ACL rupture

From my experience of ACL rehabs, i definitely agree with Nancy that the hamstrings are crucial for knee stability too.

You need to 'surround the dragon' on this one. So muscle balance of the quadriceps, hamstrings and glutes is essential. The glutes can often be overlooked, and with weak glutes, people generally tend to internally rotate their femur, which has a large imapct upon the knee bringing you into overpronation also.

For eg. a weak glute med, usually results in instability of the pelvis in the frontal plane, and will bring the femur into internal rotation again leading to overpronation. People with this (trendelenburg syndrome) also often develop repeated ankle sprains on the same side as the weak glute med.

Even the coordination of your core will help. For e.g, if you have a lack of coordination in your lower abdominals, then you may be pulled into an anterior pelvic tilt which can hyper extend the knees and cause overpronation again!

It is then essential to teach the strengthened and balanced muscles to activate during functional movement patterns too.

Anyway, i wish you the best of luck as i know the process you are going through is a tough one. Always look at the whole package, not just the site of the injury.

James

p.s the VMO will probably atrophy to a large extent too. - this is a b*tch to strengthen!!

Sunshine,

Sorry, just signed on and read your post. From my own experience after surgery - hhmmm -

Short-term, depends on the Ortho (seem like most surgeries my Ortho performs are practically all knee related - which is a good thing) so shop around for a good one, extent of damage and how much repair work is done. I had my surgery on a Friday, WALKED out of the hospital and never used the crutches I was given (great Ortho!). Did EXACTLY what my Ortho told me to do, or NOT to do. In other words, 1 day at a time. Another student at the school where I trained (he was 19 at the time - BTW, I was 42 at the time of my surgery) ended up NOT listening to his Ortho and was on crutches for 8 weeks and not back to training until after 4 months. I was back to training, although lightly, in 4 weeks.

Personally, I wanted to get back to training (Taekwondo) right away - however, since I am a "little older and hopefully wiser", I knew better. However, what I did do was use those "rubber band" type exercise bands (slowly and not many reps at first) to start my rehab at home, strengthening the hamstrings as well as the quads and glutes. I also started "walking" (distance-wise, fast-paced). When I went back to my Ortho to get the stitches removed, he was thrilled with my progress.

Long-term - I continue to work the hamstrings, quads and glutes, now using weight machines as well as utilize the treadmills at the gym I now train at. I don't ever want to not be able to train again :D.

Having a great outlook helps mentally and preparing yourself to "help" yourself afterwards. My Ortho did not have to prescribe rehab for me because I took it upon myself to "work it out" on my own (carefully). The more information, I found, that you have before, the better off you are after.

If you have any more specific questions that I may be able to answer, please let me know - I'd be glad to pass on "my experience" with you.

Nancy

The ACL prevents the tibia from moving foreward of the kneecap so the biggest muscle grouping you should look at is strengthing your hamstrings. They will anchor your knee.
You must make sure you do not have too much of a muscle imbalance in your thighs so go careful to ensure your quads are not stronger than the hamstrings.

Try to avoid open chain exercises like hamstring curl as when your feet are not in contact with the ground or weight plate your knee is the only point of anchor and it puts too much strain through the knee joint.
Try free weights - deadlift / squats / straight lefg deadlifts
try hack squats / leg press.

Good luck

Can anyone help????????
I had a injury playing football in Feb, where i heard a snap from my right knee. The long and the short was I had a MRI scan in April where is was discovered that i had a torn ACL. It was decided by my consultant not to have surgery. I am 37yrs old and i think that also had a part in the decision making from my consultant, even tho he has sent the results off for a second opinion. I was advised to go and have a two wk intense physio and rehab sessions. Prior to that i was doing physio twice a week and doing my own training at the gym, and was lucky to have built my quads and hamstrings up.
Reading some of the comments it seems the hamstring plays a cruical part of a stable knee. One of the exercises i need to start doing is twisting on my leg. Can anyone recommend any exercises i can do in the gym in addition to what i am doing now?????????

To be honest OC i'm extremely suprised that your consultant did not book you in for reconstructive surgery. As the ACL has very little blood flow to it is tends not to heal very well if at all. Do you know what level of tear you suffered? This is normally a 1, 2 or 3. Personally I had a grade three in both MCL and ACL and have had the reconstructive surgery around 8 weeks ago now.

Without surgery i understand that you will experience greatly reduced knee stability and are threfore likely to tear your ACL completely or one of the other knee ligaments (MCL, PCL etc).

Mike

Not sure what grade it was, my consultant just studied the result and said no surgery. The rest of the knee was intact, which was a good thing, it was just the ACL was torn (thats what it said on the MRI results). I'm thinking it was minor, just finished physio and have been given the go ahead to return to work. Did the usual stuff, running, side steps, hopping etc...
The leg performed well, mind you have been at the gym for the last two months building on the muscles. To be honest the leg feels great (without putting a curse on myself) I rang the hospital and they told me its gone to the knee specialist for a second opinion. Its a strange one, will keep you up-dated.
What was the recovery time after yor surgery?

Help! Just got a call to say can I come in for my op on Friday 5th Sept 2008.My story is; injured my right leg playing 5 a side March 2007, left it for 6 months to heal, still pain when compressing so went to docs, finally got scanned in May 2008 showed ruptured ACL and tear in cartlidge.State of leg by now is no pain even on full compression, can run around and boot a football, not competitvely!. I am still cautious when twisting and turning as something occasionally seems to flip inside. Quite a lot of the time I have a dull ache in my knee. I am a 39 year old female. Surgeon recommends I have the op, says I'm a good case for surgery. Really in two minds, have read loads. I am booked in to have ACL recon using hamstring and cartlidge repair. Don't know if it will make it worse or whether it will put life back into me after rehab. ANY SUGGESTIONS? But they better be quick! Thanks

Hallo Linda,

I have just read your entry from August. Did you have the reconstruction?
I am in the same situation apart from the fact that between 1991 and 1994 I have already been through this scenario. ACL tear and a tear to the medial meniscus were repaired with exactly this technique but the ACL has torn again (had the scan yesterday). If you have had the op then you must be nearing the end of the first stage of rehab and I hope everything is going well. If not, please tell me what factors made you make that decision.

All the best,

Graham.