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-   -   Preparing ACL for the upcoming season (http://www.wakeworld.com/forum/showthread.php?t=785473)

wakesetter_WW 01-13-2011 11:01 AM

Preparing ACL for the upcoming season
 
I know so many people on this site have torn their ACL and many are tired of hearing about it...with that being said I had surgery almost 4 months ago. I'm wanting to know what exercises helped you the most. I want to make sure my knee and leg is ready to go when spring comes around. Also how long did it take you to get back to your old riding ability? What should I expect come spring when I ride again?

adamsilcio 01-13-2011 6:25 PM

I had my second acl surgery in July. By month 5 I started doings plyometrics and explosive type exercises. I'd say if you are coming off of an injury, your knees need to get used to the impact of landing tricks so I would do a lot of plyometrics once the doc gives you the okay. Remember to take it easy and listen to your body then gradually turn it up until your knee feels comfortable jumping the trampoline, box jumps, and pivoting/cutting. And stretching regularly and warming up before you ride should be done religiously.

adamsilcio 01-13-2011 6:30 PM

Basically anything to help simulate the impact of landing tricks. Your knees and hips and ankles all need to be conditioned to take those hits. Strength training and high impact exercises

wakesetter_WW 01-18-2011 1:38 PM

Any advice on what to expect when I ride again in the spring?

adamsilcio 01-18-2011 7:40 PM

depends on how hard you rehab. some people come back strong and don't have any problems... some people slack off or have complications with their graft and don't make a full recovery. i'd say if you are gradually feeling better and the pain and swelling goes down, then you should be fine as long as you don't push it. most people are back 100% after a full year. i am at month 6 and i still have a little bit of swelling and soreness. but i won't ride until the doctor releases me...

01-18-2011 8:07 PM

you better have been doing PT. if not you're an idiot. that said, hip abductors are crucial as is stretching. anyways, take a wake video to your PT and have him/her watch it and explain to them what muscle groups are used most.

wakesetter_WW 01-18-2011 8:10 PM

I did PT for the first 3 months and then the therapist released me. He pretty much said jog and do some weights. Do you think I should go back to a private place to get more intense therapy?

01-18-2011 8:24 PM

depends. how strong does your knee feel? best way to not injure yourself is to lift weights "intelligently." the stronger you are and the more flexible you are the less likely you are to get hurt. a cti isn't a bad idea

wakesetter_WW 01-18-2011 8:30 PM

I got a custom CTI a few weeks ago that I'm really happy with. I have been jogging a mile every day with no real problems. Today I did some jumps onto a box and couldn't do more then two sets of ten because of knee pain. I didn't want to push it to hard. The one thing that really concerns me is getting my leg locked out straight. I can do it but it doesn't feel natural. Once or twice a day I put an ankle weight on my leg and hang it off the bed to try to loosen it up. When locking out my leg I get a lot of pops in the knee. My therapist told me it was just scar tissue but it still hasn't improved any.

adamsilcio 01-18-2011 9:16 PM

haha, parker you sound exactly like me. my doctor and therapist said the same things about the scar tissue. did you also tear your meniscus as well? doctor told me that due to a meniscus tear, it may take a while for your leg to totally straighten out, and if there is still some swelling... that may be the "unnatural" feeling you're referring too, and the popping too...cause there is fluid moving around in there. talk to your doctor for sure and make sure he runs tests on you each time you visit. i can straighten out my leg all the way but it doesn't feel like its totally locked out, despite it visibly being as straight as my other leg. these things take time. some knee injuries longer than others... but everyone is different. sounds like you and i are on the same page, kind of.

if you had surgery almost four months ago, i wouldn't push the plyometrics too hard. jogging is fine. but box jumps and any other intense exercises can be risky business, especially if the difference in atrophy is substantial. my quad on my bad leg is not nearly caught up with my good leg. and i am 6 months out.

bottom line, make sure you visit your doctor on a regular basis and he evaluates you each time.

wakesetter_WW 01-18-2011 9:25 PM

Yeah I probably won't do box jumps again for a few weeks. Yeah I did the meniscus too. Adam, I'm relieved to hear that others have had the same experience. Being 6 months post op, do you feel like your ready to board or close to it?

