Staying healthy and strong
During this phase you will
work on building your strength back while allowing the ligament to heal
into the bone tunnels in your femur and tibia. Most physical therapists
prescribe closed chain kinetic exercises during this phase. In this type
of exercise your foot is planted on the floor and it is not free to move
about. Squats are an example of a closed chain kinetic exercise whereas
quadriceps extension exercises on a weight training machine are an open
Most surgeons prefer to wait
until at least three months have passed before allowing their patients
to return to agility training exercises. When to return to competitive
or recreational sports after an ACL reconstruction is a difficult decision.
The timing of your return will depend upon how well you have done with
your rehabilitation, how solid your knee feels to you, and what you and
your surgeon decide is reasonable for you. Even after you return, it is
important that you pay special attention to keeping your quadriceps and
hamstrings in good shape, as this is considered an essential part of protecting
your quads strong.
Two very good exercises for maintaining quadriceps
strength are short arc squats and lunges. In the short arc squat,
which is illustrated below, the feet are kept shoulder-width apart,
the back is held straight, and the knees are bent to the point where
this is still a comfortable exercise. The goal of this exercise
is to strengthen your quadriceps muscle, and not to force your knee
through a complete range of motion. Therefore, it is not wise to
try to squat down as far as you can possibly go, but rather to perform
the exercise to the point where you just start to feel pressure
inside your knee. When first starting with a strength training program,
it is a good idea to have a physical therapist give you instructions
on how to perform each exercise.
|Lunges are also an excellent exercise for maintaining
quadriceps and hamstring strength. In this exercise, start with both
feet shoulder-width apart, and then step forward with one foot. Allow
yourself to dip down to the point where you just start to feel pressure
inside your knee, and then come smoothly back up to the starting position.
As your quadriceps get stronger, you can increase the amount of weight
and repetitions that you perform.
Agility exercises are
designed to improve the power and strength in the muscles that move
your knee after the ACL graft has healed. These exercises are often
called plyometrics, and they are an important part of agility exercises
and retraining. In this first box jump exercise, stand to the side
of the box and hop up onto the box, landing with both feet. Then
hop off the box down to the ground, again landing with both feet.
strength and agility increases, you can progress to jumping completely
over the box, landing with both feet together on the far side.
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