Sebastian Brosche · 16 min · 1,248 words
Previously titled: Video 2 - Post-Op ACL Rehab Program
Hi everyone, welcome back to day two of our post-operative ACL rehab plan. Now, day two is suitable for people where it's been at least two weeks since the operation and you're able to wait there on the effect of the leg. So, for today's exercises we're going to use the towel and the belt that we were using in day one. We're also going to use a length of theraband and we're going to use a swiss ball or a physio ball, one of these big inflatable things.
We're also going to need a chair later on in the session. So, to start with, we'll start where we finished last session and we're going to be mobilizing that knee into extension again. So, hopefully that extension will be getting a lot better at this stage. So, I'm stretching the knee down and pulling back on the toes at the same time.
So, again, I'm keeping it within the reasonably comfortable range. I don't want to force anything. I'm just going to encourage that movement. Just relax slightly with the foot and lean forwards into the stretch.
So, I'm stretching the hamstring as well. Repeat that. So, I'm just going to come back, pull back on the toes. I'm trying to encourage that knee as close to full extension as I can get it at this point.
And relax and lean into the stretch. And relax there. Drop the towel and the belt off to one side. You can lie onto your back, link your hands behind your thigh and then I'm just going to move the leg up and down as far as I can in each direction without too much pain or discomfort.
It's quite a nice mobilization. Feel a little bit of a stretch on the hamstring at the top and it's usually the swelling in the knee that's limiting the movement as I come down. These mobilizations are things that I want to keep doing really as often as I can. In the early days, little and often is absolutely the way forward.
Okay, I've done that. I'm going to grab my ball, put that on the wall. I'm going to put my back onto the ball, leaning slightly against it, but keeping my balance on my feet. And all we're going to do is we're going to do mini squats.
So, it's important we don't go too far into flexion at the moment. So, I'm not going to try and do a full squat. Even if I can, I don't want to do that. Okay, so I'm going to keep the squat.
I'm going to go at most to 45 degrees of knee flexion. It's a nice small movement. And again, the idea is the ball is just giving me a little bit of support to start with and helping to make that movement a bit easier. I don't want to rely on it too much.
And then I'm just going to hold it at 45 degrees. And come back up. Do a few more. And rest there.
Pop the ball to one side. And I can just do some shifting in my weight, one side to the other. So, the idea here is I'm getting used to just weight bearing on one leg at a time. So, if I can, I'm almost going to a single leg balance.
Rocking side to side. And this is also helping with your balance and your proprioception. A sense of where the joint is in space. Start to hold it on one side.
And back. And then just grab the ball again. And we're going to do another quick set of mini squats. And once again, just hold that 45 degree angle.
Take some nice deep breaths. And finish off with a few more. And drop the ball to one side. Just go back into that weight shifting again.
Rocking side to side. Just start to build up that balance on one leg. And if you want to have a hand on a wall or the back of a chair or something while you do this, that's absolutely fine. The idea is to try and rely on it as little as possible, but as much as you need.
And if you can start to balance for a few seconds on that leg. And grab your chair. So I've taken my length of thera-band and I've tied it into quite a small loop that's just going to fit around my ankles. Now the idea with this exercise is this leg, my affected leg, is not going to move.
This is going to be working isometrically and I'm going to keep it at about 60 degrees of flexion. So about 30 degrees from the horizontal. So I'm going to go to about here. And the idea is the other leg, my good leg, is going to apply the tension.
So at the moment, because I've got this good leg back, the tension is pulling back on my affected leg. I'm not having to work with my quadricep muscles to keep it where it is. We're just going to do a static hold there. And then from there we're going to move this leg.
Now if you've had a hamstring graft, so the hamstrings on the affected leg were involved in the operation, you may need to leave this out. So again, if your surgeon has advised you to avoid hamstring exercises, don't do this next bit. I'm going to straighten the other leg. So I'm putting tension in the other direction.
And now it's the hamstrings on my right leg, my affected leg, that are working. I'm going to hold that, static hold. My good leg's getting a workout at the same time. And I'm just going to pull back.
I'm going to go in the other direction. So once again, it's the quadricep muscle that's working. And switch over. And for a final time, I'm going to pull back.
Now the reason we're restricting the angle of this knee is to avoid putting too much stress on that graft. So again, we want to be a little bit careful with what we're doing because it's important that we don't stress it too much in those early stages while it's still healing. In the other direction. In the other direction.
And rest there. And just drop that band to one side for a minute. I'm going to stand up. And we're just going to do a few calf raises.
Just coming up onto the toes and back down again. Grab the band again. I'm going to do one more set. So once again, set this knee's position first.
So 60 degrees of knee flexion, approximately. And then I put the tension on using the other leg. And switch over. And switch again.
And make sure you keep breathing while you're doing these holds. Switch. And one final time. And go the other way.
And again, you can adjust the amount of tension you're putting on with the other to make sure that you get the right amount of force. So we're going to start nice and easy and then gradually build up as the leg gets stronger. And rest there. And drop the band to one side.
Do one final set of calf raises. And rest there. And that's all for day two. So day three, the next step in the programme, that starts from four weeks post-operatively.
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