23 Weeks post ACL (thurs 11NOV to WED 17NOV)

11 Nov Thurs
*1 hour fat burn stationary bike
Hamstring Curls
L 3 sets of 15 (5kg)
L&R 3 sets of 15 (10kg)
=
*Quad press L&R (3sets 15 - 45kg, 52,5kg & 60kg)
Hamstring Curls
L 3 sets of 15 (5kg)
L&R 3 sets of 15 (10kg)
=
*Ball squats (-3x sets 15 reps-elastic on knees )
=
*stretches /quads&hamstring
_________________
12 Nov Fri
*Cardio 171bmp 20mins Airwalker
*DeadLifts 15 each leg

*Hamstring Curls
L 3 sets of 15 (5kg)
L&R 3 sets of 15 (10kg)
=
*BOSU squats (-3x 10secs holding -elastic on knees )
*Stability Ball - hip raises (x 10 )
*Stability Ball - Hamstring (alternate leg raises ,hips up , hold leg forward x 10 each leg)

*Lats 15 reps (30kg)
*pullups 15 (50kg assisted)
*Balance on 1 leg L & R ( 3 sets of 20secs eyes closed )
____________
SAT 13 NOV
150m swim - varying strokes
____________
SUN 14 NOV
*Trail Run 5km's
4running exercises:
3sets sideways running
**=
(1set = Sideways L ~10steps,Sideways R ~10steps, :Alternating 3 times)
**
Run backwards 2x 100m's
**
Verticle Jumps X 30

22 Weeks post ACL reconstruction

Thurs 4 Nov
*10min stationery bike level 13 (out of 25) 118-122bpm
*20mins Step Machine fat burn
*Quad Press:
L&R -3x sets 15 reps( 45kg & 52,5kg & 60kg

Hamstring Curls
L 3 sets of 15 (5kg)
L&R 3 sets of 15 (10kg)
=
*Ball squats (-3x sets 15 reps-elastic on knees )
*Stability Ball - hip raises (-3x sets 15 reps)
*Stability Ball - Hamstring (alternate leg raises ,hips up , hold leg forward)
*Crab walk :elastic on knees
(L)4 sets 10 steps , (R)2 sets 10steps

_________________
SAT 6 NOV
*Bike *Fat Burn(117-120bpm)

*DeadLift 2 sets 15 L &R

*Verticle Jumps x 20

Lie on side-elastic Band on knees:
Leg raises:
R"Leg 2 sets 15
L"Leg 4 sets 15

•Squats on Bosu
Elastic around knee -Open knees (3sets of 15)

***
HAMSTRING CURLS
R& L : 3 set 15 ( 10kg )
L only: 3 sets 15 ( weight: 5kg )

*Towel stretch
*Heel to butt stretch

*Wobble Board -1 Leg- 2 x 30secs each balance

_________
Sun 7 Nov
4km trail run.
*Verticle Jumps x 20
5 sets 10m backwards running
5sets sideways skipping (L&R) 10m

_____________
Mon 8 Nov
5km trail run
*Verticle Jumps x 20
5 sets 10m backwards running
5sets sideways skipping (L&R) 10m

1hr Stationary bike- fat burn (117-122bmp)
*Towel stretch
*Heel to butt stretch

Stability ball-
~ 2 legs on ball - bridge (hip raises x 15)
~ bridge - 2 feet on ball , alternate leg raises (straight leg) 10 each leg

_____________
WED 10 NOV OFF

21weeks post ACL reconstruction- Month 5- (wed 27 Oct - tues 2 Nov)

WED 27 OCT
*Jog 3kms - alternating side shuffles , skipping , "wide legged running" , and side stepping.
__________
Thurs 28 Oct
Swim 100m
__________
FRI 29

Lie on side-elastic Band on knees:
Leg raises:
R"Leg 2 sets 15
L"Leg 4 sets 15

•Squats against the wall- Ball
Elastic around knee -Open knees (3sets of 15)

***
HAMSTRING CURLS
R& L : 3 set 15 ( 15kg )
L only: 3 sets 15 /10 /7reps ( weight: 10kg )

Quad Press
3 sets 15 reps ( weight: 52,5kg &60kg & 60kg )
***

Ball work(hamstrings)
L & R (2 sets of 10 -balancing on alternate legs )
____________
Sat 30 OCT
*Swim 200m
*20pushups

•Airwalker: FAT BURN (117-122bpm) 20mins
SUPER CIRCUIT:
Between weight resistance machines:
1) using step up, jump off on and off- fwds and bckwards.
2) Stepping up and sideways (left and right alternatively)
3) running up the stairs and down
4) hopping on and off the step both feet

HAMSTRING -BOSU BALL
BOSU Ball Side Squats and Hops
Side to side squats on a bosu ball involve stepping off to the side and doing squats with one foot on the ball and one on the ground.3 sets 20 (alternate L and R)

Read more: How to Do Bosu Ball Side to Side Squats: How to Do Bosu Ball Exercises | eHow.com http://www.ehow.com/video_2280465_do-ball-side-side-squats.html#ixzz13v7jLX48



Lunges. with weights in hand:
Alternate legs : Leg 3 sets 20


•Squats against the wall- Ball
Elastic around knee -Open knees (3sets 15)
____________
Sun 31 Oct

•Airwalker: FAT BURN (ave. 126bpm) 20mins

SUPER CIRCUIT:
Between weight resistance machines:
1) using step up, jump off on and off- fwds and bckwards.
2) Stepping up and sideways (left and right alternatively) -Quick moving-
3) running up the stairs and down
4) hopping on and off the step both feet

Quad Press
3 sets 15 reps ( weight: 45kg & 52,5kg &60kg)

*Bosu Ball Side to Side Squats
(From one Bosu to next not touching the ground!)

_______
MON 1 NOV
*Trail Run 4km's

20 Weeks after ACL reconstruction (Wed 20 - Tues 25 OCT)

Wed 20 Oct

•Airwalker: Cardio (140-160bpm) 20mins
•Super Circuit (50mins)
Including- Step (jump up down then backwards up and down)
•Tredmill 20mins
~2mins walk(6.5) & 2mins run(10)~ alternatively
•Squats against the wall- Ball
Elastic around knee -Open knees (2sets 10)
__________
Fri 22 Oct
40mins Cardio

HAMSTRING CURLS
LEFT ONLY
3 set 10 , 5 , and 10 reps ( weight: 10 , 15 and 10kg )

Quad Press
LEFT ONLY
3 sets 15 reps ( weight: 45 kg & 52,5kg )
***
Calf press
LEFT ONLY
L )3sets 15 reps ( weight: 30kg )
***

Lie on side-elastic Band on knees:
Leg raises:
R"Leg 2 sets 15
L"Leg 2 sets 30


•Squats against the wall- Ball
Elastic around knee -Open knees (3sets 15)
___________
Sun 24 Oct

•Tredmill 20mins
~2mins walk(6.5) & 2mins run(10)~ alternatively

Lie on side-elastic Band on knees:
Leg raises:
R"Leg 2 sets 15
L"Leg 2 sets 30

•Squats against the wall- Ball
Elastic around knee -Open knees (3sets of 10)

***
HAMSTRING CURLS
R& L : 3 set 15 ( 15kg )
L only: 3 sets 10 reps ( weight: 10kg )

Quad Press
3 sets 15 reps ( weight: 45 kg & 52,5kg &60kg )
***

Ball work(hanstrings)
L & R (2 sets of 10 -balancing on alternate legs )

19 weeks after ACL reconstruction 13 OCT - 20 OCT

13 OCt
Fat Burn 40mins Ex-Bike

Hamstring stretch(towel) 30secs p/leg
Hib flexor/quad stretch
Calf stretch
Bridging gym Ball
Whole Body Stabilization gym ball
Lunges (2sets 15 right leg , 3 sets 15 Left leg)
***
Quad Press
2sets 15 reps ( weight: 45 kg & 52,5kg )
***
Calf press
R )2sets 15 reps ( weight: 22kg )
L )4sets 15 reps ( weight: 22kg )

HAMSTRING CURLS
R & L )2sets 15 reps ( weight: 15kg )
L ) 2 set 15 reps ( weight: 5kg )

_________________
Thurs 14 Oct
Step machine 10mins Cardio (13/25 effort)
Ex-bike 15 mins Fat burn (117-120bpm)
Ex-bike 5. mins Cardio (140bpm)
Tredmill: 10mins
•1min walk (effort 6.5) alternate 1min jog (effort 9.5)

