ACL Rehab

[bikelet]

I don't know the answers to all of your questions but on the first point are you following any post op rehab protocols? If you aren't then i'd suggest it as a good idea. When you can handle more dynamic exercises and single limb exercises in your rehab program then you would be able to start running. As you are running for fitness, you would be able to return to this relatively quickly (sooner than someone who needs to return to sport and be able to dodge obstacles etc). A fitness alternative is cycling and this can be started very early in a program, provided the seat is high enough and there is low resistance for minimal knee stress. In fact many exercise protocols use static cycling as a means of trying to increase knee range of movement.

[physiofi]

Cannot give any definitive answers as obviously differs from person to person. All the surgeons in the acute hospital I worked in had different protocols regarding their ACLs (one instructs patients are NWB for 4 weeks whereas another gets them FWB from first day post-op). In most ACL reconstructions I've seen, and the conservatively managed ones who weren't operated on, I never stressed that they perform exercises on both sides (unless it was unintentional) as generally found that the affected limb would be considerably weaker and require much more rehab to get back to the uninjured level.

As bikelet said^, rehab is important. What specific rehab protocol are you following? The surgeons where we work have differing rehab protocols, also depending on what type of graft it was. Generally most that I've seen have said to avoid any open chain activity and work hard on proprioception and hamstrings strength. As a rule of thumb, they said to avoid full return to sports until 12-18 months post-op. Specifically 16-18 if contact sports, if I remember correctly.

P.S. how far post-injury are you? perhaps you're being a little hard on yourself. I have treated an 18 year old whose MRI showed complete ACL rupture who had superb core stability and muscle strength and on examination was completely asymptomatic after a few sessions "prehab." He was continuing with all sports aside from football as he had been advised against this (by myself and the surgeon) but he was continuing to run considerable distance every night (although on the advice to avoid sharp turns/fast changes of direction).

I would say you probably need to give it more time before you judge whether or not you're "back to normal." If you're working hard at your exercises and core stability, you will reap the rewards.

[sarahkelly]

Hi there,
Sorry for the lack of details.
I'm 5 weeks post-injury, MRI scan next week, but me and physio pretty sure its ACL tear, Im not following a specific protocol but a physio is overseeing the rehab, I'm not even sure how it works from here, does an orthopaedic surgeon look at my MRI and prescribe a protocol? I will be managing this without surgery regardless. I've been working my ass of at rehab in gym/pool every day etc, but not working too hard on core strength (should probably focus a little more on that...). The reason I ask about jogging (jogging in straight lines, its my only sport, I don't play nor wish to play other sports) is that I have SLE and the muscles around some of my joints tend to get a bit weak and my nightly jog is the one thing that keeps them strong. But the physio said I wasn't allowed to jog right now (Next physio appointment = next week). I'm just wondering if it will be months b4 I can jog again, also the feeling of instability when I turn (even slowly) in walking, is that something that will never go away or will it decrease the more I work on proprioception, I'm ok walking in straight lines but cannot turn I have to pivot on the good leg, and that's not improved at all...
Also despite slight improvements, (I no longer feel that I'm going one way and everything below the knee is going another) will I always have a "dodgy knee"? Everyone keeps talking about rehab but how much of a recovery will I be able to make and will it ever feel "normal"?