ACL Reconstruction and Powerlifting

Training Injuries
21

[quote]UpChucker wrote:
been there, done that…a couple of times. First time I tore my ACL I wasn’t into lifting yet, but I rehabbed by myself and probably did too much too soon. I was 19 and couldn’t differentiate the good pain from the bad.

Over the years the graft stretched and my acl was basically worthless. I was still able to squat 545 in single ply poly walked out and 600 in the monolift (walk out was hardest part due to lack of knee stability). Then I got it fixed again and it was GREAT. That was March 2006. By Nov 07 I was back to squatting 365 x 2-3 with just a belt and pulling 500 with just a belt…then I tore my acl and shattered my tibia wrestling.

They had to put in a metal rod and a bunch of screws, that got infected. I was on crutches for 5 months and had 4 surgeries on the leg in 13 months. Before they took the hardware out in Dec of 08, I was back to squatting 225 for a set of 5 (very carefully). Doc damn near shit when I told him. Squat and DL are no longer a priority for me as I am chasing a 405 raw bench. Eventually I want to get back to a 500lb pull and would like to squat 315x10. This is with no ACL and a stretched MCL.

Advice for rehab: Start flexing your quad as soon as you are conscious. Do the stupid stuff the PT tells you to do, and then start working on range of motion ASAP. Avoid leg extentions at all cost. Exercise bike is good to start and then start working on squats, good morings, deadlifts, and leg curls. You will be shocked at the atrophy…but if you work hard you can get it back. really work on getting your legs balanced again strength wise, or you will have more problems down the road (at least I did).

What kind of graft are you getting? I had the patellar tendon done the first time and hated it. 2nd time was hamstring and that was great![/quote]

judging from the feedback of the hamstring graft, i’m most likely going for that. originally i was shooting for one from a cadaver but i’m worried about the possibility of my body rejecting it… and having to go through the horrors of rehab once again.

[quote] Matt wrote:
Also, if you have any interest I have my entire rehab documented and I can send it to you. I know I was pretty freaked out and seeing how someone else went through it would have really helped.

Let me know if you want that.[/quote]

yeah matt, that’d be great. i’ll message you my email once i figure out how haha.

just about an hour ago, i was dragging a sled around outside my apartment. earlier today, i did dynamic deadlifts followed by squats. my knee was fine but i honestly do not know the long term repercussions of heavy weightlifting without an ACL. i really do not want surgery but i’m worried that without an ACL, it might affect my pcl or meniscus. just a rant… no real point in what i just wrote :\

anyways, thanks for the input guys. atleast some people feel/felt my pain and helplessness :\

22

[quote]awwww_fuq wrote:
During spring break I was involved in a car accident and tore my ACL in the process… I’m scheduled for reconstructive surgery on May 17th. I talked to my doc about it and she walked me through the phases so I pretty much have a grasp on the process.

However I’m looking for more specific info mainly related to powerlifting. I know pull-ups and dips are the obvious stuff I can do but other stuff like bench press totally eluded me until I wrote this post. Without an ACL, I can no longer bench powerlifting style :frowning: i can’t do heavy squats nor deadlifts and I guess I can’t do barbell rows, standing shoulder presses, or standing good-mornings either.

I’m just looking for individuals to share their experiences and details on their road to recovery. inputs from people who suffered a similar fate are greatly appreciated. [/quote]

Rest and focus on simple accessory actions body weight stuff until surgery. Then keep up with your range of motion, the most important thing is that you maintain your extension in your knee.

Make sure your insurance company and your dr are providing you with a CPM machine. Continuous passive motion. Its very imp. Could be the difference between off crutches and the brace in a week verses a month. Trust me.

23

[quote]WhiteK wrote:

[quote]awwww_fuq wrote:
During spring break I was involved in a car accident and tore my ACL in the process… I’m scheduled for reconstructive surgery on May 17th. I talked to my doc about it and she walked me through the phases so I pretty much have a grasp on the process.