-- LOW PULLEY (abduction)
R"Leg 2 sets 15 (10kg)
L"Leg 4 sets 15 (10kg)

---LOW PULLEY.(Extension)
R"Leg 2 sets 15 (10kg)
L"Leg 4 sets 15 (10kg)

***

Quad Press
2sets 15 reps ( weight: 37,5 kg & 45kg )
***
Calf press
R )2sets 15 reps ( weight: 22kg )
L )4sets 15 reps ( weight: 22kg )

HAMSTRING CURLS
R & L )2sets 15 reps ( weight: 15kg )
L ) 1 set 15 reps ( weight: 5kg )
L ) 1 set 5 reps ( weight: 10kg )


Lie on side-elastic Band on knees:
Leg raises:
R"Leg 2 sets 15
L"Leg 4 sets 15


Hib flexor/quad stretch
Calf stretch
____________________
Fri 15 Oct
•Airwalker: Cardio (140-160bpm) 20mins
•Tredmill: 10mins
= 1min walk (effort 6.5) alternate 1min jog (effort 9.5)

Quad Press
2sets 15 reps ( weight: 37,5 kg & 45kg )
***
Calf press
R )2sets 15 reps ( weight: 30kg )
L )4sets 15 reps ( weight: 30kg )

HAMSTRING CURLS
R & L )2sets 15 reps ( weight: 15kg )
L ) 1 set 15 reps ( weight: 5kg )
L ) 1 set 5 Reps ( weight: 10kg )

Ab. Curl: 3 sets 10 reps ( weight: 35kg )
Overhead pullover - 3 sets of 10 ( weight: 37,5kg)

Hamstring stretch(towel) 30secs p/leg
Hib flexor/quad stretch
Bridging gym Ball: Lift alternate Legs :stabilize (tight hamstring and glutes and hold leg straight - 10secs each ) -once-

_________

16 Oct
Stationary Bike : Fat Burn 40mins (117-122bpm)

Quad Press
3 sets 15 reps ( weight: 45 kg & 52,5kg & 60kg )
***
Calf press
R )2sets 15 reps ( weight: 30kg )
L )4sets 15 reps ( weight: 30kg )

HAMSTRING CURLS
R & L )2sets 15 reps ( weight: 15kg )
L ) 2 set 10 & 5 reps ( weight: 10kg )

Lie on side-elastic Band on knees:
Leg raises:
R"Leg 2 sets 15
L"Leg 2 sets 30

-- LOW PULLEY (abduction)
R"Leg 2 sets 15 (15kg)
L"Leg 4 sets 15 (15kg)

---LOW PULLEY.(Extension)
R"Leg 2 sets 15 (15kg)
L"Leg 4 sets 15 (15kg)


Lunges (2sets 15 right leg , 3 sets 15 Left leg)

Stiff one legged Deadlift (3kg weights in each hand) :
Left Leg : 4 sets 10
Right Leg: 2 sets 10

Hamstring stretch(towel) 30secs p/leg
Hib flexor/quad stretch
_________________
Sun 17 Day Off
____
Mon 18 Oct
•Airwalker: Cardio (140-160bpm) 20mins
1 hour Stationary Bike : Fat Burn 40mins (117-122bpm)
•Hamstring stretch(towel) 30secs p/leg
Hib flexor/quad stretch
•Super Circuit (50mins)
No Quads / No Hamstring weight resistance :I am very stiff. So badly so ,that I feel I am walking with a limp??
:I made a physio appointment for tomorrow appointment

___________
Tues 19 Oct
*7:30 Lynette Physio
__________

week 18 ( 4mnths) post ACL reconstruct

Tues 5th
Cardio 15mins Ex-Bike
Hamstring stretch(towel) 30secs p/leg
Hib flexor/quad stretch
Calf stretch
Bridging gym Ball - 5 seconds max balance on each Leg .
Whole Body Stabilization gym ball

***
Quad Press
2sets 15 reps ( weight: 45 kg &52,5kg )

Calf press
R )2sets 15 reps ( weight: 22kg )
L )4sets 15 reps ( weight: 22kg )

HAMSTRING CURLS
R & L )2sets 15 reps ( weight: 10kg )
L ) 1 set 5 reps ( weight: 5kg )

______________________________________
Wed 3rd Oct
Cardio 15mins Ex-Bike
Hamstring stretch(towel) 30secs p/leg
Hib flexor/quad stretch
Calf stretch
Bridging gym Ball
Whole Body Stabilization gym ball
Lunges (2sets 15 each leg)
•left leg 1set 15 extra
Stiff one legged Deadlift
***
Quad Press
2sets 15 reps ( weight: 45 kg & 52,5kg )
Calf press
R )2sets 15 reps ( weight: 22kg )
L )4sets 15 reps ( weight: 22kg )


HAMSTRING CURLS
R & L )2sets 15 reps ( weight: 10kg )
L ) 1 set 10 reps ( weight: 5kg )

_____________________________
Thurs 7 Oct [DAY OFF TOO STIFF]
FRI 8 Oct [Still very stiff , but at gym]
Stationary Bike:
Fat Burn : 40mins HOUR 117-120 bpm

HAMSTRING CURLS
R & L )2sets 15 reps ( weight: 10kg )
L ) 2 set 15 reps ( weight: 5kg )

Lunges: 2 sets 15 R. Leg
4 sets 15 L. Leg
Dead Stiff 1 -Leg Lifts- Hand weights
• 2 sets 15 R. Leg
•4 sets 15 L. Leg

No Core Stability Ball
Abdominals: 3 sets of 10(35 &45 & 50kg)
Lats. 3 sets of10 ( 30kg )

_____________________
FRI 8 Oct
20mins Cardio
-- LOW PULLEY (abduction)
R"Leg 2 sets 15 (10kg)
L"Leg 4 sets 15 (10kg)

---LOW PULLEY.(Extension)
R"Leg 2 sets 15 (10kg)
L"Leg 4 sets 15 (10kg)

HAMSTRING CURLS
R & L )2sets 15 reps ( weight: 10kg )
L ) 2 set 15 reps ( weight: 5kg )

Lie on side-elastic Band on knees:
Leg raises:
R"Leg 2 sets 15
L"Leg 4 sets 15


Hib flexor/quad stretch
Calf stretch
Bridging gym Ball
Whole Body Stabilization gym ball

__________________
Sat 9 Oct
20mins Cardio

-- LOW PULLEY (abduction)
R"Leg 2 sets 15 (10kg)
L"Leg 4 sets 15 (10kg)

---LOW PULLEY.(Extension)
R"Leg 2 sets 15 (10kg)
L"Leg 4 sets 15 (10kg)

Hamstring Stretch _ (towel on foot) 30secs each foot

Lie on side-elastic Band on knees:
Leg raises:
R"Leg 2 sets 15
L"Leg 4 sets 15


_________
Sunday (Horse Riding only) No Gym

I feel like this coming week is bringing great promise for my exercise program. I'm feeling motivated /strong. I have adjusted my diet , adding more essential fats. I also feel I hit a dip in my training / a block because my body was not as healthy as it shoud be _ I was "too health" conscious and cut out too many fats to get my fat % down. Which at its lowest beginning Sept = 13.9%.


_________
Monday 11 Oct
Stationary Bike: 50mins (fat burn 117-122 bpm) & 10mins Cardio 130-142bpm

•Hamstring stretch(towel) 1min p/leg
Hib flexor/quad stretch (heel on L"Leg nearly touching glut - 5 degree difference)

Bridging gym Ball - 10 seconds max balance on each Leg .

