TRAINING AFTER A KNEE INJURY
Getting back into the gym after a significant injury can be a scary thought. There are many ways you can lift and train properly while avoiding re-injury.
Two of the most common knee injuries are the tearing of the ACL and/or the meniscus. First, it is important to understand what kind of injury and repair you have received. There are multiple options to replace an ACL and this will largely determine which strengths and weaknesses you will have. Without proper knowledge of your body, it will be more difficult to train properly. Warming up and stretching become even more important after an injury. Increasing blood flow to the area of concern will greatly decrease the risk of re-injury. Loss of muscle strength after injury makes the importance of unilateral training even more important. Training each leg separately will show any disparities in strength from one leg to the other and help to identify where improvement is needed most.
Your quadricep strength will take the largest hit as you will be physically restricted during early recovery. Working to increase its strength will be one of the biggest keys to stabilizing the knee and getting you back to where you were before the injury. Poliquin step ups (see below), split squats, modified squat variations and leg presses are great exercises that can help to strengthen your quads. The Polquin step up is exceptional because it specifically focuses on the medial quadriceps muscle (VMO), responsible for maintaining proper alignment of the knee cap. This is crucial as the medial quad tends to be significantly weaker than both the middle quad (rectus femoris) and lateral quad (vastus lateralis), resulting in a muscle imbalance that can lead to instability. By targeting the VMO, the Polquin step up effectively addresses this imbalance and promotes greater stability in the knee joint.
It is important for us to determine the difference between pain and discomfort during training. If any pain occurs while training, it is important to immediately stop whichever exercise you are doing and talk to a training professional about what to do as a replacement. Training after an injury can create discomfort and become frustrating. Regaining your strength and mobility is a long process and will be challenging but it can be done if the goal and focus stays consistent throughout.
There are exercises to avoid after a knee injury. One of the first to avoid is the leg extension machine. Leg extensions are very hard on the ACL and cause a “shearing”effect on the ligament. With a new ACL in place, the replacement graft is still very raw and takes a long time to heal. This can often lead to knee pain which can be exacerbated by using this machine. Full range squats should also be avoided as they put too great of force on the ACL in the beginning of the rehabilitation process. You also need to make sure your body gets proper rest and recovery. It is easy to overdo it after an injury, especially if we feel good. Knowing when to take rest days between training sessions will go a long way in increasing the longevity of your knees. Feel free to ask any of our trainers any questions you have if you have experienced a knee injury and are unsure of which steps to take.
Here are some resources that can provide more information and guidance on training after a knee injury:
1. American Academy of Orthopaedic Surgeons (AAOS): The AAOS offers a comprehensive guide to ACL injury prevention, treatment, and rehabilitation. Visit their website for valuable insights: https://orthoinfo.aaos.org/en/diseases–conditions/anterior-cruciate-ligament-acl-injuries/
2. Physical Therapy Web: This website provides exercises and rehabilitation protocols specifically designed for ACL injuries. Their detailed guides can help you navigate the recovery process: https://www.physiotherapy-treatment.com/acl-reconstruction-exercises.html
3. Mayo Clinic: Mayo Clinic offers a range of resources on knee injuries, including information on common knee conditions, treatments, and exercises for rehabilitation. Explore their website to access helpful articles and videos: https://www.mayoclinic.org/diseases-conditions/knee-pain/symptoms-causes/syc-20350849
4. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS): NIAMS provides educational materials on various musculoskeletal conditions, including knee injuries. They cover topics such as treatment options, managing pain, and exercise recommendations: https://www.niams.nih.gov/health-topics/knee-problems
5. Sports Health: The journal Sports Health offers research articles and reviews related to sports medicine, including knee injury management and rehabilitation strategies. You can access their publications online for in-depth information: https://journals.sagepub.com/home/sph
Remember that it’s always crucial to consult with a qualified healthcare professional or physical therapist who can evaluate your specific condition and provide personalized recommendations tailored to your needs.