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