ACL Injury: Where You Can Be 6 Months After Surgery with these two helpful tips

If you have had an ACL injury or you know anyone that has had one, you might be aware of the inconsistent information and "facts" regarding the return to activity. The confusion of a client being told that a full 12 months is needed and seeing others farther in their rehab in less time can be very frustrating. On average my clients and athletes are back to their sport and regular daily activities around four months. I have had pro athletes back on the professional tennis tour at the end of the sixth month. How is this possible? It is quite simple. If you have struggled from an ACL injury that needed surgery or are still experiencing ACL injury symptoms – these two tips will be beneficial.

 Tip #1: Learn How to Walk with Crutches

 One of the most important things someone can do when they are out of surgery and allowed to walk with crutches is to walk with proper mechanics. This means an adequate heel to toe gate. Often clients were never taught how to use their crutches and are not aware of how important the correct gate is when they walk - with or without crutches. Of course, it is not possible to walk with a standard gate after an ACL injury without crutches, but when used correctly the crutches give us a considerable advantage and increase the healing process of the knee. One of the ACL injury symptoms of the knee is instability. This is why it is so important to walk heel to toe with the crutches as soon as possible. If you are still in this stage, then try to use your crutches, and when the injured leg is forward (while walking) put as much weight onto the crutches as needed, this will allow you to take a proper heel to toe step. This movement will activate the muscles and begin to work on the ankle, knee, hip and the rest of the body's proprioception. This small change will allow the individual to start correcting the mechanics that most likely caused the ACL injury in the first place. When the knee becomes better, and the ACL injury symptoms begin to dissipate, the client will be able to place more weight on the injured leg, thus decreasing the time they will need until they are fully weight bearing.

 It is these small changes that make the most significant difference. Often my clients ask how the professional athletes can come back from an ACL injury much faster than the general public. Many think it is the multiple appointments they have each day. Of course, this helps – but it is these small modifications in our approach that make a huge difference and something you can easily add to your daily routine.

 Tip#2: Get Your Knee Straight & Heel in the Air

 One of the most common ACL injury symptoms is the ability NOT to straighten the knee. In the first stages of the injury and post-op, this is normal. Full ROM (range of motion) by the doctor is not permitted due to the ACL still being fresh after the surgery. However, after a few weeks (and when the doc says it is ok) we need to get the ROM back! Don't get me wrong, flexion (so bringing your heel to your butt) is also very important. However, there is a significant issue that comes with the lack of complete extension (straightening your leg.)

 Notice that muscle on the inside of your leg, next to your knee that resembles a teardrop shape? That muscle is your VMO (vastus medialis oblique) and is CRUCIAL for your knee tracking. After an ACL injury and especially after surgery, this muscle has lost its ability to activate. This loss of activation is dangerous because the VMO keeps your knee tracking correctly and prevents other injuries such as knee tendonitis (which is often mistaken within the umbrella of ACL injury symptoms.)

 What Does This Have to do With Your Heel?

 Great question. Our VMO only contracts during the last 15-30 degrees of terminal knee extension (this is a fancy way of saying "straightening the leg.") By getting our heel in the air (See the video below from my Knee Mobility & Rehabilitation Program) we are guaranteeing the contraction of the VMO. Why is it important to have the heel in the air? Well, that means we do not only get the last 0-30 degrees of terminal knee extension, but we are getting more. In physio land, we can reach this "negative" 1-3 degrees. This extra extension means that your knee can express the full ROM of extension - of course, we must continue to work on the flexion of the knee, but more daily activities and stretches focus on this area while full knee extension is not so common. When you can perform this on the ground in an "open chain" format. Try the standing version and see if you can do the same (see the video below from my Knee Mobility & Rehabilitation Program)

 Quick side note: An Open Chain Exercise in this example means the foot is not in contact with the ground. These are always the beginning of any rehab therapy because they are not as demanding on the body. Closed Chain Exercises focus on (in this example) the foot staying planted to the ground. Closed chain exercises are more functional and vital in the later stages of rehab. Both are crucial for any ACL Injury.

 Try implementing these two tips into your daily routine or rehabilitation program. I am confident they will help you reach your goals faster and decrease your chance for future injury! Stay tuned for a future blog where I will uncover some simple tips concerning tightness from an ACL injury.

 If you have any questions regarding your specific ACL Injury or want to know more about the ACL injury symptoms and what can be done – please do not hesitate & send me an email! If you found this helpful PLEASE SHARE IT and leave your comments below. I would love to help you further with your questions and treatment. Click here to learn more about my Knee Mobility & Rehabilitation Program. Each program comes with a movement, corrective exercise, mobility, stretching, and lifestyle program organized into two easy to follow plans!

 Movement is our Medicine & Education is our Therapy!

Best of all - NO MEDICINE, NO PILLS, JUST TWO STRETCHES THAT EMPOWER MY BODY TO HEAL ITSELF!

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