Whole Body Stabilization_press up 1min

Quad Press
3sets 15 reps ( weight: 45 kg & 52,5kg &60kg)

Calf press:
R )2sets 15 reps ( weight: 22kg )
L )4sets 15 reps ( weight: 22kg )


HAMSTRING CURLS:
R & L )2sets 15 reps ( weight: 15kg )
L ) 2 sets 15 reps ( weight: 5kg )

Upperbody:
Lats pullover 2 sets 15 (37.5kg)
Bicep Curl 2 sets 10 (10kg)
Verticle row 2 sets 10 (37,5kg)

PHASE IV (4-6 months)

Return to Practice Progression 120 -150 days

a. Gym and PT (see table 2)
b. Pool and Swimming progression 1 hour Including Aqua jogging with
Buoyancy vest (table 1)
c. Continuation of Bike 1hr/day with progression of time, load and speed
d. Stairmaster, Elliptical to enhance cross training diversity.
e. PEP program to start as a 15 -20 minute warm up 3x /week to all field
training, all elements (See ACL Prevention Program)
f. Run and Sprint Box progressions on field or court. Start at 15 minutes.
Box at 10 yards lengthening to 40 yards. You must be able to sprint box
both ways by 120 days. Once you are at full speed on the box drill,
then you may begin to return to practice as outlined below. You must
continue box on daily basis even though you transition back into
practice!
g. Practice criteria and on field progressions non-contact drills only
during practice x 28 days
h. Practice May play criteria on field progressions contact drills only
during practice x 28 days once safely and effectively passed non-contact
drills
II. Return to Play/Practice/Compete Progression 150-180 days
a. Gym and PT ( see table 2)
b. Pool and Swimming progression 1 hour Including Aqua jogging with
Buoyancy vest (table 1)
c. Continuation of Bike 1hr/day with progression of time, load and speed
d. Stairmaster, Elliptical to enhance cross training diversity.
e. PEP program (See ACL Prevention) to start as a 15 -20 minute warm up
3x /week to all field training, all elements
f. Run and Sprint Box progressions on field or court. Start at 15 minutes.
Box at 10 yards lengthening to 40 yards. You must continue box on
daily basis even though move into practice!
i. Continue on field progressions contact drills only during practice
x 28 days. Once you have safely and effectively passed contact
drills then you are ready for competition progression, can
progressively start games 15 minutes, 20, 25, 30. Up to 90 minutes
by 180 days. Full release when one can play 90 minutes with
comfort.

 3 L's of ACL Injury Prevention on the field: 

1) Soft Landing following jumps at all times. 

2) Stay Low while running at all times.

3) Keep your knees in Line with your feet at all times.

Table 2 – In Physical Therapy REHABILITATION PROTOCOL

Massotherapy:
• Draining massotherapy of knee and calf
• Decontracting Massotherapy of the quadriceps and ITB
• Decontracting Massotherapy of the hamstrings muscles starting from week 2-3 (patients treated
with autografts, paying attention to the harvesting area), or starting from week 1 (patients treated
with allografts).
ROM exercises and joint mobilization:
• Passive mobilization of the patella
• Manual and self assisted passive mobilization in order to improve flex-extension
• Posterior chain stretch on the wall
• Active mobilization using a stationary bike (improving ROM as much as possible) or sliding the
heel on the wall or following an imaginary path while lying on the bed
Stretching:
• Hamstrings
• Triceps surae
• Quadriceps (when a 130° flexion is reached)
• Ilio-psoas
• Tensor fasciae latae
• Postures for the posterior muscular chain
Strength recovery:
• Electrostimulation (even with co-contractions)
• Quadriceps/hamstrings co-contrazctions
• Hip Flexors, adductors, abductors and extensors with weights and tubing
• Soleus with tubing
• Knee flexors starting from week 4-5 (patients treated with ST-G grafts) or from week 3 (patients
treated with PT grafts)
• Closed Kinetic Chain exercises:
o Leg press with elastic resistance from week 2-3
o Leg press with weights, wall slide, step-up from week 4-5
• Open Kinetic Chain exercises:
o Last 30° knee extension (VMO) performed with natural weight from week 2-3, then using
weights (from proximal to distal position)
o Leg extension ROM 90-40° from week 5
• High velocity isokinetic training (limited ROM ) from week 6
• Full weight-bearing exercises:
o Plantar flexion of the foot with full weight bearing in eccentric-concentric mode
o Knee movement control exercises (varus-valgus) lateral step-up like
o Strengthening exercises for trunk and deep abdominal muscles (core stability)
o Eccentric control exercises with natural weight bearing using differents motor patterns
Proprioception:
• Walking using a correct gait cycle
• Exercises with proprioceptive board without weight bearing (bi and monopodalic) progressively
increasing weight in stand position
• Bipodalic and Monopodalic stops on bouncer
• Proprioceptive paths
• Proprioceptive exercises for trunk muscles (core stability)
Sport specific and skill exercises:
• Running and skipping on bouncer
• Bipodalic and monopodalic jumps on elastic leg press (plyometric exercises)
• Aerobic training: stationary bike, stepper, cross trainer, running on treadmill at slow speed
• Sport spcific exercises using equipment specific to sport of desired return

Rehabilitation


Criteria to Advance to Phase IV
Regularly completing isotonic strengthening program in supervised physical therapy
Starting to transition strengthening activities to local gym or athletic team’s weight room
Approximately 70-80% strength vs. contralateral (uninvolved) lower extremity
Demonstrates appropriate control of knee with neuromuscular retraining exercises in the physical therapy clinic





Rehabilitation


Phase IV- Advanced Functional Activities (10 weeks- 6 months)
The primary goal of the fourth phase of rehabilitation is to prepare the athlete for return to sport. Running, cutting, and jumping are near universal requirements of the sports in which athletes most often tear their ACL’s.
be cognizant of other tasks which are important parts of the sport to which the athlete hopes to return
&ladder drills or other simulated running tasks, then advance to interval jogging.
Once 70-80% of their pre-injury speed, cutting drills begin.
&Land based jumping, jumping up to a box and/or completing all plyometrics activities by landing on two legs

Week 17 Post ACL reconstruction

WED 22-FRI 24sept ~Rest~

Sat 25 SEPT
~Super Circuit Gym_ all major muscle groups~
~10mins Step~

Mon 27 September
GYM:
1.20min Fat Burn Exercise Bicycle
Mat Work: stretch,hamstring,calf raises, Boso ball, squats

Tues 28 Sept
Gym:
1.20min Fat Burn Exercise Bicycle
Mat Work: stretch,hamstring,calf raises,
Resistance Training:
=Lat Pull Down 30kg (5reps) 37 .5kg(10reps) 45kg (2 x sets of 5reps)
=Bicep Curls 7,5kg (3 sets of 10)
=Tricep machine (1 set 10reps :15kg & 1 set 20kg : 10kg)

WED- 29 Sept
-flu hit me , not able to train

THURS- 30 Sept
_Day in bed_

FRI- 1 October
_Day indoors , better , but chest not yet recovered, no training

-4months-Week 16 After ACL reconstruction ...

Wed 15 Sept
SAT 18 Sept
~TEAK PLACE~
Trail Run 14 Km - 1hr 40mins

SUN 19 Sept
~Trail 3km -loosen up~

Mon 20 Sept
~Trail 7km ~ +-1hr

Tues 21Sept
~Fast Trail~Short&Fast run~3km in 10mins

Week 15 (7Sep-14Sep)

I did no riding /running -
Sick in bed:(

14 Weeks Post ACL Reconstruction

WED 1st Sep
THUR 2nd Sept REST DAY
FRI 3rd Sept
~20mins ex bike
~Quad press: 15kg (3 ( toe up /in/out ) sets of 20)
22.5kg :(3 ( toe up /in/out )sets of 10)
~Shoulder Press - 22.5kg 3sets (10-5-5)
~Lat Pull down - 30kg :1set 20 & 37,5kg: 2 sets of 10
~Verticle Row : 30kg : 2 sets of 20 & 37,5kg :1set of 15
~Ab Curl Machine : 3sets of 10 on =35kg & 40kg and 45kg
~Hamstring Curl-Machine : 10kg and 10kg and 15kg ( 3 sets of 10)

Worked 3 horses- Schooling (2hrs total) no jumping


SAT 4 Sept
~19kg~ TRAIL RUN - 2hrs !
Wonderful, pushed myself!

Sun 5September
~Rest Day from running~
~Rode 3horses -2hrs~

Mon 6 Sep
~Rode 4 horses 3hrs~
~Interval training over 3km's~
Fast Sprints -very tiring

Tues 7Sep
~gym:
~Super-Circuit (all muscle groups no running in between)
~Exercise bike 10mins Cardio HOUR:155-166
~Step Machine :5mins Cardio (HOUR:155 -166)
I twisted my knee yesterday-stepped skew on a brick-its a little sore.

