We are not very good at ACL rehab. 50% of athletes who under go ACL surgery will not reach pre-injury levels. Obviously there are other factors, but poor rehab is high on my list for potential reasons that it is so high. There is a lot of conflicting information out there so this will serves as 5 key things I think are crucial for laying a solid foundation early on in the rehab process.
1. PREHAB PROGRAM
There has been a lot of research to indicate that a 4-6 week strength training program results in more favorable outcomes after surgery. These programs result in better range of motion (ROM) early on and quicker strength gains in the early phases. This also increases our chances of returning to competitive sports,
I get a lot of questions like "what should I be doing in my prehab program?". So we created one!
This program gives you modifiable and progressive exercises to improve your strength and ROM before surgery even starts! The secret is really to stay as active as possible. Sure, we may have some swelling and pain, so let's modify the exercises till they are relatively pain free and keep going!
2. MOTION IS LOTION
Swelling and pain are the two biggest issues we face early on in the surgery process. When a muscle contracts it squeezes the blood and lymph vessels around it helping stimulate venous/lymph flow aka decrease swelling. I always recommend my patients and athletes engage in "exercise snacks" throughout the day to keep swelling at bay.
Here are some examples:
3-5 x 10-15 min walks throughout the day
Performing 200 leg extensions while watching TV
Performing 300 ankle circles while doing homework
Performing 10 air squats every time a commercial comes on
Performing 15 calf raises every 30 min
Performing 5 x 60 sec wall sits throughout the day
This will help keep the blood and lymph flowing to keep the swelling down while also strengthening the mind muscle connection of the brain to the operative leg.
3. DON'T DETRAIN
It absolutely frosts my cookies when we stop training the "good" side during rehab. Too many times we let the non-operative side waste away as we rehab the operative side leading to tearing the ACL on the formerly "good" side the minute we get back into sports. When we let the non-operative side not get any training stimulus for 6 - 12 months we leave ourselves open to a massive increase in risk of injury. We must keep training the non-operative side as hard as possible, both strength and plyometrics, throughout the whole rehab process. Please, please prioritize single leg strength and single leg plyometrics on the non-operative leg while rehabbing. Yes this might require modifications to common exercises but be creative or hire me;)
4. FUEL YOUR BODY
Yeah, yeah, yeah we get it nutrition is important for healing. Well then why doesn't your rehab reflect that? Too many athletes either continue eating poorly which does not give their body the necessary building blocks to heal optimally or they restrict their calories significantly because they are "no longer an athlete". Both of these are costly mistakes to make in the rehab process. We highly recommend continuing to get 30-40 grams of animal protein per MEAL, not per day. As well as supplementing collagen and bone broth to give the body the ingredients it needs to heal properly.
Sleep is another easy step that most people do not take seriously, yet the benefits are staggering. Sleeping 8-9 hours is crucial for recovery and a smooth rehab.
Couple tips to help you get quality sleep:
- Go to bed and wake up at consistent times (even the weekend)
- Make it a priority
- Don't look at screens for 1-2 hours before bed
- 30 min before bed read a book
- Keep the room pitch black
- Turn your phone on airplane mode an hour before bed
- Don't get on social media an hour before bed
- Keep the room cool 68 degrees is good
- Wear blue light blockers (if they are cheap/not red lens they probably don't work)
- Get red light - brand matters so much here. Gembared has low cost options with low flicker and low EMF unlike bigger companies like Joov.
Code BCP10 for 10% off!
There we have is folks! Those are a couple keys I want you to take away from your ACL rehab. It is a tough journey; but we can do some much better from the physical therapy side of the isle. I encourage you to reach out with questions or book a discovery call if you are interested in doing your rehab with us and want to learn more! I am very unbiased but I truly believe our service is unmatched on the market.
Look forward to hearing from you! Praying for a fast recovery!