However I’m looking for more specific info mainly related to powerlifting. I know pull-ups and dips are the obvious stuff I can do but other stuff like bench press totally eluded me until I wrote this post. Without an ACL, I can no longer bench powerlifting style :frowning: i can’t do heavy squats nor deadlifts and I guess I can’t do barbell rows, standing shoulder presses, or standing good-mornings either.

I’m just looking for individuals to share their experiences and details on their road to recovery. inputs from people who suffered a similar fate are greatly appreciated. [/quote]

Rest and focus on simple accessory actions body weight stuff until surgery. Then keep up with your range of motion, the most important thing is that you maintain your extension in your knee.

Make sure your insurance company and your dr are providing you with a CPM machine. Continuous passive motion. Its very imp. Could be the difference between off crutches and the brace in a week verses a month. Trust me. [/quote]

Also once you begin rehab, make sure you get Homework from your PT, cause a few times a week wont be enough. Make sure you do whatever you can everyday. Also dont limit yourself just because of your knee, lift upper body, do core,back etc. exercising other parts of your body will help your knee heel as well.

24

I have had a cadaver tendon as an ACL since 2004. It took me a good year to be back to regular people normal. Probably another 6 months to be Squat/Deadlift/Long Run normal. I’ve ran 2 marathons on it and squat and deadlift regularly. (Nothing on the level of UpChucker but beat my own PRs)

My biggest issue were getting my quad to fire early on and scar tissue later. My hardware is all permanent but I don’t have any issues with it. But sometimes I can tell when its going to snow.

25

i hope the OP is doin’ alright considering he was scheduled to get cut yesterday.

i had no interest in the putey the first two days. i was managing the pain as best i could.

tomorrow will be a week post-op for me. the first several days and nights were quite a bear. make sure you take the pain meds. it’ll only be for a few days. i’m 335 so crutching is an incredible chore. i hate life right now but i know it’s only temporary.

btw, a cpm machine is def not standard issue anymore. it was all the rage for quite a while but apparently it doesn’t truly help in studies and in some capacity poisons many people’s work ethic when it comes to initial exercises. i quizzed the crap out of my doc about it pre-op and he was steadfast on this. i researched and found it to be a common sentiment.

hope all is well, OP.

26

[quote]builthatch wrote:
i hope the OP is doin’ alright considering he was scheduled to get cut yesterday.

tomorrow will be a week post-op for me. the first several days and nights were quite a bear. make sure you take the pain meds. it’ll only be for a few days. i’m 335 so crutching is an incredible chore. i hate life right now but i know it’s only temporary.

btw, a cpm machine is def not standard issue anymore. it was all the rage for quite a while but apparently it doesn’t truly help in studies and in some capacity poisons many people’s work ethic when it comes to initial exercises. i quizzed the crap out of my doc about it pre-op and he was steadfast on this. i researched and found it to be a common sentiment.

hope all is well, OP.[/quote]

Yes i know its old school, but it does help, and since ROM is the most important, you dont want to get stuck a month out with less then perfect extension. Decreased work ethic isnt proof it doesnt truely help, it just means people are lazy. Two athletes i worked with this year…one with CPM and one with out. The first was off crutches in days and off the brace in about a week. The other was in the brace for almost a month, and still doesn’t have full ROM. Some orthos do prescribe it to patient still especially when they will only be seeing a PT a few times a week instead of seeing an AT everyday. Just my professional opinion. Most of the time it depends on if your insurance would cover it, and if your doctors individual opinion. Just like the debate on how long to keep it immobilized. Good luck with your ROM. Keep up the good work.

27

I agree with WhiteK. I see much more benefit behind using the CPM and just educating the athlete/patient into the importance of not relying solely on the machine and being lazy. And I definitely agree with giving a CPM to a patient who will only be afforded 2-3 visits to the PT a week, rather than being able to see an AT more frequently.