13 Weeks Post ACL reconstruction

Wed 25 Aug
~Run_ Faster 4km

Thurs 26 Aug
~No run
~GYM;
Cycle effort 10 on fatburn
•Lat pulldown- 20reps on 22,5kg
10reps x 2 sets on 30kg

•Lat pullover- 20reps on 22,5kg
10reps x 2 sets on 30kg

Usual ab's and stability ball-stretches /lifts

Fri 27 Aug
~run&gym day off
~Rode horses lightly~

Sat 28 Aug
~Trail Run= 15kg at Teak Place ,decent run, very enjoyable!
**FIRST LONGEST RUN**

Sun 29 Aug
~Rode 3 horses~
~No run~
~No gym~

Mon 30 Sept
~10km Trail run~
*Fastest run for that length 1hr 5mins**

12 Weeks After ACL reconstruction

18 Aug
~Gym~
1hour exercise bike (level 6) fat burn
Lats pulldown - 22,5kg (3sets of 20)
Vertical Rower - 30kg (3sets of 20)
Quad press (left Leg) :
7,5kg 3sets of 20
15kg. 3sets of 20
22kg. 3sets of 10

19 Aug
~Horse Riding~2 horses schooling walk out (2hrs)

20 Aug ~rest~
My leg is VERY tired and stiff,better on the 21st (Friday)

21Aug Saturday_
I rode 1 horse lightly,and it was not feeling great.
I went for a Run :
10km - 1hr 5mins ! Trail;'"" WOW!! WAS great!
After feeling pretty bad,because I was not able to run the past two days ,this day made me very happy!
Endorphins I Love you!!!!
******
en·dor·phin⁠ (ĕn-dôr'fĭn)
n.
Any of a group of peptide hormones that bind to opiate receptors and are found mainly in the brain. Endorphins reduce the sensation of pain and affect emotions.

[ENDO(GENOUS) + (MO)RPHIN(E).]

22 Aug Sunday_
My left leg is very stiff today:
I have come to gym to cycle it out _
=1hour fat burn
=Core work, pushups (3sets of 10),Hamstring curls, triceps ~medicine ball.

23 Aug-MONDAY
~TRAIL RUN- 1hr20mins ~12,2km !!

24 Aug -Tues
Trail Run- slow 5km's

The 10 week mark, after ACL reconstruction

Wednesday 4th
~Trail run 5km
Thursday 5th Aug
~none

Fri 6th Aug
~Trail run 3km (interval training)
~Squats (x2 held for 15secs)

Sat 7th Aug
~Trail run 5km
~Squats (x2 held for 15secs)
~run up &down 3flights of stairs
~5lunges per leg

Sun 8th Aug
~Trail run 5km
~Squats (x2 held for 15secs)
=stretches
=~run up 3flights of stairs

Mon 9th Aug
~Road Run in 51mins = 7.4km

Tues 10th Aug
~Farm Run 50mins = 6,3km
~Lunges x 5 each leg
~Squats holding 20seconds +arms up straight-low- X2
(Was a great day,time to get into the gym &do weights again)

The 11 Week Mark after ACL Reconstruction

Wed 11th Aug
~gym
•Cardio -Stationary Bike = 10mins H.R= <150bpm
•Quad press -
##Left leg:
*7,5kg straight foot:20 ,toe in: 20,toe out: 20
*15kg straight foot:20 ,toe in: 20,toe out: 20
*22,5kg straight foot:5 ,toe in: 5,toe out: 5

##Right Leg:
*15kg straight foot:10 ,toe in: 10,toe out: 10
~Hamstring stetches

~Thurs 12th Aug
RUN (1/2road , 1/2 trail) : 8km
=1hour 10mins

FRI 13th Aug
~TRAIL RUN :6km : 50mins

Sat 14th ~OFF DAY~

Sun 15th ~Day Hike~ + 12km

Mon 16th *Aug
~8km~ 1/2 trail , 1/2 road= 1hour 10min
~Was great!But I am exhausted tonight.

Tues 17th *Aug
~Rode 2 horses_very tiring : 1hr 30mins !
~No run: too stiff!

The 9 week mark, after ACL reconstruction

(Wed 28- Fri 30July: I've been on a course-no time for gym!)
~Thurs 3500 Steps
~Fri 4600 Steps
~Sat 2300 Steps
~Sun 6500 Steps
~Mon 11600 Steps

~Tues 6300 Steps
•AND 3km RUN•

8 Weeks POST ACL Reconstruction

21 July ! Wednesday
Today after yesterday's first road run,I don't feel sore,my knee feels great.
At first I thought maybe I'll cycle today ,give my knee a break....
The road was calling me: so I ran just over 1km...
I went to gym:
10mins super cardio on step machine ,but I couldn't keep my eyes off the tredmill..... So..On the tredmill= I ran 2km !!!!
Praise God !! Amen !! Wow wow wow , I'm so ecstatic! And my knee's fine , feeling good,I'm feeling strong !! Wow..

I was smiling all the way!Like I had a huge secret , cos I DID!!

~*: Bosu Ball -> Balancing &light squatting
1 legged Balance
1 legged squats Holding for 15 seconds...
'Heel-toe -Heel-toe' in squat position
~*: Quad Press (Left Leg Only):
7,5kg :Toe up:10 reps , Toe out 10reps , Toe in :10reps
15kg :Toe up:10 reps , Toe out 10reps , Toe in :10rep
~*: Quad Press (Right Leg Only):
7,5kg :Toe up:5 reps , Toe out 5reps , Toe in :5reps

Vertical Rowing machine (22,5kg ) 3 sets of 15 reps
Mat: Ab crunches -stability ball
Hamstring Curls /stretches

22 JULY
~3km RUN (dirtroad)~ Fantastic! I'm really excited , I feel good. My left hamstring is really stiff compared to right one, its just going to get stronger and stronger.

23 July
6200 steps on podometer
~no gym today~

24 July -Saturday-
1 hour Fat Burn (exercise bike)

25 July ~no gym~

26 July
~3500Steps~
~GYM~:
*Exercise bike: 1hour Fat Burn(level8)
Lat pull down: 22.5kg (3x sets of 20)
Lat pull over: 22.5kg (3x sets of 20)
*Quad Press: (left leg only):
• 7,5kg :Toe up:20 reps , Toe out 20reps , Toe in :20reps
• 15kg :Toe up:20 reps , Toe out 20reps , Toe in :20rep
~Mat :Hamstring curls

27 July Tues
Morning:
~*Exercise bike: 1hour Fat Burn(level8)*~
•Abs: Ab Curl Machine (4 sets of 20 reps on 30kg)
Stability Ball: using 3kg Medicine. ball, ab crunches . (3 sets of 10)

Hamstring curls/stretches

Afternoon:
~3km RUN~
~2000steps for afternoon, before run~

7weeks after my ACL reconstruction

Muscle Development Above the knee...


Goals From the 7th Week to the 12 week:

Early sports activities can be started and patients can often begin light jogging, cycling outdoors, and pool workouts. Side-to-side, pivoting sports -- such as basketball, soccer and football -- must be avoided.

Toward the end of this phase, some athletes can begin shuttle runs, lateral shuttles and jumping rope.

14 July Wednesday:
_Gym_
[•]1hour 40mins Fat Burn on Exercise Bike
[•]Mat_hamstring curls/stretches
[•]Bosu Ball_Balancing &light squatting
[•]10mins Cardio Step Machiine

15/16 July :No gym
~i was busy studying,didn't have time to take out to gym.
~with not going to gym for these two days, I definitely feel a decrease in my leg strength. The knee joint moves,feels unstable,feels like swelling has built up ,there's pressure in the joint (watery and it 'squishes' when knee bends)
~I have to flex my muscles when I walk -'Tell them' to work for me to bend the knee ,otherwise it doesn't feel sore... Strange feeling : forcing my Leg's muscles to contract when I walk, so my knee feels more stable.

