Haha, i bet it sucks. The thing that i suspect will take the longest is to equalize the imbalance, especially with squatting. I noticed the i tend to shirt to my uninjured leg a lot. I had the same suspicion with my meniscus repair so I am hoping that is a good sign. Scar tissue seems to be a big problem but i’ve been working it none stop. I feel you on the progress, it comes in lurges. Hopefully the next one will be a good one. It also gives me an opportunity to relearn a correct sprinting technique
I’m 6 years out from a hamstring graft ACL replacement. Everything is going good, strength, speed, ROM, etc. I got into kiteboarding in a big way a couple years ago and it has taken the massive amounts of abuse that sport dishes out just fine.
My recommendations based on my experiences are:
Ice - long after you stop feeling pain or noticing swelling in the knee, ice it. After a workout, a quick game of pickup or even a long walk. Seriously. When I started doing this 2 years ago it was the single biggest improvement I made. The reason is simple - that knee is always gonna get pissed off relatively easily (compared to an uninjured knee), when it gets pissed off you get swelling, even if it isn’t visible (I can usually spot it as a very very slight stiffness in the knee), when swelling starts your body automatically starts shutting muscles around the knee to protect it. Then activation patterns that you have been working your ass off to fix get messed up, again, and those muscles you’ve been trying to build up start to atrophy, again. So yeah, ice the fuck out of that knee for the next 5 years or so. I’ve gotten lazy again lately and while not as bad as before, I have just recently noticed some negative effects again.
Posterior chain work - deadlifts, RDLs, GHR, etc - most physios focus on quads and VMO work (step ups etc), my knee never got 100% stable and pain free until I really upped my ham and glute strength.
Single leg work - lunges, and especially leg curls. Seated cable curls are my current favorite. After all these years my left hamstring still has a massive strength deficit on the right, although I admit that this is mostly due negligence on my part.
The above recommendations are for the post-rehab phase of your recovery - ie, after full ROM and normal daily usage is restored. Sounds like you are there already. Good luck with the recovery.
Were your ACL tears contact or non-contact tears… because if either were non-contact… your lifting programs can use a tune-up because that shouldn’t happen with good training. If they were contact injuries, then nevermind.
Both were non-contact. The first was the result of a hyperextension - was playing flag football in college, jumped during a run to defend a pass and came down on one leg, SNAP and no more ACL. That was back in 2004 way before I started lifting. I did absolutely no leg work other than the occasional jog.
The second was also non-contact, done playing basketball. I was running up the court and made a sudden step to retrieve a loose ball. SNAP, no more ACL. I will say that I had a very, very intense leg workout the day before the injury and did not stretch or warm up the day of the injury. I was very sore that day and never should have played. Both VERY stupid things on my part and I regret doing it every day.
Taking advice from this board, I’ve started doing glute activation work in addition to the rest of my rehab. This is a fantastic article if anyone is interested:
Hey TripC checking in on the progress, I just got cleared to go at it again, (meniscus seems to have healed). I jogged for the first time about a week ago, so far so good. Still a whiles away from squatting deadlifting etc.
Things are coming along well. I hit the 4-month mark last Friday (Dec. 10). I’m running anywhere from 1 to 1.5 miles three times per week. Yesterday, I ran a mile in 6:59. I know that’s not burning up the track, but I felt like it was pretty good considering the only running I did beforehand was on a basketball court.
My strength is coming along. My physical therapist hooked me up to this Cybex machine about two weeks ago to test my strength in comparison to my “good leg.” I had to do a series of seated leg extensions and leg curls at various speeds and resistance. It then compared both results and looked something like this:
Force applied during extension
Good leg: 225 lbs (~115% of bodyweight)
Surgery leg: 195 lbs (~100% of bodyweight)
Force applied during flexion
Good leg: 149 lbs (~76% of BW)
Surgery leg: 113 lbs (~58% of BW)
Quad vs. Hamstring strength
Good leg: ~66% quad:hamstring strength
Surgery leg: ~58% quad:hamstring strength
So basically they were testing my quad and hamstring strength in relation to my bodyweight and then my quad and hamstring strength in relation to each other. My PT said that an average person’s hamstring is anywhere from 60-80% as strong as their quad. So I have a ways to go with both legs, but I’m well ahead of the curve at this point. I would love to get my hamstring strength up to at least 70% of my quad strength on both legs before I go back to sports.
My surgeon was pumped that I’d done so well less than 4 months out. The hospital where I had everything done has also been conducting some research on ACL reconstruction patients, and I participated in that as well. I had to do several functional movements (upper body as well) to see how symmetrically I was moving. I had to do a deep squat, lunge, pushup, and a lot of balance stuff. I did alright, but the doc conducting the tests said the best thing to do would be to hammer my glutes and the posterior chain. I was told to do a lot of single-leg exercises to get the motor pattern on my injured side back on track. Apparently I’m still shifting my weight to my good leg at the bottom of my squats, and doing the same thing with deadlifts.
I’ve also been hitting the weights pretty hard over the past month and it feels great. I recently switched from an upper/lower split to a push/pull split. I’m sticking to 3x8 for now. Eventually I’d like to get back in the 5x5, 4x6 and 6x4 range, but right now I’m just concentrating on form.
Here’s what a typical push day has looked like:
1 mile jog warmup
Agility drills
Barbell squats, wide stance
Dumbell bench press
Bulgarian split squat, wide stance
Chest flies
Calf raises
Skull crushers
And a pull day
1 mile jog warmup
Agility drills
Deadlifts (or RDLs depending on what day)
Barbell rows
Single-leg deadlift with dumbell (very light at this point)
Pullups
Glute-ham raise
Glute activation work (barbell hip thrusters, bird dogs at the moment)
That’s some awesome stuff. Yeh the hamstrings are a major weak point (the hamstring harvesting really messes it up). I am not too far behind but I find the further down the line you get it improves exponentially. I just did a light sprint for the first time the other day. I still have a big pelvic tilt towards the left (towards the uninjured leg). I have been doing a lot of single leg work and like you said hitting the hamstring hard. I have also been working it hard with the ultra sound and then foam rolling and stretching. Although it is feeling a lot better I can tell I am still miles away from heavy bar work. What are you doing for muscle pattern development? I find that starting on the shuttle (back laying sliding cart with push off platform) then working up to slow sprints has worked really well. Are you taking in supps to aid in recovery?