ACL Recovery Day 129

Took a break from my rehab for about a week for the holidays, and haven’t been keeping up with my exercises for the last few days because of New Year’s, but am getting back on track with a good workout today. At my last PT appointment, my physio said that I’ve progressed really well and on track in terms of what activity level is 4 months out. The problem is that she can only do so much for me, so now I’m on the hunt for a new physio focused on basketball-specific training.

My friend is a PT in NYC and I had my first screening with him a few days ago. His assessment of my condition:

  • On track for 4 months from surgery (knew this already)
  • Quad strength is good (but can always be stronger)
  • Glute and hamstrings could be stronger
  • Hip muscles pretty weak on both sides (wtf?)
  • Flexibility needs work

The last two points were surprising to me since I’ve never had any hip strength problems, but now that I think about it, it might be that I never had good hip strength since I’ve don’t consistently do exercises focused on these muscles. The flexibility aspect was also interesting, and he worked on my flexion and extension (pushed me to a little hyper extension) and was able to get my leg to 150 degrees flexion by me laying on my back and bending my leg backwards.

Next Steps

My focus will be on the jumping and agility for the next few weeks, and hopefully getting into a regular routine with my friend who does basketball-specific training. Aside from all the workouts and exercises, dealing with all the logistics of scheduling the training is also a headache (but nonetheless necessary). My original physio accepted my insurance, but my friend’s clinic doesn’t take my insurance so I’ll be paying out of pocket, although we’re going to try to work something out.

When it comes to my healthy, I’ve never been shy about spending the money or resources to get the best treatment, but at times the reality of the cost of healthcare leads me to fall back on what providers accept my insurance. This is always a slippery slope, but in this instance of getting back on the court, I can’t see no other option but to pay for this myself since it’s important to re-gaining a healthy knee for the rest of my life. Once I’ve set up a schedule with my new physio, I’ll still see my old physio for checkups on my progress, but they will most likely be limited to once per month.

Additionally, the surgeon’s rehab protocol kind of “stops” from 4-6 months. The primary goal during this phase (according to the protocol):

Gradual return to athletic activity; Discharge onto home program

The exercises prescribed include “Jumping,” ” Unilateral hopping,” and “Agility drills; running, cutting.” Not super helpful in terms of detail so I’ll have to start doing my own research on what kind of drills and exercises I should be doing to build up the endurance and speed I need to get back on the court. Most likely, it will be a combination of agility and jumping, mixing in the usual strengthening and conditioning exercises I’ve already been doing. On top of this, I need to allocate more time for stretching to re-gain flexibility in my quads (to prevent tightness around my patella). It feels like the exercises just get added on top of each other, I almost miss Day 1 when the main exercise was the leg raise.

Exercises

Not a whole lot of new ones, but I recently purchased an agility ladder to help with all the agility exercises I want to do built speed and quickness. Having a ladder has allowed me to use my creativity and doing exercises that I wouldn’t do otherwise. Who would have thought a simply object as a ladder could be so beneficial for sports recovery?

ACL Recovery Day 106

It’s been roughly 30 days since my last update and about 3.5 months since my surgery. The recovery has been going well, although each incremental percentage of progress gets that much harder.

Diminishing Incremental Progress

What I mean is that the first month I actually saw the most visible progress. Going from 0% to 50% in 30 days was awesome since every day it felt like I was accomplishing something. Whether it was doing a basic leg raise, to starting to squat again, or being able to jog.

Then from days 30-60, the progress went from 50%-70%. Only 20% of progress but that 20% was so necessary in order for me to start doing agility exercises and lifting heaver weights.

Now on day 106, I’m probably at 80% of my pre-injury athletic level, so in the last 45 days or so I’ve only made 10% of progress. While the recovery is not as visible as before, you must continue pushing forward despite not seeing the results. There were times over the last few weeks where I thought “damn I’m pretty much there, why do I need to still work so hard to squat and do agility exercises?” The answer is that I’m not in game-shape like I was before, so getting to the point where I can cut and move laterally with ease is the goal.

Exercises

My exercises haven’t changed much, except now I try to alternate between strength and agility days. Strength-wise, I’m still doing the normal bilateral squats, deadlifts, single leg squats, and lunges. I started introducing anterolateral and anteromedial lunges which basically means lunging diagonally so that your knee is not straight when you plant the foot. This helps train the knee to perform under stress and weird angles.

In terms of agility, I’ve really started experimenting with all types of new shit and of course things the physio has taught me:

  • Line Hops/Ankle Bounces 3X30 – A pretty basic exercises where you lay a jump rope on the ground and bounce with both feet side to side as fast as you can.
  • Mini-Suicides 3X10 – To train your knee to stop laterally and change direction. Overall this is a tiring exercise since you’re running back and forth.
  • Side Lunge Jumps 3X10 – A pretty fatiguing exercise since you are pretty much jumping off one foot side to side as fast you can. I also go slower and go for distance to help build my explosion.