17 July Saturday
~none~

18 July Sunday
~Gym:
40mins Cardio:Exercise bike
10mins Cardio:Step maxchine (80floors)
Tredmill = 500m in 4mins. :)

Mat
*Stability Ball- ab workout
*Hamstring stretches
*Balanacing and manueveing ball,whie on it straight /sideways/half body &Full body
*Medicine Ball for triceps and lats /biceps
*Quad Press (Left Leg Only):
7,5kg : Toe up:15 reps , Toe out 15reps , Toe in :15reps
15kg : Toe up:15 reps , Toe out 15reps , Toe in :15reps
*Ab-crunch : on 30kg & 40kg =3sets of 20 each

19 July
*: 20mins Cardio:Step Machine
*: 20mins Fat Burn Cycle
*: 1km RUN on tredmill !!! (Whoohoo!!)
*: Bosu Ball -> Balancing &light squatting
1 legged Balance
1 legged squats
'Heel-toe -Heel-toe' in squat position

*: Quad Press (Left Leg Only):
7,5kg :Toe up:20 reps , Toe out 20reps , Toe in :20reps
15kg :Toe up:20 reps , Toe out 20reps , Toe in :20reps

20 JULY
FIRST ROAD RUN , JUST OVER 1km
~GYM:

*: 20mins Cardio:Step Machine
*: 20mins Fat Burn Cycle
Mat Work: Abs stability Ball &Medicine Ball,crunches
Hamstring Curls
Stretches
'Bosu'Ball, light squats

6week mark after ACL Reconstruction

7 July Wednesday
~7800 steps
~no gym

8July Thursday
~2 hours on exercise bike at gym
~'Bosu'Ball,matt , stretches /legraises
~10pushups

BOSU BALL:


9July Friday
~My knee is sore today, it feels as if its 'clicking' . I have to continually 'tell' my leg muscles to contract when I walk to support the joint. It is as if the legs proprioception is not there? I 'd better go to Gym tonight. The legs muscles need to be reminded to work!

10 July *Rest Day, No Gym*

11 July Sunday
GYM:
30 mins cardio on Step Machine
20 Mins Tedmill - walking
30 Mins Fat Burn - Cycle
Mat Work -Push ups, ball work, stretches, hamstring curls
Quad press- (Left leg only)
Toe in : 10 reps 7,5 kg & 10 reps 15kg
Straight foot : 10 reps 7,5 kg & 10 reps 15kg
Toe out : 10 reps 7,5 kg & 10 reps 15kg

12 JULY : MONDAY
GYM:
1 hour Fat Burn Exerise Bicycle
Mat Work:
~Bosu Ball , squats /balancing exercises
~Hamstring Curls using Exercise Ball

Quad Press( left leg only):
Toe in : 12 reps 7,5 kg & 12 reps 15kg
Straight foot : 12 reps 7,5 kg & 12 reps 15kg
Toe out : 12 reps 7,5 kg & 12 reps 15kg

5th Week Mark after ACL reconstruction

30 June 2010 Marked 5 weeks after my ACL Reconstruction

_I went to physio this morning, it was testing as my muscles are stiff from the gymning
We were able to get flexion in knee joint to 5 degress less than the othe leg.

_I didn't walk too much today , 2/3kms in total (podometer)
_i did 1 hour on the exercise Bike : Today I started now pushing it to my Heart Rate Maximun : I could push to 176 , then it took 2mins roughly to return to 117 ( low HOUR within zone for fat burn)
_more stretches for legs /hamstrings etc .. As I am working muscles harder they are getting more stiff &shortening.


1 July
_1 hour on exercise bike 7:30am
& 1 hour 30mins Exercise bike 6pm = 2hours 30minutes total.

2 July
_6pm : 1hour 20mins on exercise bike
_stretches and calf exercises (step work /calf raises)

3 July
_Walking: lots of it at the farm: from 9am - 3pm 4.5km!! Most in 5 weeks !!
_4:30pm. on Exercise bike for 1hour 20mins , fat burn only , no cardio (high heart rate about 140 bmp) While I Watched World Cup Soccer: Ger vs Arg.

4 July
~on exercise bike for 2hours
~Calf raises left leg only
~step streches
~"Bosu" ball squats and balancing



~scar split open as pressure in knee couldn't excape , I was wearing knee brace for suPport. Puss came out , I cleaned with Hydrogen Peroxide 10% Volume,diluted and put absorbent plaster on
~i didn't walk much today




5 July
~4kms walking
~Gym:
Exercise bike 30mins fat burn
Step machine 10mins
Lats pull down : 3 sets of 15 reps on 22.5kg
Pullover : 3 sets of 15 on 22.5kg
Quads press (left leg only ) many sets of 10 reps on 7.5kg
Ab cruncher : 3 sets of 15 on 45kg
Mat work : stretches,hamstring curls , calf raises/stretches
"Bosu" Ball : Balancing and light squats

6July
*2hourse exercise bike
*5mind /500m Run(treadmill)
*Matt work
*Bosu* Ball : squats / balancing exercises / toe up&down &stepping up & down
*leg stretches etc,.
*3800 steos (step counter/ podometer)

Goals From the 7th Week to the 12 week

Goals From the 7th Week to the 12 week:

Early sports activities can be started and patients can often begin light jogging, cycling outdoors, and pool workouts. Side-to-side, pivoting sports -- such as basketball, soccer and football -- must be avoided.

Toward the end of this phase, some athletes can begin shuttle runs, lateral shuttles and jumping rope.

In the 4th Week post-ACL Reconstruction.

Lots of Gym time , spent on exercise bike & Loving the workout!
I have 1 more day left(sunday 27th June) of anti-biotics.
I am on 2 pain pills per day :
Coxflam (S4) Morning and Night (one each)

Exercise summary_
_Thursday 1 hour Bike
_Fri 1 hour Bike
_Sat 1 hour Bike

_Sun 27 June
** 1hour 20Minutes Bike
& Lats Pull down 3sets X 20 reps
& Quads : leg Press 3sets X 15 reps 15kg
& Abs: Cruch 4kg 3sets X 20 reps
& Verticle Stationary Rowing 3 sets X 20 reps
& Ball work :Hamstring/abs/arms shoulders

Anti-Biotics Finished Sun 27 June !

_Mon 28 June Nearing end of 4th week:
1 hour 20mins on exercise Bike

_TUES 29 June
1 hour 30mins on exercise bike.
& overhead lats , triceps pull over ( 4 sets of 15 on 22.5 kg)
& abs on matt
& quad presses 15 kg
& ball work on matt , hamstring curl and stretches
& step work - calf raises . 15 (both legs), 15 left leg,


--- I'm OFF PAIN-MEDS ,take occassionally at night when needed.

--- I am Happy, I feel the frwd Progression !

Today its 4 weeks :23 June

Past weekend been waking up in tremendous pain.

I found I had infection under the skin- the scar burst on sat,sunday I was in terrible paain.

I went onto anti-biotics.
And new painkillers..

* Myprodols ineffective.
Haven't been to gym since last week. It was too sore.
Today I went to gym_ on the exercise bike for :r (hats right folks no prob- I was thrilled and feeling great all the way ddnt even have 2 Half pedal' to warm joint up'...
Let's see how I feel tomrw.

Good night & God Bless

Week 3_ Day 5_ Monday 14th

Scar Tissue:
Scar tissue is the fibrous connective tissue which forms a scar; it can be found on any tissue on the body, , where an injury, cut, surgery or disease has taken place, and then healed. Thicker than the surrounding tissue, scar tissue is paler and denser because it has a limited blood supply; although it takes the place of damaged or destroyed tissue, it is limited in function, including movement, circulation, and sensation. Other than with minor cuts and scrapes, scarring is a common result of any bodily damage.

http://www.wisegeek.com/what-is-scar-tissue.htm

What I did at gym:
15mins exercise bike
_Overhead pulls_on 22.5kg ( 3 sets of 20)
_Stomach Crunches_on 25kg ( 5 sets of 20)
_Stomach curls_ (external obliques) -( 3 sets of 10:left and right)
_Leg raises 3 sets of 15_
_Heel slides and lifts: proved extraordinarily sore.

So much so , I left the gym and i cried out of frustration when i got home.
My myprodols were finished. I remembered I never took before the gym session, they are by far necessary because with out them I don't /can't push through the discomfort - fear of making it even more sore.

I did walk the rest of the day without crutches....
tomorrow is a new day :)

Week 3_Day 4_ Sunday 13 th June

This morning i went to gym.
wow..can i say it? ...\IT WAS GREAT TO BE BACK IN THE GYM.

I'm off the crutches from today. I have decided.

also the brace catches me across the biggest scar (on the front of the tibia) , so i am wearing it less nd less.

What i did at gym:
* Exercise bike: 15mins ( on lowest setting, no resistance, just the flowing motion)
* Leg raises and hamstring curls ( free weight no resistance)
* Upper body: Pecs : 3 sets of 20 reps on 7.5kg
Verticle rowing machine - (biceps,deltoids,rhomboids) 22.5 kg at _3 sets of 10 reps_
Stomach crunches: 5 sets of 20 on 25kg (ab machine)

My scars hurt quite abit today. There is alot of scar tissue, so when the skin stretches (as in walking and exercise) it "pulls"tremendously.
so i bought Bio-Oil and am now rubbing the scars - as mucg as pain and dicomfort allows. To loosen the scar tissue beneath the skin.

