Knee Injury - some advice please

Hello All,

Hope someone can help me with this if possible. Its quite long!

A year ago I was playing football, I jumped and landed on my weak leg (left) - it was 'hyperextended' this meant I was in a lot of pain and I couldn't walk for 6 weeks.

I went to see a physio and she suggested I do some exercises to build up my knee strength. I did this and knee got better. But after a few more months I wanted to get back into footy and my knee didn't feel 100% so I saw a different physio. This guy said my left knee was more lax or loose than the right leg and that he suspected a torn ACL.

I had read up all about torn ACLs and I dreaded that news. But anyway he suggested I get an MRI. I then saw my GP, got reffered to a specialist. Who also said my knee was looser than the right knee. The worrying thing was that he just did a few quick tests and started talking about an MRI and surgery like it was definite (I am guessing he has seen it all before).

I had my MRI last week and am awaiting the results.

Anyway I am fairly sure I have a torn ACL and am fine with having surgery in 6-9 months or whenever.

I have stopped all forms of sports (I did play footy once or twice sicne I injured my knee).

Basically I am kinda glad I am having surgery because my knee doesn't feel quite right, The description of it being a bit lax/loose because of a torn ligament fits because it does feel a bit loose, like I have less control over it and it isn't as responsive as my right knee. Like for example when I am walking at normal pace the left leg sometimes feels like it doesnt want to follow the ntural motion or is slow at doing so - basically there is a noticeable difference!

My issue is that I am starting a fairly phsyical job next week which involves bending and lifting (not extreme weights though)

I can walk/bend with no pain so I should be fine for work - but I think I can do a bit of streghening work to get my knee as solid as possible for work and for before the operation. I think I will be seen by a physio before the operation but that won't be a for a while yet I imagine.

I have also read you can actually continue playing footy etc without a repaired knee ligament IF you do enough training and build up a lot of stregth. My physio I saw also said I could continue with football but recommended the surgery (which I will have of course).

So if its possible to live on without surgery it must be possible to get knee feeling much better before I have surgery.

So basically what I am is looking for is some advice on some exercies I can do to build up as much strength as possible in (both) of my knees so I am in a position of having a knee about as decent as it can get up to surgery.

I am of may light weight training squats etc.

My physio also suggest all kinds of footy training liek shuttle runs and diagnol runs as it will build up the stability which I am guessing is the mai nreason my knee doesnt feel responsive.

Any advice appreciated. I have until next Monday til I start so I can put a lot of effort in and then continue after work.

I am physically fit aside fro mthat. I have dumbells at home but can also visit the gym if needed.

Thanks!

You are correct when you say that you are able to continue with sport even when the ACL is torn. this normally depends on the stability of the knee. If it is 'stable' then most physios would generally try conservative rehab before surgery. This basically involves lots of exercises to strengthen the muscles surrounding the knee so that they take the job of the ACL. If the knee is 'unstable' in that it is giving way and affecting you in daily life then surgery would be the prefferred option.

Most surgeons that I have delt with on this issue tend to do the conservative route for a number of weeks, see how it responds and then decide on surgery or not. This works to either fix you without the need for surgery, or it will stengthen you up so the detriment from surgery is not as great

I would do my research before seeing the surgeon. There are different grafts that are used if you do require surgery. The most common ones are hamstring and patella tendon. Each has its positive and negatives and generally each surgeon will favour one or the other.

I wouldn't be happy with prescribing any exercises on a forum as it is not that easy to explain. The exercise I would start with most people do wrong when I ask them to demonstrate it to me and then I have to correct it. Obviously I would be unable to do this. I would go and see a physio and get them to show your the exercises.

hi

whilst its true you can in some case continue playing sport with an ACL deficient knee you do need to get it strong beforehand, also working on your proprioception (balance) is very important to help prevent further injury.

a cautionary note however you do put yourself at risk of further wear and tear of the remaining ligaments and cartilage if you train/play on a knee that has more movment than is normal for you. however the stronger you get your knee preop the better and quicker your rehab progresses post op.

i agree though that the bestthing to do to get specific exs is to get a session wiht a physio as if you use the worng technique you may end up causing more damage.

I totally agree with the colleagues
A famous german soccer player without any lig.s is "Lothar Matthaeus" although he was and is beeing treated on a weekly basis now over years.

Another thing to keep in mind, if you try to go on without having it fixed is the infiammation-process of the torn and hurt structures, which CAN tend to reinfiammate and with this CAN cause the chondral elements to decompensate, when being trained.

Go see your physio and also talk to her/him and also probably about enzymes or any supplements to prevent such a process.

Best wishes

Hi
ACL injury as you have experienced results in typical instability which is classically described as "giving way". This is particularly felt in turning at high speeds & while climbing down the steps.
In absence of ACL (when it is torn completely) hamstring muscles can be trained to perform restraining function of ACL thereby reducing instability in the knee particularly in activities like walking, climbing & squatting. The muscles are trained to contract where ACL function is expected. This is done by physiotherapist & is called proprioceptive training. Remember only increasing strength of muscles is not sufficient. you need to learn how to control the knee with the help of quadriceps & Hamstring muscles. This will help you minimizing instability & reduce possibility of chondral damage which is a long term effect of ACL tear. These exercises are also part of your postoperative rehabilitation. So learning them & doing them right from now will help you in postoperative rehabilitation phase.
it is a welknown fact that success of ACL reconstruction largely depends on effective postoperative rehabilitation. this is the time when you should get yourself introduced to various aspects of this phase.
You must also be conscious that you are nurturing an ACL deficient knee. Any indulgence in high speed contact sports will suubject it to further damage. So no footy till you undergo surgery & full course of rehabilitation. Patience in resuming sporting activities till your rehabilitation team gives you green signal is the best policy you can adopt now.
Best of luck for your upcoming surgery!!