I purchased a $9 agility ladder on Amazon to do more agility exercises that involve precision. My physio told me that it’s not just about speed but accuracy as well. So being able to step in and out of a ladder knowing exactly where you want your foot to land will help you get back into game-shape.

Running

I’ve probably made the largest progress in this department. Prior to my injury, I wasn’t really running on the treadmill that much since I got most of my cardio from playing basketball. After the surgery, I really have no option but to get back onto the treadmill to get back the endurance and wind to play a full game. When I used to run on the treadmill, these were my typical numbers:

  • 1.5 incline
  • 8.0 mph
  • 10 minutes

It’s not the greatest, but I would mix in some jogging at 6.5 mph and do a little sprinting here and there at 10.5 mph for 30 seconds-1 minute. I never really ran long distances and treated treadmill work as just a warm up for strength training. However, I know after 10 minutes of 8.0 mph I would get winded so I set that as my benchmark.

Yesterday, I was able to do those same numbers except at 7.5 mph. I know I can probably get back to 8.0 mph easily, so my “cardio” is back to normal and I even did some sprinting at 9.5 mph without any issues. Being able to run/sprint and feeling my legs and hips extend to accommodate a sprinting gait was definitely a great feeling since I haven’t done that in close to 5 months. Long story short, I think I will get back to full-on sprinting in a few weeks.

A few videos from the last few weeks:

ACL Recovery Day 33

It’s been one month since my operation, and I’m definitely starting to feel the mental grind of going to the gym every day and doing the same exercises over and over again. One aspect of the workouts I’ve tried to change to make the exercises more fun is by gamifying sets. This means trying to get in a few more reps than normal, going to a higher weight, etc.

Since I have “graduated” from b-reddy’s one-month manual, I’ve stopped doing some of the exercises from his manual and moving to more technical and physically demanding exercises for strength and flexibility prescribed from my physio. Being able to squat with a 50-lbs weight has definitely helped with building my confidence that I will be able to build my posterior chain without too much pain or stiffness.

I’ve also changed the frequency in which I see the physio, so now I’m only seeing her 1/week on Monday mornings. She says many of the exercises I can do myself, and my dedication and commitment will determine how far I progress without see her as often as I should (to make sure I have enough sessions with my insurance to see her for at least 4 months post-op).

Exercises

As I said before, many of the “old” exercises from the 1-month manual have been phased out of my protocol. Straight leg lifts, side-lying leg lifts, active hip flexion, quad sets, etc. have been phased out and I’ll only do them as a warm up for the more physically demanding exercises. Many of these exercises are difficult to do even on my healthy leg:

  • Bike – I start at level 4 at my gym, and physio wants me to get to level 16 at her office tomorrow
  • Wall Squat or Squat – I’ll do the wall squat with two 20-lb weights which actually makes the exercises tougher on my core. The regular squat I’ll do with 50 lbs on my back and it’s difficult just because I’m trying to get equal force on both legs.
  • RDL – 4X8 with 50 lbs. Form on the RDL is much better now since I focus on shooting the hips back and shooting them forward.
  • Single Leg Press – 3X12. I do this on the leg press machine and am able to get to level 7 or 8. Comparatively speaking, my good leg is at a level 12, so I’m at 66% of full strength which is better than I thought. I still don’t get flexion to 90 degrees in between contractions.
  • Lunges – 3X10. This is a new exercise added from last week, and I step forward with each leg and lower into the lunge. It’s difficult when I’m stepping out with my left leg since my right leg doesn’t want to bend as much, forcing me to put more weight forward on my left leg than I should. Trying to fix this by making larger steps so that my right leg doesn’t have to flex as much.
  • Glute Bridges – May be phasing this exercise out since the strength stimulus is not very high compared to RDLs or squats.
  • Single Leg Squat With Weight – 3X10 with 10 lbs. This is one of the more difficult exercises since I’m training my knee to bend again and putting my entire body weight on the lift. It’s not a regular single leg RDL, since I’m bending the leg, but there’s still a lot of hip hinging involved.
  • Single Leg Calf Press – 4X8 at level 8. This is done on the machine, and much easier than doing a standing calf press/heel raise. Will mix this up this week between the leg press machine and standing.
  • Single Leg Squat With Opposite Leg On Bench – This is really a ROM exercise since I’ll put my right leg bent on a bench and lower with my left leg until I feel a stretch. Definitely gets painful since I’m doing active flexion.

Other things the physio asked me to include is massage the scar tissue and stair master. The scar tissue on the lateral side of my knee almost feels like a golf ball at times, so I’m constantly massaging to break up the scar tissue before it gets too stiff. I haven’t done the stair master yet, since I feel like walking up and down the subway and stairs at work have helped with the strength stimulus from walking and the cardio involved as well.

In other news, having more time at home has afforded me the ability to focus on fixing a broken Samsung LCD TV. Replaced a 2200 micro-farat capacitor (which I think was the issue) and also chipped away a lot of the gunk and glue that has melted on some of the power supply board. TV works for now, but will check tomorrow to see if it turns on again!

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