat and sit your butt down a little before jumping back to the other side.

Week #14

Exercise #44: Wobble Board Squats: This is just like it sounds. Balance yourself on a wobble board and then start doing squats - I was only do a 1/4 of the full squatting motion. Stick your arms out straight and look up a little bit as you feel as if you are sitting down into the squat. I was working for 3 sets of 15.

Exercises #45: Dumbell Press (with squat): This exercise almost resembles a clean and jerk type of motion. Start with two dumbells on the floor to each side of your feet. Squat down and grab the dumbells. Drive to an upright position and using your arms kind of raise the dumbells to the position at your shoulders where you would normally press from. Now just press the dumbells straight over head then lower them back to your shoudlers. From here lower the dumbells so your arms are by your sides and then finish by squatting back down and touching the dumbells to the floor. I was working for 3 sets of 15 with a light weight (10 pound dumbells).

Week #15

* At this point we modified my program so I will be mixing up treadmill workouts, stationary bike workouts and rowing machine workouts. Basically shoot for 4 or 5 sessions per week at 30 minutes per session.

Exercise #46: Treadmill Variations: 30 minutes on the treadmill mixing up the following variations.
   1. Standard Forward Jog
   2. Backwards Walk
   3. Sideways shuffle (both sides leading)
   4. Shuffle with a cross in front and then a cross behind step. This does put a slight twisting motion on the knee so go slow and easy with this (both sides leading)

Exercise #47: Plyo 90 Degree Turns: Start facing forward with feet spread about shoulder width. Jump up and turn 90 degrees to your right and land in same position (make sure you bend your knees as you land). Jump up and turn 90 degree to your left so you are back to the position you started in. Now do the same turning again to your left 90 degrees. Finish by jumping and turning to your right 90 degrees so you are in the position you started in. That would be 1 repetition. My goal was 3 sets of 5 repetitions.

Exercise #48: Plyo Lateral Ski Jumps: Stand with your feet pretty close together (maybe 1 or 2 inches between them). Place something on the floor to your left almost touching your foot (about 1 to 2 inches tall to start - you can just imagine this too). Now jump up and over to your left landing in the same position with soft knees, pause for a brief moment and then jump back to the starting position. That would be 1 repetion and my goal was 3 sets of 10 repetitions.

Exercise #49: Plyo Jump Ups: Start standing on the floor with a short step in front of you. Jump up and land on the step with just the balls of your feet. Jump back down to the starting position. That would be 1 repetition and my goal was 3 sets of 10 repetitions.

Week #20

Exercise #50: Plyo Lunge Jumps: Stat in a lowered lunge position (as low as you can comfortable go) - let's assume you start with your right foot forward. Jump up and change your feet in mid air so you land in a left foot forward lunge position (keep your knees soft so as you land you sink down to the same height you started from. That would be 1 repetition and my goal was 3 sets of 10 repetitions.

Week 28:

Exercise #51: Leg Extensions: My PT Ok’d me to work on light leg extensions (start with ankle weights and work up to machines and heavier weights). He actually said I probably could have started this 6 weeks ago.

Exercise #52: Caricoa: This is a modified shuffle. Run sideways about 5 yards to your left and alternate crossing your right foot in front, and then crossing it behindm, and then change directions and do the same thing running sideways back to your left. This has some mild twisting and pivoting actions. He said start with about 5 times in both directions.

Exercise #52: Skater: This exercise looks a little like a speed skater, and also a little like Exercises #43: Lateral Jumps (see that description). The biggest difference between this and #43 is you go a little faster and the leg that is not landing crosses behind the lead leg and kind of sticks out in the air (this forces you to catch your balance better and works the knee more). So if I am jumping to my left and landing on my left leg, my right leg kind of drifts behind my left leg and my foot is pointing to the left (again – this actual looks like a speed skater).

Exercise #53: Obstacle Shuffle: We did two versions of this – a wide version and a narrow version. They are both the same movement but the narrow version just has you moving quite a bit faster. For the wide version place two small obstacles (something that is only 1 or 2 inches tall) about 5 feet apart. Assume you start standing on the left side of one of the obstacles (so the other one is about 5 feet away from you to your right and the close one is just next to your left foot). Now you are going to shuffle from where you are to your right and to the far side of the obstacle. Your right foot will step down once in between the obstacles, and your left foot will do the same (so to get to the far side you will step with your right, then your left (you are now in the middle) and then with your right and lastly with the left again (and you are now on the far side of the right obstacle)). Now reverse the direction and come back. That would be 1 repetition and he had me doing 15 repetitions (moving fairly quickly). Now place the obstacles about 2 feet apart and do the same thing and it will speed the entire motion up.

Exercise #54: T’s: You need a decent size space for this (either outside or a large room). Imagine a T drawn on the floor and you are standing at the bottom of the T. The distance from you to the top of the T should be about 15 yards, and the distance from the top left of the T to the top right of the T should be about 15 yards. Sprint straight forward and when you get to the top of the T squat down a little and touch the floor (you should look like a football player (American football – not soccer) where the center is about to hike the ball). You then immediately shuffle sideways to your right until you hit to top right side of the T and do the same touch down. Now immediately shuffle to your left to the top left of the T and do that same touchdown. Now run backwards to the bottom of the T (your starting point) and do the final touchdown. That would be 1 repetition and he had me doing 10 of these.

[Rob_W]

The 1st post hit the maximum number of characters so I had to continue on a 2nd post - I am just posting this for a place holder just in case I need a 3rd post at some point in the future (let's hope not - that would be alot of exercises for one injury!!)

[celinenj03]

Rob, your journal is excellent and right on point. I have no doubt you will have an excellent recovery with this routine. Keep us posted with your progress! and God bless,

[Rob_W]

Thanks Celine.

[cmvsm]

Hey Rob.  I was given the OK by my OS today to do the eliptical machine.  Are you going to be doing it anytime soon? 

[Rob_W]

CM - It has not been mentioned yet so not really sure. I have no real interest in doing it unless they tell me it is something I should be doing (I don't have access to one so it would mean signing up at a gym just to do that one piece of equipment). I'll definitely post here if I am told to do it.

[cassieoz]

Hey Rob do you get any pain with number 50? All these exercises are great, i have started doing some of your latest ones.

Cassie

[Rob_W]

Cassie,

Many of the exercises I still find slightly painful sometimes (like controlled step downs) - oddly however, I usually don't find the Plyo Lunge Jumps that painful (but for some reason when I am working a regular lunge with my injured leg back I sometimes still find that painful - I think it is how deep I go on the regular ones compared to the jumps maybe)?

Keep in mind I was told to only work the plyo's once a week at most (they are very demanding on the knee - I do the Plyo Mini Hops twice per week) - I do them at the end of my PT workout when my knee is very warmed up (if I did them early in the workout I think they would be more painful - I happen to do my regular lunges earlier in the workout so that also might be why those are sometimes still painful).

I am still working the updated workout that I put in green text - the only difference is in Routine #1, once per week I do about 3 to 4 different plyo exercises (not just the mini-hops like outlined in that section).

Rob

[Rob_W]

Just a quick note that since I was officially released from PT in February I most likely won't be updating this post since I wanted to keep it strictly exercises I learned at PT and not just exercises I do.

I sent my PT an e-mail asking him at this point how often should I be doing my knee specific PT sessions and he sent back the following:

Once you hit that 6 month post-op time frame as long as you are physically active and the knee does not interfere with your activity level, you do not need to keep up with the routine. The idea of the surgery and rehab is to get your knee to the point of full functioning. That being said, the exercises are just good exercises from a conditioning stand point so you could always integrate them into your weekly workout.