“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

Life Lessons . . . Sarcopenia


I’ve been absent from blogging for about a month. We went to Germany for vacation. Upon returning home it took a week to adjust, as usual. We had multiple appointments and the kids started school. I mention all this not as an excuse but because it has helped me to learn a life lesson. The kind of life lesson that you embrace in your head (because you teach it to others) but have never truly embraced in your heart, as a way of life.

In Germany we walked an average of 8 miles a day, touring the cities and towns. For the first few days I was stiff and sore ~ yoga (und bier) helped. My knee (plagued with 30 years of patellofemoral tracking issues) was killing me for a day or so. By the third or fourth day I woke feeling young, strong, vibrant ~ 18 years old again!! No achy joints, no struggling to get up from a chair, no jolting of my frame when running across the street!

 The life lesson I learned in Germany. . .

 . . . Exercise Keeps You Young.

 Related to this topic is Sarcopenia or muscle loss that occurs with aging. In our 30’s we begin to lose muscle mass and thus muscle function, which equates to strength and coordination. Those of us who are physically inactive (think desk job or long commutes)  can lose as much as 3-5% per decade in our 30’s and 40’s, 10-20% in our 50’s and up to 30% in our 60’s.  Another life lesson . . . Use it or Lose it!

 The treatment for Sarcopenia? Resistance Training! Unsure of where to start? Development of a strength training program is easily done by your Physical Therapist. He or she will help you select the best exercises and dose them based on scientific evidence, identify your movement patterns and teach you correct form to decrease your risk of injury.

 Final Life Lesson for today . . .

. . . Practice What You Preach!

As for me, I am putting these lessons into practice by

  • Committing to walk my dog at least 1 mile daily.

  • Doing at least 15 minutes of yoga daily save for my hour session once a week.

  • Doing Pilates once a week.

  • Creating a plan to incorporate consistent strength training.

I invite you to join me.

Be Well!  Roxi