ACL Tears (REHAB TIPS AND BEST EXERCISE!)

Prevent injury and re-injury by training like an athlete

What’s up guys? Jeff Cavaliere, ATHLEANX. COM. Today we’re going to talk all about ACL injuries in a continuing effort to bring you guys a little bit inside of my life of what’s going on. My best friend here Charlie, he had an ACL tear.

He’s recovering from his surgery. I’m going to take you all inside the knee. Why this happens, what you can do about it and most importantly what you can do soon after it happens to you to help speed up your recovery like we’re going to be doing with Charlie. Alright guys, so my best workout lately has been carrying this guy around, all 80 pounds of him, because he tore his ACL. I know how debilitating this injury can be especially if you’re an athlete out there.

But don’t worry, you’re in good company. Because it’s not just Charlie that’s got this going on. It’s one of the most popular injuries that you can possibly get orthopedically. So learning how to deal with it, especially if you’re watching this having dealt with this injury in the past, is going to be helpful alright. So, Charlie I’m going to put you down big boy.

He’s already falling asleep in my hands. The most important thing about our knee is it’s impacted no matter what we do, every single step we take. If you’re an athlete, you’ve got a lot more than just steps you’re taking. You’re taking a lot of cuts, and you have to be agile. You have to be able to push and change direction.

Well a lot of times the ligaments that run inside of our knee are the only support we have against those forces that are caused by the change of direction. And unfortunately, sometimes the forces are greater than the strength of our ligaments and we have issues. So, first of all I want to show you guys what the ACL does so you can get a better understanding of it. Because the thing that always amazed me was there are no mistakes when it comes to our anatomy. Everything is placed exactly where it should be, for an exact reason because it serves a very specific function.

So, if you were to look at your knee as you would with this rubber band, here’s going to be your ACL. This is going to be the top part of your knee joint, your femur, and this is going to be the bottom part of your knee, the tibia. If you were to put a rubber band over your thumb, ok, and then make a fist, and then from here wrap it around your index finger of your tibia. When I then put them together, we’ve now created a knee joint, right. It runs from the back side of the femur, ok.

Behind our knee and the upper part of our leg and it runs and attaches across to the inside front of the tibia. So what happens is, we know first of all, if I try to pull the tibia forward on the upper bone in our thigh, the femur, it doesn’t like that. We’ve got some resistance there. The ACL is trying to prevent that from happening. It also will prevent, this is one of the things that people don’t realize, is the internal rotation of the knee.

So if the foot is planted and the leg turns out to the side, right. You want to change direction, plant your foot and then turn to the right to push off that way, you’re getting a relative internal rotation down at the knee. And you can see that there’s tension on that band. If I were to try to externally rotate my leg, right, there’s less tension on the ACL. So understanding the placement of the ACL in the knee will tell us everything about it’s function and what we need to worry about.

So, what happens when this ligament that runs again, from back to front, tears? Well we don’t usually just get an ACL tear, as some of you guys out there can imagine. We also get damage to the medial collateral ligament, that usually winds up getting torn too in a very severe ACL injury. And we get damage to the meniscus that sit on top of the tibia here because once we lose that control of internal rotation we get a grinding of the two bones together, that’s just basically grind and tear the surface. And my friend Charlie, he actually had a meniscus tear as well that had to be repaired.

So the most important thing that you can do when you have an ACL injury is to control the inflammation. Right now with Charlie we’re not doing anything but trying to keep him limited on his walks, make sure that what he does is just enough to be outside to get some weight bearing. Because we know that early weight bearing is definitely going to be useful and more able to accelerate your recovery than some of the older approaches that casted you and didn’t want you to move at all and restricted your motion. We want to get some weight bearing but you’re definitely going to want to make sure that you’re getting in control of the inflammation because the worst thing with inflammation is it shuts down the whole operation. As soon as your body senses inflammation, even in the knee in cases of just inter articular fluid, right, we can get that from time to time, water on the knee.

You’re going to get a shutdown of the function of the muscles around it, and most importantly the quadriceps. Once the quadricep stops to function, you don’t really have the good ability to straighten your knee and when you lose that you can actually start to develop scar tissue and have your knee shorten in a contracted position. And if you don’t have full knee extension that’s a whole other issue in and of itself. But first and foremost you’ve got to control inflammation. So once we do that and we start to progress ourselves to work on the range of motion, we’re going to be able to get full knee extension first, then start worrying about the flexion in our knee, second.

Alright, remember full knee extension first, then start worrying about that. And you can work on full knee extension by literally pushing down on your leg, trying to get it to straighten out. But really what you guys watch our channel for is strength and conditioning. And where are we really doing strength wise to help with this ACL to hopefully make it come back stronger and faster? Well we want to make sure that we’re doing closed chain exercises versus open chain exercises.

You guys have heard me talk badly about the knee extension a lot. And I feel for good reason. In a case here for the ACL, there’s a lot of stress placed on that, shearing force placed on the tibia in a knee extension that we just don’t want to really subject it to. Plus, I always feel like, you want to strengthen yourself in the position that you likely got hurt in, and that was likely with your feet on the ground. Ok, 70 percent of the ACL injuries come from a non contact injury.

It’s just planting, cutting and your feet on the ground. We want to be able to strengthen that knee with the foot back in the condition it was when it got hurt to try to hopefully prevent that from reoccurring. So, what I’m going to have you doing is squats. And I think the best version of the squat that you can do is going to be a front squat. Because if we can put that center of gravity a little bit in front of our body, by bringing that weight in front of us and having a more upright stance, as opposed to a back squat where we’re going to be sitting our hips backwards more.

You’re going to have a much less perceived stress by the ACL in that position, which will allow you to load up quicker, strengthen your quads and return to action faster, with a stronger more functional leg than you might if you’re focusing on back squats. So if you haven’t torn your ACL, I hope you never do. We actually have a video on testing your intrinsic knee strength to see how well you might be fortified against a possible knee injury or ACL tear. You’re going to want to watch that video. I’ll post it here as well.

So there you have it guys. The ACL, what it is, how it functions, what you have to do if you hurt yours and last thing I can tell you most of all, It’s a bitch if you do so you want to make sure you don’t do it in the first place.