I drove to church(automatic) this evening, and i didnt wear brace or use crutches, i did howere take one with me,
why? because the brace's front strapping is right across the biggest scar below the knee on the Tibia....= Sore!

Had a good day.

WEEK 3_ DAY 3_ FIRST DAY AT GYM

This day was my first day back at Gym after my ACL recon.
What i did:
15mins slow/light on exercise bike, 5mins of which were half pedals, (like a swiminging boat)
my knee "softened up"and i could then go all the way around (backwards first) This was less "tight" this way.
I then could go forwards pedalling in the right forwards motion. It was not sore. I just had to work on my right hip over working to compensate for the "stiff"movement on my left knee.

Other exercises:
* Leg raises 2 x ( 3 sets of 10 reps)
* Hamstring curls (no resistance) me on my stomach) : 3 sets of 10 reps each
* Latissimus dorsi - 3 sets of 10 reps on 30kg
* Over head pulls - 3 sets of 10 reps each on 22.5kg
* Stomach crunches (machine) 25kg = 5 sets of 20 reps each
* Bicep curls - 7.5kg = 3 sets of 10 reps each

__________
I had a lot of pain and discomfort as i did not take pain meds until the afternoon when the pain got really bad.

But all in all it was a good day.
I am very glad to be back at gym.

Week 3_DAY1 _ saw the orthopedic surgeon today.

Today was a great day. I was very productive this morning, lots of typing done, sitting at a computer for many hourse gets straining on my hamstring, but very soon i was up.
When your knee is stiff, it can be difficult to stand from a sitting position

Had 2 Myprodols each at:
7pm, 12:30pm
3pm and 8pm.

The Doc was very happy, sitting today he got the range in my knee joint to about 95degrees, that is still passive not active flexion:
Continuous Passive Motion Improves Active Knee Flexion .

Flexion is a movement which moves the two ends of a jointed body part closer to each other. In this case, knee flexion is how close you are able to move the heel of your foot close to your buttocks. This distance is measured in degrees.
*The three muscles of the posterior thigh (semitendinosus, semimembranosus, biceps femoris long & short head) flex (bend) the knee

Flexion

Bending the joint resulting in a decrease of angle; moving the lower leg toward the back of the thigh;Hamstrings


Extension

Straightening the joint resulting in an increase of angle; moving the lower leg away from the back of the thigh.
Quadriceps femoris


______________________
Doc's orders.
______________________

* Alright... in two weeks time : ditch the brace
*only put as much weight on the leg as pain allows
*get onto a stationary bike asap, we need to build up quads and hamstrings (as seen above needed in flexion and extension of the knee joint)
*on 6 wkees, slight jogging and must be nearing full extension (have 4 weeks to achieve that)
*on 8 weeks, ( 6 weeks from 2day) a proper cycle -out and more jogging
*between 6 and 12 weeks , full bend and use of hamstring, and then we have to build it up..

Week 2_DAY 7 The end of the 2nd week.

Well Today started with ALOT of stiffness and pain,
2 Myprodols administered @
7pm, 10:30 , 1:30, 6pm and 10pm.

I am walking unasissted more @ home.
Hamstring very stiff, i massage my quadricep and hamstring group after bathing (muscles warmed up)
Did alot of office work today , all the sitting make my leg tired.
I do "toe pull-ups" , hell slides, leg raises and muscle contractions when i think of it while im working.

I had a good day.

Week 2_Day 6_ TUESDAY

This Day started as any other....knee sore/stiff/ joint tight, muscle sore.
Myprodol was taken 4 times....every 4 hourly.
It does work.

Did alot of sitting today -on chairs-
I find this gets very sore as the edge of the chair hurts the mamstring.
The Hamstring is taped up still from Yesterday's visit to the physio.

I also did alot more walking today- with brace on , and in controlled area (my room) - without.
I walk with and without crutches , slowly, in controlled "known" environment (my flat)

Note to self-
*go places where you will be sitting with a cuchion for your leg.
*always have extra painkillers , just in case.
*a sand arena is NOT crutch friendly...

Tomorrow is the end of the 2nd week, and i have not been on a statonary bicycle.

Statistics on ACL Reconstructions

Pre-Op Statistics
*Runners who rupture an ACL (this usually happens when they participate in another sport; ACL break-ups during running are very uncommon) will sometimes - after the knee swelling and pain diminishes - go on to run for several years without realising that a key knee ligament is missing. Eventually, though, problems usually arise, especially in higher-mileage runners, because the loss of the ACL leads to a lack of stability in the knee, which increases the risk of damage to the menisci and (ultimately) arthritis.

*After an ACL tear, doctors sometimes tell patients to 'test their knee out' for a period of time while they're considering the possibility of surgery. While this can help the person who exercises fairly lightly decide whether to have surgery, the strategy can also place the patient at risk of further damaging the menisci inside the knee, or eroding the cartilage caps at the ends of the femur and tibia - the two important bones which form a junction at the knee. An important point to remember is that if your sports activity produces pain, you shouldn't blithely continue exercising. Stopping a painful workout is disappointing in the short run but far better for your health over the long term
http://www.pponline.co.uk/encyc/0281.htm



Post_Op Statistics

*Statistics also show that female athletes have a 25% chance of tearing their ACL a second time after having the reconstruction surgery done.

*Individuals who sustain a rupture of the anterior cruciate ligament (ACL) are at an increased risk for developing early-onset knee osteoarthritis (OA).
_______________________________

The following study presents the first data with 2 year follow-up from the Danish ACL registryAll orthopaedic departments performing ACL reconstructions in Denmark, inlcuding private clinics, report to the registry. .

*Established in 2005:
During the first 30 months, 5,872 knee-ligament reconstructions were registered.
A total of 4,972 were primary ACL reconstructions, 443 were ACL revisions and 457 multiligament reconstructions.

*A total of 85% of all knee ligament reconstruction were reported to the database. A total of 71% of primary ACL reconstruction used hamstring tendon grafts and 21% used patella tendon graft.
*Meniscus injuries were treated in 35% of all patients
*A total of 17% had significant cartilage lesions.


IN THE UNITED STATES IT IS DOCUMENTED:
*The average cost for surgical repair of an ACL tear is approximately $11,500. If all *ACL injuries were repaired, the associated expenditure for 100,000 procedures would eclipse $2 billion annually
*ACL injury rates are estimated to be 2-8 times higher in women than in men
*Not a single report of mortality was found in 6 different studies examining the morbidity and mortality of anterior cruciate ligament repair.

Race
No known correlation exists between race and occurrence of ACL injuries.

Sex
According to numerous studies, female athletes sustain a greater number of anterior cruciate ligament (ACL) injuries than do male athletes. These results are well supported in 2 different papers. The first paper, by Arendt and Dick, showed that female athletes sustained significantly higher incidences of ACL injuries than their male counterparts did when competing in collegiate soccer and basketball.1 The authors' data demonstrated that women have a 2.4 and a 4.1 times greater chance of incurring ACL injury when compared with males in soccer and basketball, respectively. A second paper, by Hutchinson and Ireland, reported that female athletes competing in the 1988 Olympic basketball trials sustained 81% of ACL injuries during the trials.2

Age
Anterior cruciate ligament injuries occur most commonly in individuals aged 14-29 years. These years correspond to a high degree of athletic activity


Up to 50% of patients with acute knee injuries who report feeling or hearing a snapping or popping sound are found to have an anterior cruciate ligament (ACL) injury.

http://emedicine.medscape.com/article/307161-overview
http://www.springerlink.com/content/r37w344rj74r0h16/ACL
http://www.pponline.co.uk/encyc/0281.htm

Week 2_Day 5_ Monday The interferetial current machine{Physical Therapy Equipment}

At The Physical therapist this morning from 8:30.
Got muscles massaged .

And had treatment via the interferetial current machine:

A piece of equipment commonly used by physical therapists is the interferential current machine. This machine produces electrical currents (~4000HZ) that pass through the affected area of the patient. The current tends to penetrate deeper than other electrical modalities and has a number of physiological effects that have therapeutic value.

