[Aslan93]

Hi there, I unfortunately tore my ACL and am curious about your recommendations for cardio training while I recover?

It seems like I may be on a bike shortly after surgery 5-6 weeks (I have a torn meniscus as well that will limit my initial movement). Running doesn’t seem like it will come easy for some time. A lot of base work before was done on a treadmill at 15% incline at around 2.6-3mph on the treadmill. Sometimes I’d put a weight vest on to not run and stay in Z2.

Do you think its possible to maintain or even build my aerobic base during this period? I need something as a silver lining and this might be it. I’m a non competitive cyclist but regularly put down 100-200 mile rides and have an indoor trainer. What might building an aerobic base on the bike look like. What about a ski erg?

Curious to hear Scott, Andy, and any other coaches thoughts! Ha – and any advice about ACL recovery would be appreciated to if you’ve got it.

[radu.diaconu]

Hi,

I tore my ACL, MCL, and meniscus in February last year and had surgery at the end of March. Since I had all 3 fixed at the same time I was not weight-bearing for 6 weeks. During the 6 weeks, I’ve used a machine that was moving my leg to certain angles. That helped a lot with regaining full range in the knee. As soon as I was able to walk I started riding the indoor trainer (very low resistance and focus on increasing cadence, also monitored the power ratio operator leg vs non-operated one) and walking as much as possible. This was later followed by very easy incline treadmill walking and outside hiking.

Once I was able to run, around 3-4 months after surgery I started running on the treadmill using a Lever system, which helps you take some of your weight off. Also, followed the running protocol my doctor suggested. Start very easy and do more as long as there is no pain.

Key advice would be:

– move as much as you can and keep it low intensity, you don’t need to be that sport-specific until you regain your quad strength and a full range of motion.

– strength train and follow your doctor/PT protocol. You might want to talk with a strength coach if you have the means. Also, one app that I found useful is Strength Training.

Hope this helps and you get back to doing what you enjoy as soon as possible. Let me know if you have any other questions.

Radu

 

[Aslan93]

Thanks – greatly appreciate your input.

[Dr Andy Reed]

Hi there

Sorry to hear about your ACL. I see 4 or 5 of these daily in clinic right now, so can imagine your pain. Your first two weeks post surgery will be tough – it’s couch time, crutches and icing unfortunately, but after this (and with clearance from your surgeon) you will likely be able to start some easy spinning on the bike. Some of this will depend on whether you have a meniscal repair and the type of ACL graft used. Once cleared to bike though, this will be a good option for maintaining some fitness. You would be advised to keep the resistance low and work up to a high cadence to limit stress on the knee as it heals – and also better to get the HR up. Other options would be swimming (once wounds are healed up) – feels good, low impact, promotes healing, and then treadmill walking as you say.

You will need to be steady on your feet with no significant pain or swelling afterwards if you use a treadmill, so you will have to go very easy at first. Alter G treadmill also effective if you can find one, and there are also underwater treadmills, would you believe! We typically allow our patients to run at 12 weeks, again dependent on other patient specifics. I like the idea of the ski erg.

Hope that helps. I’d say most of our patients feel almost 100% by 6 months, though we don’t clear them for high risk sports until 12 months post op.

Your PT and surgeon can provide more tailored advice of course. Good luck!

[Aslan93]

Thanks Andy, any comment on graft choice in between patellar tendon and quad autograft. Thanks.

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