Issues 6 months post ACL reconstruction

[LizzyMathews]

Hey all,

I am recovering from an ACL reconstruction I had this year mid-Jan.
I had another surgery in august '13 for my mensicus and recovered amazingly well.

I had a hammy graft used, and have since - had issues with my rec fem firing, thus I am still quite strong and dominant on my unaffected leg.

I have followed a pretty intensive 3-4month rehab and moved onto advanced functional training (I'm at twisting and turning right now)

Before I was discharged from the hospital I had concerns with my ROM (I'm probably a few degrees of 0 for extension, literally 1-2deg off i can slightly slip my finger underneath), the therapist who was discharging me said it could be down to having a tight posterior capsule, or the graft is tight (Which is still an ongoing issue) but said my hamstrings seemed to be stronger.
Now, I'm obviously concerned because as a ST student, I'm aware of the arising issues with a poorly rehabilitated ACL injury and its imposing risks of a possible re-rupture.

I went back to my university clinic last month and they said my Rec Fem is really weak, seems to be firing really poorly and I still have a large area of numbness/lack of sensation anteriorly and laterally. I have done unilateral work, I even invested in a TRX which i take out once a week to encourage myself to stay on top of my unilateral rehab exercises.

My thoughts are because of the tightness i'm experiencing at the joint, I'm not going through my full ROM - this is potentially causing poor inhibition of my Rec Fem?

I am now refreshing my basic quad, VMO and leg extension exercises, but find my glutes are trying to dominate the activation as a result of this (which i am also trying to correct).

Any advice or exercises would be really appreciated as I would like to get back to sport at my expected date of October!

Thanks alot,
Lizzy

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[finchr]

From what you say, you have great inhibition of your r. femoris. A couple of degrees extension lag will not affect your quad. Goniometers are only accurate to+/- 5 deg. Do sustained prone hangs combined with QS and TKE as long as your shin is only 1/2 off the table to prevent hyperextension. Use NMES ( muscle stim ) with your quad exercises to augment muscle recruitment. You can do one leg presses 0-50 deg, walking lunges. The strongest leg will always dominate so use 1 leg
You will have some post-op skin numbness. I wouldn't worry about that.