The physiological effects include:
1. an increase in localized blood flow which can improve healing by reducing swelling (the additional blood flowing through the area takes edematous fluid away with it) and as a result helps remove damaged tissue and bring nutrients necessary for healing to the injured area

2. the stimulation of local nerve cells that can have a pain reducing/anaesthetic effect due to potentially blocking the transmission of the pain signals (pain gate mechanism) or by stimulating the release of pain reducing endorphins (opiod mechanism)

3. some degree of muscle stimulation as muscle contraction can be achieved through external application of an electrical current, overcoming some of the muscle inhibition often caused by local injury and swelling


Also treatment via infrared:

Medical effect

*Infrared light is an important energy force that promotes healing. It raising the white blood cell counts. Improved cell growth, DNA synthesis and protein synthesis in cells.
*Promote blood circulation: Cue chronic rheumatism; eliminate sourness& pain, fatigue, stress and relief from all forms of arthritis.,
*Hyperthermic therapies for detoxification.
Sport injuries; musculoskletal injuries, such as repetitive strain injury,
*Hypertension, arteriosclerosis, coronary artery disease. (dilate your arteries blood vessels and tiny capillaries.
*Infrared ray stimulate your metabolism, promoting the elimination of some really nasty toxins that accumulate in your cells. Such thing as poisons carcinogenic heavy metals, toxic substances form food processing, lactic acid, free fatty acids, uric acids and fatigue.
___________________________________
Today:
2 x Myprodol 3pm.
For pain and discomfort.




Read more: http://www.automailer.com/tws/interferentialCurrent.html#ixzz0qBle2avB

Week 2_Day 4_Sunday

Today started very slow , had breakfast, took meds , and had to sort out dogs /feed them,let them out/in, that kind of thing.
Made me think of having kids ??(Same effort)
Did some leg muscle contractions ,all exercises &iced, My leg.
Then I got picked up for church.
Sitting in church for the duration of the time was manageable but it did get very uncomfortable after 1st hour. Luckily it ws not much longer than that...
My dad and I proceeded to the movies : watched THE GREENZONE (if u must know ?!)... Also quite uncomfortable sitting, I did toe points and calf muscle contractions and all sorts all through movie ,it did get better once we started moving (left the cinema) .
I am now walking using both legs, with crutches , and just relying on the crutches to take most of the weight off my left leg.
I just move very slowly.
Came home, relaxed ...did more exercises...
Dinner time had anti-inflammatories and 1 x synap forte with dinner.
I now feel ready for bed.
Goodnight.

Week 2_Day 4_Sunday

Today started very slow , had breakfast, took meds , and had to sort out dogs /feed them,let them out/in, that kind of thing.
Made me think of having kids ??(Same effort)
Did some leg muscle contractions ,all exercises &iced, My leg.
Then I got picked up for church.
Sitting in church for the duration of the time was manageable but it did get very uncomfortable after 1st hour. Luckily it ws not much longer than that...
My dad and I proceeded to the movies : watched THE GREENZONE (if u must know ?!)... Also quite uncomfortable sitting, I did toe points and calf muscle contractions and all sorts all through movie ,it did get better once we started moving (left the cinema) .
I am now walking using both legs, with crutches , and just relying on the crutches to take most of the weight off my left leg.
I just move very slowly.
Came home, relaxed ...did more exercises...
Dinner time had anti-inflammatories and 1 x synap forte with dinner.
I now feel ready for bed.
Goodnight.

Week 2_Day 4_Sunday

Today started very slow , had breakfast, took meds , and had to sort out dogs /feed them,let them out/in, that kind of thing.
Made me think of having kids ??(Same effort)
Did some leg muscle contractions ,all exercises &iced, My leg.
Then I got picked up for church.
Sitting in church for the duration of the time was manageable but it did get very uncomfortable after 1st hour. Luckily it ws not much longer than that...
My dad and I proceeded to the movies : watched THE GREENZONE (if u must know ?!)... Also quite uncomfortable sitting, I did toe points and calf muscle contractions and all sorts all through movie ,it did get better once we started moving (left the cinema) .
I am now walking using both legs, with crutches , and just relying on the crutches to take most of the weight off my left leg.
I just move very slowly.
Came home, relaxed ...did more exercises...
Dinner time had anti-inflammatories and 1 x synap forte with dinner.
I now feel ready for bed.
Goodnight.

Week 2_day 2_

Ok So WE are into the 2nd week.....

Rehabilitation After ACL Surgery
By Jonathan Cluett, M.D., About.com Guide
says......
"Weeks 1-2:
Range of motion exercises can begin immediately after surgery. The initial focus is to regain full extension (the ability to fully straighten) of the knee. In general, flexion (ability to bend) is much easier to regain than extension.
Patients will work with physical therapists to work on gait training (walking), gentle strengthening, and aerobic work. I like to get patients on a stationary bicycle as soon as possible after surgery as this improves strength, motion and aerobic activity"


Full extension in knee= CHECK
Work with physical therapist= CHECK
Pon a stationary bicycle as soon as possible after surgery as this improves strength, motion and aerobic activity = THIS WILL BE THE FOLLOWING WEEK'S GOAL

__________________________________________________________________

Todays stats:
8am:anti-inflammatories
9am:Physio
1pm:Anti-inflammatories and 1 x Synap Forte
8pm:Anti-inflammatories and 1 x Synap Forte

__________________________________________________________________

This day was a difficult one, as i went out in the morning for physio , and then was out and about for breakfast with my gran, went to her house, didn't really relax , as my leg was uncomfortable,
i went home and just took it easy for awhile.
Tonight i am not so tired.
But what i can say is today is the first day in one week that i have had "real" caffeine! Real coffee! i've bn having de-caf so that i would not have a problem sleeping, which i sometimes can because of a sudden inactive lifestyle.

Week 2_day 1_

I had a good night. Slept well.
Woke at 3am, with alot of inflammation in my knee and it was hot to the touch and 'pounding'. So went and got ice pack, after it was firmly attached i fell asleep.
This morning the gel- ice-pack. was WARM(WARM Water Bottle temperature).

Didnt have pain this am.
Had Voltaren Anti-inflammatories, and Synap Forte at 12 pm.

The afternoon was spent mostly with ice on leg.

Today i was putting more weight on my leg, but i notice an imediate swelling thereafter.

Anti-infammatories and pain meds at 6pm again. That should set me for the evening.

DAY 7 _ week 1 _ Post ACL op.

Left Leg ACL RECONSTRUCTION:

Note:

Muscle atrophy

is defined as a decrease in the mass of the muscle; it can be a partial or complete wasting away of muscle.

Today i dont feel so great.
Woke up with pain all -over my body, couldn't wait to get pain meds in and for them to start taking effect.After a long night without meds, i tend to wake up feeling like a bus has gone over me.
From 7:25 , it takes till 9am till full effect of the meds are noticed.
i take them every 5.5 hr / 6 hr.

midday meds taken at 13:30.
effect less pain, but drowsiness.

Exercises completed successfully today:
hamstring & Quad contractions
Heel Slides
Leg raises
Ankle pumps and roles

Hamstring Tendon Graft Reconstruction of the ACL

There are many different ways to do this operation. One is to take a piece of the hamstring tendon from behind the knee and use it in place of the torn ligament. When arranged into three or four strips, the hamstring graft has nearly the same strength as other available grafts used to reconstruct the ACL.

This is the method that was used on my knee!

The hamstring muscles run down the back of the thigh. Their tendons cross the knee joint and connect on each side of the tibia. The graft used in ACL reconstruction is taken from the hamstring tendon (semitendinosus) along the inside part of the thigh and knee. Surgeons also commonly include a tendon just next to the semitendinousus, called the gracilis.

The hamstrings function by pulling the leg backward and by propelling the body forward while walking or running. This movement is called hip extension. The hamstrings also bend the knees, a motion called knee flexion

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What does the surgeon hope to accomplish?
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The main goal of ACL surgery is to keep the tibia from moving too far forward under the femur bone and to get the knee functioning normally again.


There are two grafts commonly used to repair a torn ACL. One is a strip of the patellar tendon below the kneecap. The other is the hamstring tendon graft. For a long time, the patellar tendon was the preferred choice because it is easy to get to, holds well in its new location, and heals fast. One big drawback to grafting the patellar tendon is pain at the front of the knee after surgery. This can be severe enough to prevent any pressure on the knee, such as kneeling.


For this reason, a growing number of surgeons are using grafted tissue from the hamstring tendon. There are no major differences in the final results of these two methods. When it comes to symptoms after surgery, joint strength and stability, and ability to use the knee, either method is good. However, with the hamstring tendon graft, there are generally no problems kneeling and no pain in the front of the knee.

