post acl reconstruction activities to brace or not to brace

I blew my acl in feb, had the patellar graft done in march. spent my 3
months with the physical therapist, but I moved back to tahoe in july and
haven't started with a new therapist over here. I've noticed that I'm
getting some pain and tenderness again when walking and specifically going
down stairs. This is really starting to WIG ME OUT, since its only 3 months
'till the snow is back. I thought (and the therapist and surgeon told me) I
should be able to return to normal activity with in 6 months.

But this is the part that's really getting to me, most every one I have
talked to that's had this procedure is in a brace when they ski or workout.
My therapist told me that a brace would make the knee "lazy" and I wouldn't
get maximum results for my workout if I wore one, plus the pricks at the
insurance company wouldn't cover one. So I assumed that if I kept up with
the workout all would be fine. Well its been almost 6 months now and I still
have pain, my strength is only about 60% of normal. So my 1st question is,
should drop the $400 and buy a brace, my 2nd, dose anyone have a specific
exercises other than those painful squats for strength building??

Any help would be appreciated

Chris

On Sun, 24 Aug 2003 18:40:08 -0600 (MDT), "CurtisLemay"
wrote:

ChrisChorn wrote:

Listen to your body. But a common sense approach could involve
going to a gym and using a weight program involving leg
extensions (sitting and lifting to the point that your leg is parallel
with the ground). Start light - you shouldn't feel any pain when you
perform the extensions and gradually work up the weight. There
are also leg abduction and adduction machines that will work the
leg muscles that help stabilize the knee. Again start light. Walking
is also a wonderful exercise for the legs.

As far as the brace is concerned, and this is just my opinion, I
would be inclined to use one until I was certain my leg was up to
snuff and I was confident that everything is working well. My
concern is with the muscles stabilizing the knee (those involved
with the adduction and abduction). You might want to try skiing on
the flats without the brace to build some strength and use the
brace in more challenging situations. I personally like the Donjoy
Legend Brace and it is about $400 as you stated.

I hope this provides some useful thoughts.

Seconded. Leg extensions, leg curls (to work the all-important
hamstrings) ad/abduction are what you want. Squats seem to put a lot
of stress on the knees, so are probably a bad idea. I had the same
procedure (patellar tendon graft) years ago, and still ski with a
brace, although I don't work out with it.

bw

Exercises: I'd stay away from squats for quite a while. Until then I'd
recommend leg extensions, leg flexions, leg extensions through limited
ranges of motion, calf raises, shin flexions and cycling. Once the knee is
stable and pain free through the full range of motion I'd add leg presses at
various foot positions then maybe some hack squats at very light weight. For
general ski fitness I'd add abduction and adductions exercises on a machine.
Once the knee is stable and pain free I may add light weight
abduction/adduction using an ankle cable to add more knee stability but back
off completely if experiencing any knee pain with that exercise. Once you
can exercise both legs individually at the same level I would start adding
balance and light motion activities (cushioned treadmill walking for
example).

Brace: I suggest one during skiing and any motion sports. I would not use it
during gym exercises.

Advice: Get yourself back in the care of an orthopedist and physical
therapist ASAP. Once the insurance has expired go to a personal trainer. I
meet with mine once every two weeks for assessments and workout planning.
I'd suggest you meet with yours for every workout for about 2 weeks then,
say, every other for about a month then slowly back off as you understand
more about the biofeedback that will help you avoid further injury through
training. They will start you with exercises you can do and upgrade you to
more challenging exercises as your joint stability and fitness improve.
Screen your personal trainer well - make sure they are certified and have
helped clients recover from similar injuries previously. In your case I may
even recommend you find a CPT who has a BA in an exercise science or is in
their last year of study toward that degree.

Aar

"ChrisChorn" chrischornatcharter.net wrote in message
...
I blew my acl in feb, had the patellar graft done in march. spent my 3
months with the physical therapist, but I moved back to tahoe in july and
haven't started with a new therapist over here. I've noticed that I'm
getting some pain and tenderness again when walking and specifically going
down stairs. This is really starting to WIG ME OUT, since its only 3
months
'till the snow is back. I thought (and the therapist and surgeon told me)
I
should be able to return to normal activity with in 6 months.

But this is the part that's really getting to me, most every one I have
talked to that's had this procedure is in a brace when they ski or
workout.
My therapist told me that a brace would make the knee "lazy" and I
wouldn't
get maximum results for my workout if I wore one, plus the pricks at the
insurance company wouldn't cover one. So I assumed that if I kept up with
the workout all would be fine. Well its been almost 6 months now and I
still
have pain, my strength is only about 60% of normal. So my 1st question is,
should drop the $400 and buy a brace, my 2nd, dose anyone have a specific
exercises other than those painful squats for strength building??

Any help would be appreciated

Chris

ChrisChorn wrote:

I blew my acl in feb, had the patellar graft done in march. spent my 3
months with the physical therapist, but I moved back to tahoe in july and
haven't started with a new therapist over here. I've noticed that I'm
getting some pain and tenderness again when walking and specifically going
down stairs. This is really starting to WIG ME OUT, since its only 3 months
'till the snow is back. I thought (and the therapist and surgeon told me) I
should be able to return to normal activity with in 6 months.

But this is the part that's really getting to me, most every one I have
talked to that's had this procedure is in a brace when they ski or workout.
My therapist told me that a brace would make the knee "lazy" and I wouldn't
get maximum results for my workout if I wore one, plus the pricks at the
insurance company wouldn't cover one. So I assumed that if I kept up with
the workout all would be fine. Well its been almost 6 months now and I still
have pain, my strength is only about 60% of normal. So my 1st question is,
should drop the $400 and buy a brace, my 2nd, dose anyone have a specific
exercises other than those painful squats for strength building??

Any help would be appreciated

Chris


A few years ago I had a hamstring acl repair done. After a short spell
of physio ( a couple of months) I was declared fit. From then on it was
normal work outs in the gym (no squats since I have always hated them).
Intially when I started jogging the knee hurt a lot but with time this
eased. After skiing it still sometimes hurts, but interestingly it never
hurts while skiing. I have never used a brace, but I have had some
twisting falls on it. When I compared the strenth of the two legs on a
quads machine the damaged leg was about 10% stronger than the undamaged leg.

Other posters have suggested a useful set of excercises for leg
strenthening, but 60% sounds a large differential. Are the muscles in
the legs similar sizes?

John

"ChrisChorn" chrischornatcharter.net wrote in message ...
I blew my acl in feb, had the patellar graft done in march. spent my 3
months with the physical therapist, but I moved back to tahoe in july and
haven't started with a new therapist over here. I've noticed that I'm
getting some pain and tenderness again when walking and specifically going
down stairs.

Seconds on all the good advice you have gotten to get back in therapy.
A brace will not slow you down. It will provide some stabilization. It
will reduce hyperextension and adduction.
You can help your recovery with some good vitamin therapy as well as
getting started on a regime of glucosamine. (Chondroitan is helpful
only if injected sez my consulting doctor) If you need help finding
it, google is your friend. Otherwise ask me about my Department of
Shameless Commerce.

Crashj "bee's knees" Johnson