01-19-2011 6:55 AM

To get strength back in my leg I would pedal an exercise bike one legged. It really kicked my butt. I had trouble using weight machines for a little under a year because my petella would hurt too much. I always felt like I could lift more weight with my leg, but I had too much pain from where the doc cut from my patella to use as my new ACL.

jeff_mn 01-19-2011 6:55 AM

Your knee is something you'll relay on for the rest of your life, long after your wakeboarding career is over.. Make sure you don't your time - don't rush it.. Rehab it properly. You seem like you're uncertain about how it's going - take it easy, keep rehabbing and wait til you're ready. An extra 2,3,6 months isn't that huge in the grand scheme of things if it means no more surgeries or issues.

wkbrdrchad 01-19-2011 10:19 AM

Parker, I'm at almost exactly the same spot as you, 4 months out, but this is actually my second surgery (both from wakeboarding). My first surgery was Sept. '09 then I re-tore it again in May '10 at 9 months post-op. I waited until September to have my second surgery done so I could enjoy my summer still.

The first time around I never fully recovered before I started riding again. I was snowboarding (lightly, no jumps) at 4 months and wakeboarding at 7 months. I felt totally fine and really had no pain at all when I was riding, so I quickly returned to my previous level of riding (flips, spins), without holding much back. My mistake was never fully rebuilding my leg muscles and then going to big too soon. I landed in the flats behind a fully loaded X-star heavy on my Surgery Knee. To this day I still don't know what I was thinking going that big that soon...

This time around I'm taking it way more serious, doing a lot more muscle building exercises and going to slowly get back into wakeboarding. I don't see any issues with riding right at 6 months out, just be careful how big you go.

wkbrdrchad 01-19-2011 10:36 AM

Regarding what exercises to do, my PT said that one of the biggest things you lose after the surgery is your understanding of where your knee is in space without looking at it, so it's very easy to land on it wrong and cause more damage. He also said your knee muscles become slow to respond and it takes them longer to trigger. He said to focus more on reps than weight (3 sets of 20 for most exercises), especially in the beginning, to retrain your muscles to fire fast and so that you can "know" where your knee is in space.

He has me doing a lot of "balancing" exercises on a Bosu ball (see pic) that seem to really be helpful, such as: Squats, lunges, 1 legged stands, etc. Seems to help your knee relearn how to react to keep your balance.

http://www.ab-core-and-stomach-exerc.../bosu-ball.jpg

adamsilcio 01-19-2011 11:41 AM

Chad, very good example. i use the Bosu ball to do balance exercises as well. you are right about having to retrain your muscles to fire fast.

Parker, i have been wakeboarding for a few weeks now but i have not gone wake2wake yet. i am just riding switch and doing ollie backside 180s, 1wake 180s, etc. nothing to really tweak it. i have to admit, my knee does still feel week, and i won't trust going wake2wake until after the doctor releases me. if i perform well on my strength tests at the next visit, he will let me ride... however, i want to be able to jump onto two boxes and jump off, and run and cut and pivot without any problems before actually getting back into riding. i trust the doctor, but i also have to listen to how my body responds. if i don't perform 100% in the gym and during rehab, there is no way i am going to chance it on the water.

mc_x15 01-19-2011 11:58 AM

What graft did u get. I jsut had the hamstring graft 7 wks ago. Also Meniscus repaired. I am by no means back in action but am walking normally, can bend to about 130 deg and go more than straight. I had the pataller graft last time on my other knee and it was brutal. Lot more pain than this one. Took me about 5 months before i even felt sturdy again and man was it stiff and sore. This time i almost feel like i can start running. Which clearly im not doing. But i feel great. I do get the popping in the knee but no pain from it. Was also told it was scar tissue. I was also told if i feel pain from the popping to get it looked at. Good luck, cant wait till im 5 months.

jeff_mn 01-19-2011 12:11 PM

man - I can't understand why you guys rush this so fast. if your knee is feeling "week" - why in the hell would you push yourself WAKEBOARDING of all things? Your knee is forever, wakeboarding cant wait..


