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Author Topic: 4 months post ACLr - looking for advice  (Read 672 times)

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Offline kiaran95

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4 months post ACLr - looking for advice
« on: January 10, 2015, 07:54:45 PM »
Hi all, first time I've been on here in a while, but I see that as a good sign. I had ACL recon on the 15th September, so soon I will be on the 4 month mark.  I cannot really afford professional physiotherapy advice so I have decided to rehab my knee my self using the internet and the principle of 'if it hurts don't do that for a little while' and so far it has been working pretty well.

Over the last few weeks I have moved on from home exercises to the gym, and have been doing leg weights, averagely I have been going to the gym 3 day per week do to weights + stretch and for the remaining 4 I stretch and do not do any strengthening exercises.

Typically at the gym I do 3 sets of 15 per gym session of the following machine (weighted) exercises:
- Leg Extension
- Hamstring curls
- Seated leg presses
- Hip Abduction
- Hip Adduction
- Calf Press

Weights are what I feel comfortable with, usually an indication of what is too much is when my knee and muscle I work starts to tremble.

Also been doing squats with medicine ball in-between legs to focus on the VMO, aswell as running on the spot, on treadmill (max amount of time of continuous running between 10 and 15 mins), step ups, jumping on the spot. I do not ice my knee any more as I have no swelling and hardly any pain from this exercise regime, my knee hasn't caused me any discomfort for quite sometime, but only my leg muscles have hurt the day after a workout.

In terms of the muscle loss, I'd say I have noticed an increase in the muscle amount since the first couple of weeks post-op, but still way off replicating my other leg, I guess that is the main goal for recovery for returning to sports?

What I'm mainly asking for is someone to comment on my recovery based on what I've said aswell as anything i'm missing exercise wise, it is an entirely open ended question I know but I'd be grateful for any advice or words of encouragement in terms of the stage of my recovery I am at. Just to reiterate, I am aware that a physio will provide me with the best and most personal answer, but as stated before it's really not an option.

I welcome any sort of comments, all will be a help!!!

Offline mjeffrey

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Re: 4 months post ACLr - looking for advice
« Reply #1 on: January 11, 2015, 03:09:55 PM »
Hi kiaran95

Assuming you know how to do the exercises correctly, the key things for gaining strength/size are nutrition, progressive overload and rest. If any of these aren’t there you’ll get sub optimal results. Typically these are done badly and people get poor results.
Most people don’t eat enough protein and calories. You should have a high protein meal just after you’re workout (I workout in my lunch hour, have a protein shake before my shower and then eat lunch afterwards). On workout days eat more calories and non-workout days eat less to avoid putting on too much fat  (it feels natural to do this as well). If you’re already overweight (or should I say overfat) and a beginner, cut calories but increase protein, it is possible for beginners to gain muscle while losing fat but not for the rest of us unfortunately.

Progressive overload is important. Take it very SLOWLY but steadily increase weight over months and continue overloading the muscles. You’ll eventually plateau but there are ways to break a plateau but that is too much detail for now. Keep a record of your sets and weights, if you don’t you’ll forget what you did last time! Your first set should be a warm-up of 8-12 reps at about 70% of the work weight (or more at lower weight).

If you’re trying to gain strength then you’re doing way too many reps. For size you’re also doing too many reps.
For strength the optimal is a low number of reps (e.g. 3-4) at near maximum effort (but this risky and only for intermediate/advanced lifters).  For size (plus strength) more is ok, 8-12 is often recommended though some people recommend less. I do 8 for most exercises and 3-4 occasionally when I want to mix it up a little.

Have someone who knows (most fitness instructors are pretty clueless) check your form every couple of months (I used to video myself for important exercises like dead lifts and squats). It is easy to slip into bad habits especially when pushing the limits. Check what is good form from reputable sites like here Remember that a rep done without good form does not count as completed! They have good advice for beginners as well

Recovery normally takes at least two days but more for older people or as you become more advanced. I try to leave at least 3 days between each workout for one body part and do a split routine to achieve this.

Avoid injury at all costs! That extra rep or 5kg is not worth it if you end up injured and unable to exercise for 3 months.

Concentrate when you do the exercises (leave your phone in the locker) and think about your targeted muscles on EVERY rep. I stretch between reps or do proprioception exercises just to keep focused on work and not be a zombie sitting on a machine.

Stick with the basics – the latest fad supplement, killer workout is almost certainly just BS.

Good luck

p.s. did I mention that nutrition is important?
p.p.s You can target the VMO with leg extension if you angle you toes out a bit. Don’t start with too much angle and concentrate on contracting the VMO before and during the effort especially during the “pause”. Take a second to reach maximum extension then pause for half a second, lower the weight under control for 2 seconds (this is a good tempo for all exercises).

20 Feb: Comminuted patella fracture, 4 K-wires, Cercalge, Figure of 8
11 Mar: Staples removed Flex 50
22 Apr: Control Xray, flex 80, progress stalled
09 May: MUA: flex 120, 3 weeks CPM
23 Jun: Slow Running, Flex 135
06 Jul: Flex 140
08 Aug: Hardware removed
10 Sep: full flexion