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23rd November 2017

ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION 

Post op rehab. Weeks 1 & 2   


 

ELLIE has put together a video and discussion about her rehabilitation in the 1st 2 weeks after Anterior Cruciate Ligament recovery. A physiotherapists physio journey.

IMPORTANT NOTE TO START:
In this video I am day 8 post-op. The start of my week was very different. Days 1-3 were particularly difficult due to pain and lack of movement in my knee. I was only doing exercises 1,2,3,4,8 and 9. I was on crutches for the first 3 days, then 1 crutch for 4 days and now I just use them outdoors.  
This first phase of the exercise programme was to get on top of my pain, control the swelling through regular icing and elevation and start to work on my range of movement (ROM). It is important to start exercising early but it is also important to listen to your body. I am not a believer in ‘no pain no gain’. Because of this I would not push myself through the pain but to the point before it with knowledge that this point would improve with time and repetition. 
After day 3 I started to introduce more ROM exercises with each day, still listening to my body and not pushing. Coming into any exercise for the first time it’s important to build the repetitions up slowly. My main goal was to achieve neutral extension and 90 degrees flexion at the knee. I was doing my programme 2-3 times a day and also working on my walking pattern (gait). 
Even though I am a physio myself, I will be seeing a physiotherapist to guide me through my rehab. It is important to have someone to review you throughout your own rehab to ensure you are doing exercises correctly and to progress you safely. In my case, 2 minds are always better than one, I love collaborative working and I’ve got the time.

Another important note: I apologise for the ridiculous shorts but I felt it was important that my knee could actually be seen. The dressings on my knee were changed the day before. Prior to this they were pretty gory. Also parts of the video have been sped up, I’m not doing the exercise insanely fast! 

The Exercises: 
1. Standing Roll Down: – although we are focusing on the knee here it is also important to think about other parts of your body. With this exercise it was about mobilising my spine and giving my lower back and hamstrings a good stretch as they were tight!
2. Hamstring Stretch in long sitting: – Holding each stretch for 20secs
3. Static Quads: – this exercise is not obvious but here I am pulling my toes up towards me and engaging my quads (the muscles at the front of the thigh) and then pushing my knee downwards. This exercise helps to start the strengthening of the quads but also helps achieve that neutral extension position.
4. Knee Flexion: – this was actually one of the toughest exercises due to pain and my knee feeling so odd. I had very minimal flexion to start with but as you can see I am now at my 90 degrees, whoop whoop!
5. Adductor Resistance with ball: – squeezing a ball between my knees for 3 seconds and then releasing. 
6. One Leg Stretch in Supine 
7. Bridge: – I only just introduced this exercise the day before. It was not until I achieved that 90-degree flexion at my knee and was able to hold it comfortably that I could actually bridge properly. 
8. Passive Knee Flexion in Prone: – A great exercise to keep ROM at the knee as your good leg is doing all the work. 
9. Knee Flexion in Prone: – As you can see I perform some exercises on both legs. This is for comparative reasons but also its good to keep the other leg in good nick to. You can also see this is very difficult. This is due to my ACL graft being taken from my hamstring (muscles on the back of the thigh). 
10. Swimming legs
11. Heel Raisers
12. ¼ Squats: – Another tough exercise for me. Anyone that knows me, has had physio from me or comes to my pilates classes know I love squats. They are great for building quad, hamstring and gluteal strength but are also a good functional exercise. Again my knee felt odd and weak when I started doing these so I took it very gently. 
13. Marching
14. Single Leg Stand: – It’s important to start introducing some balance early on- the concentration is real! This also starts to work on your proprioception. Wikipedia strikes again for an explanation of this: https://en.wikipedia.org/wiki/Proprioception 
15. Calf Stretch: – Holding each stretch for 20secs. 

I want to make the point that if you have sustained an injury, have pain or a physical impairment please seek help and guidance from a health professional before starting your own exercise programme. No one is the same, everyone’s healing rate is different and everyone has their own particular needs and goals. 

Thank you for taking the time to watch and read this. Get in contact if you have any questions/queries/ nuggets of gold knowledge!

Ellie 

Track on video is Electric Brae (ft. Len Carter) by Josheeba