This is really only an introduction to the many exercises that can be done after a person has already been doing the flex, extension, scar tissue massaging and the basic exercises such as straight leg lifts. All the above can be done for many weeks but as a person gets past the initial 3-4 weeks post-op period, then the PTs move them onto other bigger and better recovery exercises. Here is a basic timeline and list of the above and what would be considered in the next phases of recovery:
THIS IS ONLY A GUIDE REPRESENTATIVE OF WHAT I WENT THRU. EACH PERSON PROGRESSES AT A DIFFERENT RATE AND OS/PT PROTOCOLS VARY. IF THIS DIFFERS FROM YOUR RECOVERY PROTOCOL, THEN USE THIS ONLY AS REFERENCE TO ASK QUESTIONS AND NOT TO TAKE THE PLACE OF THE PROTOCOL YOU ARE FOLLOWING !
1st Month Of Recovery Exercises
Extension 1st 4 weeks most important
Flex (& Heel Slides) 1st 8-12 weeks most important
Scar Tissue Massaging Usually from staple/stitch removal plus 4 wks
Initial Recovery Exercises (ie. Straight Leg Lifts) Throughout recovery period
Walking -Gait : Backwards & Forwards
2nd Month Of Recovery Exercises
(Start times vary with each individual. Some will start this in 1st month, others may start a bit later.)
Straight Leg Lifts with Ankle Weights
Then these are added as perhaps some of the 1st month exercises are dropped:
Mini-Squats W/Therabands Looped Around Waist & Supported From Wall
Sitting in chair w/wheels on carpet and pulling arouind room by alternating digging heel into carpet.
2nd & 3rd Month Of Recovery Exercises
(Start times vary with each individual. Some will start this earlier or later than others.)
The above 2nd Month exercises are continued with some increased activities. For example, in therapy, I had to pump vigourously 2lb and then later 5lb freeweights in my hands as I did the Mini-squats. That provided a degree of instability to the activity.
The Straight Leg Lifts continue as well (into the 2nd month of the recovery) but with increased ankle weights. Also, the straight leg lifts can be performed not only while lying on your back but addl repetitions can b down while in all 4 different lying positions: On your back, on each side and then while on your stomach.
Treadmill - Walking at first, Then after a few weeks increase to faster speed long strides.
Some may start a few minutes of light jogging toward end of 3rd month
Biodex Training (See Knee Lingo icon in Main Index for description)
Step Downs - Stand parallel on last step and lower good leg off step so the foot almost touches the ground, then rise back up and repaet 20 times. This exercise is accomplished by the injured leg on the step being flexed so that a small bend allows the good foot to lower to the ground.
Toe Risers - 1st done as a dual leg exercise and then if leg is strong enough and ankle is able to do it, do this as a single leg exercise. You stnad next to the kitchen counter for support. Then rise up on the toes and hold for 5 seconds. Then slowly lower and repeat for 20 repetitions. This will make the hamstrings talk to you the next day, so do only 10 for starters. More advanced - Hook the good leg foot arounf the injured leg's ankle, so that the good leg is out of the way. Then do this as a single leg exercise.
My PTs started me on some basic maneuvering around cones. This was not running but walking in a zig zag around cones and also some very small leaps over tape placed at short distances apart from each other.
Fitness Center Exercises may be kicked in some time in this time period. See separate Main Index Section on fitness center type exercises.
3 TO 6 Months Post-op And Beyond
This is a confidence building period. Depending on the reconstruction, some may have started aggressive exercises already and others may be just getting started. Fitness center exercises and exercises with increased resistance will begin. It is at this time that some will make a lot of progress toward full strength. I was at 50% full muscle strength at 3 months and 85% full muscle strength at 6 months post-op. Progress has a lot to do with avoiding setbacks and yet concentrating on increased resistances on sinlgle leg exercises. As leg strength increases, the PTs may get you started on agility type drills. But this must be phased in by the guidance of your OS & PT. The muscle strength is needed to help protect ligaments and the ACL is still getting established. The OSs are not in full agreement when an new ACL is at it's weakest nor when is it fully safe to start certain activities.
The basic recovery/PT therapy has ended for many and therefore a good home program or joining a fitness center is necessary for those wanting to get to and maintain full muscle strength. See Section on Fitness Center Exercises.