The final equation: reinforce that joint with a few good exercises
Sean McEnroe, a veteran physical therapist who works with celebrity athletes from Vail's Steadman Hawkins Clinic, recommends the following short-term goals for post-ACL surgery patients (below). He's also provided a regimen of eight ski-specific exercises to get you back on the slopes (right). Though designed for skiers, this workout will strengthen the muscles that protect your knees no matter which sport you're getting back into—and they're ideal for preventing knee trauma if you've never been injured. McEnroe suggests doing this program three days a week, but stresses that it's critical to obtain clearance from your physical therapist before attempting any of these exercises.Weeks 1–2: Decrease swelling with ice; increase range of motion with simple stretching exercises.
Weeks 2–6: Begin nonimpact cardiovascular exercises such as spinning on a bike with no resistance; look to get clearance to ditch the crutches.
Weeks 6–12: Work on endurance strength (high repetition, light resistance) by riding a stationary bike, running in a pool, or walking on a treadmill.
Weeks 12–16: Begin agility drills like balance squats to rebuild proprioceptor nerve endings, which help control balance and are severed during surgery. Also work on exercises that mimic sports (e.g. side-to-sides).
Week 16: Begin workouts on grass and routines using free weights and on exercise machines.
Week 20: Develop explosive muscles using miniplyometrics, i.e. drills incorporating small jumps like the skier's hop.
Week 24: Begin full-on participation in your sport.
With one foot back and resting on a chair and the opposite foot forward, lower your torso straight down toward the floor and then rise up—your knee should never be ahead of your front foot. Do continuous, slow repetitions for 30 seconds and build to three minutes. Advanced: Add a miniplyometric by bursting on the way up, clearing three to six inches off the ground, and then landing softly. Goal: One three-minute set.
Hold your right ankle behind you with your right hand, as if stretching the quad muscle. Slowly lean forward with your arm outstretched, hold the position for ten seconds, and then return to the start and switch legs. Goal: Ten stretches with each leg.
Start with your left leg on the ground and your right leg planted on an 8- to 12-inch-high platform. In one motion, use your right leg to leap laterally over the platform and land in the opposite of the starting position. Repeat, leaping from side to side in a quick, controlled motion. Goal: Three three-minute sets.
Anchor a sport cord—rubber tubing with handles (find one at http://www.toppersportsmedicine.com)—to a stationary object. Don a waist belt, attach it to the sport cord, and lean far enough away to put tension on the cord. Hop on one foot laterally away from the anchor point, hold for two seconds, and then hop back to the starting position. Keep your legs slightly bent throughout. Goal: Two sets, 40-50 reps each.
Like balance squats, but accentuates the quads more than the hips. Stand on your injured leg with the other leg balanced in the air behind you. Place one hand on a wall or chair for added stability. Slowly lower yourself until your thigh is 70 degrees to the ground and then stand back up. Add a sport cord for resistance. Goal: One three-minute set.
Also do: hamstring curls, leg presses, and calf raises. Three sets, 20 to 30 reps each, three times a week. —C.K.
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