I can see builthatch’s physician’s point of view in regards to people becoming lazy, but generally those people are already lazy and it isn’t the machine making them lazy. With the athletes I have worked with coming back from an ACL-R, I have used a combination of active and passive means for gaining extension. It is critical to get the quad contracting and regaining the neurological aspect of muscle contraction, but it is equally as important to regain that ROM. Unfortunately, at my current setting, we do not have the luxury of affording a CPM, so we make due with manual techniques instead, like having the athlete’s heel on a bolster/foam roller, having them do repetitions of quad sets (contract their quad) while applying a manual force to assist the knee into further knee extension with each rep. I had one athlete that I wish I had the CPM for since he was very non-compliant with extension drills.

Best of luck to both the OP and builthatch. It is a long recovery but if you do it right, you will be much better off.

28

For what its worth, I used the CPM with both my ACL surgery and also my shoulder surgery and I felt they helped. My ortho said they were a big part of why I was able to recover so quickly.

29

Hey, I’m 6 months post ACL surgery this week and I’ve been able to increase my deadlift and squat since surgery. Before surgery I dropped about 5 lbs by strengthening quad and riding about 10 miles 5 days a week on the stationary bike. About 2 weeks after surgery I started back at the gym doing as much as I could for upper body while continuously doing ROM exercises.

ROM is biggg and quad strength is the key to quicker recovery. From reading here to not let your hamstrings and other areas of the leg lag either I’m hitting my calves (nonexistent since I haven’t started jumping again til recently), and hammies pretty hard now that I’m close to full strength in my knee. But ya just put in the work and before you know it you will be back stronger than ever, just need to dedicate yourself and make it a priority to be better than before.

My explosiveness isn’t back yet but I’m a leaner 175lbs and I’m squatting 315 for 5 reps going at least parralell although not quite ass to grass, Deadlift is building back did 325x5 and 405x1. So all in all don’t worry about it, don’t try to take leaps at first listen to your surgeon’s advice, dedicate yourself and you’ll be back in no time.

30

JDDOP, that’s great to hear! continued good luck with your recovery.

y0, i hope the OP is ok! OP, are you out there???

31

To the original poster -
That is a bummer, but I am in the same boat as I just tore my right ACL and will have surgery in August. However, this is my second ACL tear (tore the ACL in my other knee in college), so I’ve already been through one recovery and have some encouraging words to share.

I tore my ACL in my left knee playing flag football in college. I had surgery in May 2005 with a patellar graft. I directly credit that injury and subsequent rehab to the reason I began lifting weights.

Now take this for what it’s worth. I’m 26 years old, 6-3 and around 200 pounds. I had the surgery to repair my left ACL when I was 21. I was always pretty active - i wrestled for four years in high school and played baseball up until I went to college. However, the only “lifting” I did up until that injury was for the mirror muscles. I had no clue what I was doing, just wanted to get jacked and just copied whatever the “big guys” in the gym were doing - no leg work, lots of bench press, curls, etc.

After I had the surgery, my rehab went great. I was ahead of schedule on pretty much everything and by the time I was released from my PT, the quad on my surgery leg was slightly bigger than my good leg. The doctor told me when i went back to school that I could start squatting, as long as it wasn’t uncomfortable. At about six months out, I began squatting (terrible form at first since I’d never done a proper squat in my life). Thankfully, the school’s S&C coach was around and helped me work on my form.

I started out properly squatting 135 pounds, can’t remember for how many reps or if I even kept track. Fast forward five years and I maxed out at 300 pounds about two months ago (again I am 6-3 and very long-limbed). I’ve absolutely become addicted to lifting since then and have since found this website and made huge gains since that injury. I have no pain whatsoever in my reconstructed knee and can squat ass to ground if I want. I max deadlifted 355 in the fall, but have not maxed out since. I now lift 4 times per week, upper/lower split with a very very heavy leg day.

Anyway, the point of all this is just to say that you will be fine and can come back 100% if everything is done properly and there are no major complications. But knowing the mentality of most people on this board, the advice I would give is TO NOT RUSH IT. You WILL get your strength back, but it is a long road. Saying that, I am now facing another ACL reconstruction in my “good leg” after tearing it playing basketball.