Day 6 _ after Surgery (week 1)

Day started the same, wake up, pain meds, anti-inflammatories, bath (without wetting plasters) and ICE-LEG and ELEVATION.

i Have serious pain in my hamstring!
it feels like its being ripped aprt from the inside out& torn off the bone like its being eaten off by savage wolves!

Am on new anti-inflammatory dicloflam..

sitting on a chair is a mission as gravity pulls me leg down, onto my hamstring, this hurts!

i've just had my pain meds:
What is Synap Forte® ?
answer~ paracetamol + propoxyfene + caffeine + dephenhydramine (a sedative)~

Thats Why i feel drowsy after administering it!
Because ot the dephenhydramine.

Day 5 (week 1)
This was by far the worst day so far after surgery.
here's my stats:
Pain-high
miserable-high
sleep-low
eat-medium
weight gain-high
water retention-high
any work-low
*i didnt sleep last night because of pain coupled with my little dog princess being too active:)grrr....


The day started well, with me going to physio = Lynette
She said im a great patient, i was able to to quad and hamstring isometric contractions. The range of momevement= =- 75 degrees

i went to sister at doctors room to change (and clean) on of the plasters, there was dried blood on it!)

Definition Wikipedia: Isometrics are done in static positions, rather than being dynamic through a range of motion. The joint and muscle are either worked against an immovable force (overcoming isometric) or are held in a static position while opposed by resistance (yielding isometric).

These contractions are done while i sit or lie in the bed.

Day 3 after ACL Reconstuction

Surgery Dressing Taken off.









*Leg comfortably at 0 degrees lying flat.

and bending to 60 degrees.



bathing , but not wetting these plasters.

They must remain un tampered with till Doctors appointment 10th June.



Exercises: becoming esier

Quads and Hamstring contractions :) perfect!



Very Happy with the pain, as it is bearable+ manageable!

Synap Forte x 2 (p/6hrs)

Day 2 After ACL reconstruction 28May

At Home.





Lots of sleep.

It is quite swollen. (the leg)

This is the dressing used to compress the area.

Remove dressing:
Revealed 4 incisions, covered by waterresistant dry plasters.

No. 1 priority now is to REST + ICE + KEEP LEG ELEVATED.
No PRESSURE (FULL WEIGHT) ON LEG.

Day 1 after ACL reconstruction 27 May

Discharged from hospital 11am.

knee brace to be adjusted to 60 degrees when mobile.

Partial weight bearing on crutches.

I must always remember that no matter what my ACL Rehabilitization Program says,Each of these exercises should be done gently and gradually, and Ishould not push myself to the point where I'm in a significant amount of pain.


Exercises:

Knee extensions -- This exercise helps you to restore range of motion. Place your heel on object like a telephone book so that your heel and calf are not touching the bed. Remain in this position for five to ten minutes.

Quad sets -- This exercise helps you to maintain your strength and your range of motion. Keep your heel elevated as in the knee extension exercise. Begin by tightening the quadriceps muscle and holding it for ten seconds. Repeat ten times.


Heel slides -- This exercise is for ROM. Begin with your knee flat on the bed and slowly bend your knee until it is just slightly uncomfortable. Hold your knee in this position for ten seconds, and then relax by straightening your leg. Rest for ten seconds. Repeat ten times

*Foot pumps .... every hour

Straight Leg raises 3 sets of 20/30 (3 times a day)
Straight leg raise --This exercise helps you maintain your quadriceps strength. Start with your leg flat on the bed. Begin by tightening your quadriceps, as in the quad sets exercise. Then lift your leg off the bed until your heel is approximately eighteen inches off of the bed. Lower your leg back down and relax for ten seconds.

ACL Reconstruction 26 May 2010

Picture:Tourniquet on upper thigh


I went in at 7am this morning.
Had the operation at 9:30am.

ACL Hamstring Reconstruction Technique

*Pre-operative antibiotics, +/- regional block
*Supine postion, all bony prominences well padded.
*Anesthesia (GETA / regional)
*Examination under anesthesia.
*Tourniquet placed high on thigh.
*Perform Knee Arthroscopy.
*Hamstring Harvest
*Sartorius, sartorius fascia=superficial and proximal
*Gracilis=rounder, palpable, proximal. Proximal attachment is circumferential, i.e. after harvest you should note muscle fibers coming off both sides of tendon. If only on one side you may have harvested semitendinosis.
*Semitendinosis-flat, larger, broader insertion, difficult to palpate. Muscle fibers only come off one side of tendon proximally.
*3-4cm incision 3 fingers breadths below medial joint line, midline tibial shaft between crests
*Dissection to sartorius fascia, incise fascia just above Gracilis.
*Isolate gracilis, free fascial slips and excise with tendon stripper.
*Right angle clamp to pull semitendinosis into view, isolate, free fascial slips and excise with tendon stripper
*Deeper structure surrounded by fat is saphenous vein and nerve
*Cut grafts to 24cm and prepare on back table with #2 Ethibond whip stitches in each end.
*Debride ACL stump
*Notchplasty
*Tibial tunnel;just lateral to medial tibial spine, 7mm anterior to PCL in posterior half of ACL footprint, along posterior edge of anterior horn of lateral meniscus. Tunnel angled @45 degrees drill/dilate to size
3-4mm offset femoral tunnel guide used to place guide wire in the 11o’clock position for right knee. 1 o’clock=left knee.
*Drill femoral tunnel to 35mm with acorn reamer. Offset <5mm.
Drill endobutton tunnel with endobutton drill. Measure femoral tunnel length.
*Endobutton size = femoral tunnel length – 25mm. Usually 25-45mm. (see Endobutton Technique for full instructions)
*Place a line on the graft 6mm distal to the femoral tunnel length to indicate the point at which the graft is seated deep enough to flip the endobutton.
*Intrafix tibial fastener: make sutures 5” form tibial tunnel and knot corresponding limbs together. Loop sutures over Tie Tensioner. Cylce knee with 30 lbs of tension. *Compress tendons with sheath trial. Insert sheath with derotation lab in 12 o’clock position. Insert screw
*Consider spiked washer and screw tibial fixation augmentation.
*Irrigate.
*SQ closed 2-0 vicryl inverted interrupted
*Skin closed 3-0 monocyl running SQ
*Steri-strips, mastasol, portal sites closed with steri-strips
*Zeroform, 4x4’s, ABD’s, sterile-webril, Ace bandage, cryo-cuff, knee immobilizer locked at 15 degrees.



Picture above: Stripping of gracilis, with firm countertraction to deliver the tendon out of the incision





Picture: The two tendons have been stripped, and will subsequently be detached from their distal insertions.




Picture: The tendons have been sutured together



Orthopedic Surgeon Dr Mark Human.
Recovery afrter anesthetic = good
Femoral Nerve block dont to left leg.
feeling returning from the evening after 8pm.
Omnopon administered for pain via intravenous injection.
Knee Brace locked on 0 Degrees at night.
I sleep on my back.

Week 2_Day3_ SATURDAY

I had a pretty decent sleep this night. I did quite abit of moving in the bed, didn't sleep on my back with my leg propped up on pillows. It was acceptable!!
I have been eating really healthy.
But my skin isn't co-operating? i'm thinking ts medication, or the stress/trauma surgery does to ones body.

My leg is more bendable today. I ate breakfast with my leg on a chair opposite me with the ball of my foot on the rim, then i did some point+ flex stretches of my foot + calf muscle. It was not sore.

I was quite mobile today and starting to stand/balance on two legs ( without crutch aid) just taking it slow.
Whenever I just sit I wiggle my toes, do muscle contractions &leg raises (bended or straight leg_)

14 Dec- Arthroscopy

Arthroscopy:

A surgical examination of the internal structures of a joint by means for viewing through an arthroscope. An arthroscopic procedure can be used to remove or repair damaged tissue or as a diagnostic procedure in order to inspect the extent of any damage or confirm a diagnosis.

Two small incisions are made either side of the knee.

What they found was meniscus damage-(cartilage tear) and the anterior cruciate ligament was ruptured through.

Posterior Cruciate ligament also showed a litttle wear.

The Anterior Cruciate Ligament (ACL ) primarily serves to stabilize the knee in an extended position and when surrounding muscles are relaxed

10 Dec 2009: The Day my ACL tore

I was playing a game of catch with some kids at camp, i was going in for the tackle, and my left knee gave way underneath me, hyperextended, with me crumbling to the floor in a heap of pain.

My anterior cruciate ligament in my left knee had just snapped like an elastic band.

3 hrs later i went to x-rays