I guess I'm not "core" enough like some of you guys.. Take it easy Parker..

wkbrdrchad 01-19-2011 12:28 PM

I had the Hamstring the first time around, this time my surgeon recommended the allograft (cadaver) since he didn't want to do any more "damage" to my knee by using another part of it and he didn't want to take it from my good knee. So far it's been even less painful and a quicker recovery than the Hamstring, but I'm told I have to wait longer (9 months) to return to sports since it takes longer for the cadaver tissue to revascullarize and reach full strength.

captain_vilfo 01-19-2011 12:37 PM

I got surgery on my knee for an acl replacement during August of 2009. The next season I had was my best by far and Im convinced it was due to rehabbing/working out to stay in shape. I also wore a CTI Brace and experienced no pain whatsoever in my knee throughout the summer.

For my work outs I rode the bike religiously. I also did a ton of leg stregthening excersizes such as squats, lunges (only after 6-8 months though) and leg presses. I started doing some plyometircs too which, as stated before, help prepare you for impact.

Luker 01-19-2011 12:45 PM

April 17, 2009, blew up my knee at OWC off big white.... I had a small crack in the base of my femur, torn ACL, and torn medial and lateral meniscus. I had a hamstring allograft, lateral meniscal repair, medial menisectomy, and the base of my femur was shaved slightly to expedite the healing the crack. Surgery was May 15, 2009. I did pretty intense rehab, 3 days a week for 3 months, then 2 days a week for 2 months. I was back on my board at 5 months... no wake jumps or rails, just riding. I started hitting rails again at 6 months and was back taking falls and trying new stuff at 6.5 or 7 months.

Almost 2 years later I have developed Chondromalacia and I've torn my lateral meniscus again according to a recent MRI. I have significant pain, swelling, and popping almost all the time, but I can still ride at full speed with little problems. I had a cortisone shot in an effort to delay scoping which didn't help at all. I've been wearing my CTI Custom since day one and love the brace and the extra little security it gives me (even if its mostly mental).

Just a little synopsis of my experience with the surgery and journey back to riding. Hope this helps.

chrishopf 01-19-2011 12:52 PM

Bosu Ball is one of the best things for ya!

hco 01-19-2011 2:42 PM

I would make sure that you gus with meniscus REPAIRS and not just shavings get a second opinion if you have only done PT for three months. I had a cadaver ACL replacement, and had a bucket handle tear+flipped my lateral meniscus inside out, and had a pretty intense repair. This is month five for me of therapy, and I have been going to PT three times a week since surgery, and started walking at 8 weeks. I have been playing hockey (non contact) three times a week for a month now, and my quads and gluts are just about even strength now. I still can't do jumping/pivoting rapidly and without some pain. I would really make sure that you guys follow up with other therapists and certainly continue a home workout program.

wakesetter_WW 01-21-2011 6:32 AM

I had the patella graft done on my knee mainly because it was what my doctor recommended and felt best with. Thanks again for all in input. After reading all the talk about this Bosu Ball, I will be purchasing one soon to work on good balance along with my Indo board.

Henry, I was relieved to hear a story like yours. Gives me some hope and motivation to rehab as much as possible with out pushing past my limits.

As far as rehab, right now I've been working on jogging at least a mile 4-5 days a week. Also doing some lunges, as well as some light weight with high reps. Still getting used to wearing my brace though.

aliwake 01-23-2011 9:48 PM

Hey Parker, have you put the extention stops in your brace yet? IMO this is really important - particularly as you don't feel comfortable extending it yet. Having said that, it sounds like you're wearing your brace for jogging? the extention stops wouldn't be too comfortable for that - but definitely use them when you're back on your board. It'll prevent your knee from hyperextending, or forcing extention when you're not expecting it.

wakesetter_WW 01-24-2011 2:00 PM

Alice, no I haven't put the extention stops in. I recieved a few different ones with my brace. I don't remember the differences but will look when I get off work. Yeah, I have been wearing my brace while jogging. Doctor told me to wear it for a little while.

aliwake 01-24-2011 3:56 PM

with regards to which stops to use - I'm of the opinion that the bigger the better - but that's probably cos I still get quite a lot of hyperextention when I wear my brace. I'd suggest using the stops that stop your leg just before it gets straight - no matter how hard you force it. it only really works for things like wakeboarding where your feet are fixed. walking or running is way too uncomfortable if you can't fully straighten one of your legs! :)


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