Sebastian Brosche · 14 min · 1,288 words
Previously titled: Video 1 - Post-Op ACL Rehab Program
Hi folks, this is a basic post-operative rehabilitation plan for ACL reconstructions. Now before we start I'm going to say a few words of caution. It's really important with any post-operative rehab plan that you follow the advice of your surgeon and your healthcare providers. So they may have given you specific advice on what to do, what not to do, how far you can bend your knee at certain stages of the rehab plan, please follow those guidelines.
So if anything we say in this plan doesn't fit with those guidelines, leave it out. Now there are a couple of different variations on this surgery. Mostly it's to do with where the graft for the new ACL comes from. In some surgeries they take it from patellar tendon, other surgeries they take it from the hamstring tendon.
Those are the two of the common variations and which one of those you have will affect slightly what you're going to do in the rehab plan. I'm going to flag a few little variations in the plan that we're doing but we're really going to keep it very basic. So most of what we do will apply across the board. Now I'm going to start with day one.
This is a session that you can do very early on in your rehab program. So this is aimed at in the first week to two weeks after the operation. So today I'm going to use a rolled up towel and I've got my jujitsu belt for later on. Put that to one side and what I'm going to start by doing is mobilizing the knee into extension.
So I'm going to start with putting the heel on the towel. So there's a gap under my knee here. I'm just going to start by allowing the weight of the leg to take that knee into extension. Now this is a movement that we want to try and get back as early as we can after the operation.
We don't need to be worried about this one. This isn't going to stress the graft so we can afford to mobilize into extension. Like I said, the earlier we get this back the better our results are going to be. So I'm just going to let the weight of the leg do the work there.
I can encourage it a little bit. I'm not going to try and force it. I'm just going to gently apply maybe a little bit of pressure. Okay.
Then I'm going to switch up. I'm going to lie onto my back, taking the leg straight. I'm just going to slide the leg up towards me as far as I can get it. Now particularly in the early stages after the operation that flexion movement might be quite limited.
That's okay. I'm just going to take it to that point of slight discomfort and then back out again. So even if that range of movement is very limited, I'm just going to take it as far as I can in each direction. The idea is that we're going to do this repeatedly.
So these particular exercises can be repeated multiple times each day. Again, this early mobility is one of the things that is most important for getting a good result. Okay. I'm going to come back up.
I'm just going to place the towel under my heel again. And we're going to do another series of this. Again, just letting the weight of the leg, maybe a little bit of extra pressure, not too much. Again, I'm going to take up to that point of mild discomfort, but I'm not going to push it into pain.
So again, wherever your knee is at the moment, it may be that to start out with when you're first doing this plan, you can't get as far as full extension. That's quite normal, but we want to try and get as far as we can. And then going back into the heel slides. Now this time I'm going to place the towel underneath my knee.
I'm just going to place the hands around the knee. And what I'm going to do is I'm going to tense my quad muscles. So I'm going to tense and straighten the leg as far as I can. And just squeeze and hold that slow count of five seconds.
Just relax. And we're going to repeat that. And relax. It doesn't matter if you can't get your legs straight at the moment.
I'm just going to take it as close to straight as you can reasonably comfortably get it. And relax. Again. And relax.
And again. And relax. And then I'm going to take hold of the kneecap, patella. I'm just going to give it a bit of a wiggle.
So I'm just going to slide it left and right. Again, I'm being very gentle, keeping it within the comfortable range. I'm not going to try and force it. And then we can go up and down a little bit as well.
Just trying to encourage it slightly in each of those directions. We want to make sure that we have good mobility there between the kneecap and the joint underneath. And relax. And we're going to go back, squeeze the quadriceps muscles.
And relax. And again. And relax. And again.
And relax. And again. And relax. And once again, just give that kneecap a little bit of a wiggle.
Okay. Just pop the tail to one side. Just going to lie onto my back. What we're going to do now is some straight leg raises.
So lifting the leg up, keeping it as straight as we reasonably can. We don't have to have it locked out. Just going to take it as far up as possible until we get that pull on the back of the hamstring. It's a good way of working the quadriceps and the hip flexors.
Keep those strong. And then from there, I'm just going to roll onto my side. We're going to do the same thing. Keep the leg in a straight line with my body.
And back onto my back. Same again. And then back onto my back. And then one more time onto the side.
And then sitting up. So finally, we're going to return to that position with the towel under the heel. And this time, I'm just going to use my jiu-jitsu belt, wrap that around my foot. And now getting the knee as straight as I comfortably can.
Just going to pull back on the toes and stretch the calf muscle. Keeping the back up nice and straight. And I'm going to relax. Just let the tension off there.
So let the foot relax. And I'm just going to, keeping my back straight, I'm going to lean forward down over the leg. Stretching more of the hamstring this time. And one more time.
And one more time. Pulling back on the toes. Again, we're looking for that point where you can feel the stretch. It's maybe a little bit uncomfortable, but I don't want to overdo it.
I'm not going to push into pain. Just relax into that stretch there. And then relax. Let the foot go and lean forward.
And the final time. Pull back on the foot. And relax. Lean forward and stretch the hamstring.
And relax. And we'll leave it there for today. So that was a good programme to do early on in your rehab. So we'll come back for the next day.
We're going to leave that until you're able to weight bear. So once you can put weight on the leg, come back and we'll do the next session.
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