If you want to know anything else about my specifics, feel free to PM me. Hope you’re doing well after your surgery. I’d be interested to hear how your hamstring progresses, as I had a patellar graft but am opting for a hamstring graft this time around.

32

hi guys, its been over 2 weeks since the surgery… thanks for all the responses. its a relief to know there are people who have gone through this and survive. and to Matt, man you are a truly amazing guy.

Four days post-op not only did I lack the motivation to do anything, let alone do PT work, I lack the strength to push myself so I just slept that whole week through. I don’t know how you managed to even bench press such a short time following post-op.

as it turned out, there was also a 4 mm tear on my meniscus disc, along with the ACL tear. the doctor said it was not bad though so they just stitched it back up. the worst part about the surgery was when i woke up during the operation. this happened to me in prior surgeries like getting my wisdom teeth extractions, my circumcision and my fractured hip repair. it was not as bad this time because i gave a heads up about prior surgeries and the doctor put a block so i won’t feel pain but it was horrifying when i woke up and was tied down… not a pleasant memory but just thought i should share.

anyways, im in the process of reading the responses and will reply back as soon as i’m done. thanks again guys.

33

builthatch, i know how u feel. after the initial week of recuperating, i could not sleep. the most rest i’ve gotten in a 24 hour period is 2 hours, and that’s with the sleeping medication. the pain is bearable although i dread PT and my overall condition… the CPM, in my case, helped a lot. getting my quads to fire up and knee extension was not a concern, it was working on getting my knees to retract. that was the hardest part.

initially i rejected the machine but without it i could not increase the range of knee bending since the most degree i could bend, according to the trainer, was 8 degrees. ideally it should have been at least 10 degrees he saids, since my healthy knee bends at a -4 degree (double jointed). thanks for the wishes and best of luck to you too. be strong… and maybe take meds if needed and we’ll make it through haha :slight_smile:

TripleC223, after much mind changing and reconsiderations, i opted for the hamstring graft but my doctor (Walter Lowe) opposed it. He said that at that at this age and considering the amount of physical activities I will be going to do, I cannot risk missing a vital piece of tendon. he also said i will be experiencing minor and minor discomfort when i squat, since i informed him of my powerlifting histories.

so he manage to persuade me to get a allograft instead. i asked about the possibility of my body rejecting the graft and the guy said there’s a higher chance that my body will reject my own tendons since the allograft will be denatured beforehand. the negative aspect is that you have to live knowing some dead person’s achilles (or whatever tendon they preferred) is within you. i don’t know if those benefits are true; i can only take his words for it since he is certified afterall. hopefully he didn’t lead me astray. :\

i haven’t had the graft long ago to let you know… the expected months for me to return to normal activity is 4, provided i go through with PT atleast 3 times a week with the trainer and 3 times on my own. hope this provided atleast a bit of insights on allograft.

34

Best of luck with the rehab. It is long and frustrating, but you just gotta hold strong. With the meniscal repair, don’t expect to be cleared to do full weight bearing on your surgical leg for about 4-6 weeks post-op to protect the repaired meniscus and sutures. Get that quad firing and keep progressing with the rehab.

35

Glad everything went well with the surgery. I think the best thing going through this process is hearing from people who have done the same thing and come out fine on the other end. It can be very frustrating at times and you feel like you’ll never be 100% again. Unlike a lot of “normal” people who have this injury though, people like those on this board not only have a much stronger foundation of strength heading into the surgery, but also a work ethic for physical activity that most lack.

Supposedly recovery time from the allograft is not as long as hamstring/patellar grafts. I think if you’re a powerlifter, that is honestly the best way to go too. I have never heard of anyone tearing their ACL lifting weights (barring some insane weight room accident from doing something stupid). They usually come from high intensity sports or, in your case, an accident of some sort. Honestly I think you made the right choice with that graft.

Good luck with the rehab.

36

Glad you’re getting better man! You have my email so if there is anything I can do, or you just want perspective or anything, don’t hesitate to holler! I know it doesn’t seem like it now, but you will get through it and you’ll be really good afterwards.

take care
Matt