“Help!” Continues . . . So you’ve had ACL Reconstruction, Now What??

Hi! We are continuing our discussion on ACL tears and last post we talked about what to do if you think you have torn your ACL. Today we will discuss Rehabilitation and all the questions you should ask your Physical Therapist and Orthopaedic Surgeon and the answers they may give you . . .

If you missed the first part you can read it here Help! My daughter tore her ACL . . . We think??

So you’ve had surgery . . . 20150625__701135-s500-phHopefully you are feeling like you made a great choice ~ I don’t suspect you are necessarily happy with needing surgery and the coming rehabilitation but now that your joint is stable again proper healing can begin ~ its uphill from here baby!

I suspect you have the lots of questions tho . . .

  • How long do I have toimages-8
    • take meds
    • use the crutches
    • wear a brace
    • keep icing
  • When will it stop
    • hurting
    • being so swollen 
  • When can I get back to
    • sports
    • school/work
    • walking normally
  • Is this normal???

First lets talk about some common things you may be surprised by or concerned about that your  surgeon may not have mentioned . . .

  1. You may have a LOT of pain and swellingtherapeutic-drugs-monitoring-19-638
    1. STAY ON YOUR MEDS AS LONG AS YOU NEED TO!
      The pain and anti-inflammatory medication is needed to manage the pain and swelling along with frequent icing for the first days after surgery. If you do not take your medications regularly they will not build up in your system enough to control the pain and swelling.
    2. It is okay to use the ice machine that was sent home with you as much as you need. It doesn’t really freeze your knee just keeps it cool and comfortable.
    3. elevate your leg as much as you can during the day.
  2. You may bruise ~ tearing your ACL and Surgery are both internal injuries that can cause bruising.
  3. You may have trouble sleeping ~ Because of the pain and swelling, you may not be able to find a comfortable position.
  4. You may feel nauseous
    1. This should only last a day or two 
    2. if it lasts longer the pain medication may not be sitting well in your stomach. Speak to your physician about a different medication.
  5. You may feel more tired ~ everything you do may require more effort.
    1. Getting in/out of the car
    2. Walking with brace and crutches
    3. You may have trouble lifting your leg
      1. It will be heavy and your muscles may not be working well.

Lastly, you will (sometime in the rehabilitation process)images-6

be frustrated at the speed of recovery,

be concerned about your progress,

be anxious to get back playing your sport,

be sad that this is taking sooooo long,

be angry that this happened!

Allow yourself to have these feelings, sit with them, embrace them, accept them and move through them ~ it’s a part of the healing process.

A typical rehabilitation protocol looks like this:

Phase 1

  • Control pain and swelling with ice, medications and exercise to create optimal healing conditions.
  • Keep muscles working with exercise to avoid atrophy.
  • Introduce joint range of motion with exercise to prevent stiffening of tissues.
  • Continue wearing brace until you have adequate quad muscle control to protect ACL ~ usually 2-6 weeks depending on surgeon.
  • Use of crutches as needed when walking ~ usually only 1-2 weeks.

Phase 2 ~ continue with above and . . .

  • Introduce coordination exercises if haven’t already.
  • 6 weeks is a key healing time requiring protection of graft ~ at this point many people are feeling better and assume they can doing things that could put the graft at risk for tearing.
  • Toward the middle and end of this phase introduce balance, agility and coordination.

Phase 3 ~ continue with the above and . . .

  • Increasing speed with balance, agility and coordination
  • Remediate movement pattern dysfunction to prevent future injury.

Phase 4 ~ Return to Sport

  • Typically return to practice with a specialized knee brace at 8-9 months and playing in games at 9-12 months.
  • All making sure that you are using normal movement patterns and are cross training the opposite movements as well to reduce your risk of future injury

So there you have it  . . . The Nutshell Version of ALC rehabilitation!

Have I answered your questions? Created more? Post below and let me know . . .

Speak with you soon! Roxi

The Sport Specialized A.T.H.L.E.T.E.

The third in the series: The Athlete and the Injury . . .

kickinball
Sport Specialized Athlete

Here are some guidelines for the Sport Specialized Athlete:

Allow for rest and recovery

You must build in recovery days to your training schedule to maximize the benefit of your training as well as reduce risk of injury.

Your training is designed to build specific skills but in doing this the muscles, tendons, and ligaments take stresses that the body is not designed to take. The body needs time to recover and heal from these stresses placed upon them in order to improve your athletic performance.

Take time to condition

Incorporate flexibility, strengthening, agility, and cardiovascular exercises into your training. If you are just playing your sport you will miss out on needed conditioning that will prevent injury and improve your skill!

Hydrate

As you sweat you will need to replenish with water. You should be taking in about one ounce of water per 2/3rds of your body weight, so if you weight 150 pound = 100 oz of water a day. This can change based on how active you are. If you are sweating for more than an hour a day drink more maybe add a sports drinks for the electrolytes you are losing.

Two hints

  1. If you are thirsty you are already dehydrated! 
  2. Chocolate milk is a great recovery drink for after competition or a intense workout!

Live your whole life

Remember that sports is one component of you life ~ school, family, friends, relaxation, and fun must all play a role!

Expect overuse problems

When you perform the same types of motions day in and day out those body structures can suffer fatigue and failure. Because you are training at such a high performing, highly skilled level you are prone to injuries that we used to only see in adults. And your growing body presents other challenges as well. Sometime in your athletic career you will have an injury, the important thing to know is how to manage it without creating permanent problems or losing your edge.

Talk to your PT

Your Physical Therapist is the human movement specialist. They will help you with injury prevention strategies, general and sport specific conditioning, and injury rehabilitation. If you do not have a physical therapist you consult and trust, FIND ONE!

Exercise in other ways

Like living your whole life, be active in ways that don’t involve your sport. Take a walk, hike, bike or swim. Play a different sport with friends. The physical demands of soccer are much different than the physical demands of basketball! Providing your body with multiple physical experiences helps to prevent injury and enhances your overall sport performance!

Stay tuned . . . Up Next, the Active Play Athlete!