Life with torn ACL

[sgoknik]

I am a 36 year old woman , never been really into intense sports, but have danced all my life. I tore my ACL last month. It was a freak accident. My knee just gave away when I was dancing at a party and my friend;s knee bumped into mine. :( I still cant get over the fact that such a small thing could lead into a huge injury.
I am basically an active person. I used to do Zumba, run on the treadmill, elliptical, walk and run outside, play some tennis with my 8 year old and things like that.
My MRI report says "Proximal tear of the ACL". I opted not to go for the surgery.. atleast for now. I did not have any swelling and I was having some pain, but after 3 weeks of physio therapy I feel normal- well, almost!!!
Some days my legs are just SORE, the whole day. It wears me down totally. And I have pain when I do squats , so I dont do it anymore. I dont even squat to pick up something from under the couch :(

I am still being active around the house and outside, but have not gone back to any of my workouts, I am just nervous that my knee will give away.

What are the exercises that I can do ?? Should I have the surgery or can I just put it away? By putting away surgery will my knee ( or the other knee) get weaker as I grow older??

I am hoping to get some support and comfort and realistic advice from this forum.
Thanks!!

[Higgy]

I tore my ACL about 6 years ago and had fixed. I would highy recommend that you do as well given your age and that you are active and want to remain active.

[JasonJones]

Cruciate ligaments stabilize joints that have a very large range of motion; they don't really restrict the range of motion of the joint outside of this stabilization. A knee with a healthy ACL is going to have the same flexion/extension ROM in their knee as a person with a fully ruptured ACL — the limitation in knee ROM remains compression of the hamstrings against the calf. Non-exercise activities (like dance) will be challenging the knee now, as it is less stable against rotational forces.

An ACL tear means a reduction in knee rotational stability, so the exercise goal is to increase knee stability without applying unnecessary torque:

• Strengthen the Hamstrings;
  Perform full range of motion leg exercises (lunges, squats);
  Loosen the IT band;
  Loosen the piriformis; and
  Strengthen the glutes.

What you're really trying to do is build legs that are strong, mobile and straight. If your leg rotates externally at the hip, it's going to put rotational force on the knee. If your calf rotates internally at the ankle, it's going to put rotational force on the knee.

(cannibalized a little from a previous post I made on ACL tears)

[sgoknik]

Thanks, but can any of you help me out with what are the things I can do safely at the gym?

[stuward]

Jason already gave you the main points to keep in mind. Any squatting motion where you avoid knee rotation. This would rulle out step aeorbics classes for example but squats, lunges and leg press would be OK. Deadlifts and glute bridges would help strengthen the hamstrings and glutes. You mention earlier that you get pain when squatting. This may be due to poor form, perhaps you're twisting your knee. If you can't manage a painless squat, you probably should see a physical therapist first.

[sgoknik]

thanks!

[JasonJones]

Anything that's not going to twist, and no leg extensions. Leg press is probably fine, and I've never had an issue using it with a client that has an ACL tear, but there's some evidence it's a little tougher on a compromised knee than a squat.

IMO your best bet is the lunge and lunge variations. Lunges are fairly easy to do, they place a lot of emphasis on stability, and you can focus on moving in straight lines and keeping your feet straight (toes pointing forward) and keeping your heel down on your front foot. Squats are great if you had a history of doing them (correctly) before the injury, or if you can get someone to coach you.

[stuward]

Jason, do you recommend a rear lunge or a forward lunge? I would this the shear stresses are higher in a forward lunge.

[JasonJones]

Jason, do you recommend a rear lunge or a forward lunge? I would this the shear stresses are higher in a forward lunge.

Good point Stu. Generally speaking I prefer a rear lunge for that reason, but in the case of a compromised knee the lunge with the lowest shear stress is going to be the one that can be performed most correctly. The proprioception required for a rear lunge can make it unsuitably difficult if the person hadn't performed them before the injury or is generally uncoordinated. I'd start with a stationary lunge, and then hopefully coach into a rear lunge, in that case.

[Jungledoc]

A "stationary lunge"? As in split squat?

[waqas]

ok, so having torn ACLs in both of my knees, my advice to you is only you and your doctor are in best position to make a decision.
It depends, if the ACL is completely torn or offers some support. I was able do almost every thing with my knee with a partial tear, however, this led to a complete tearn in the future.

Knee extension are a definite no.

Squats and leg press are probably the safest, however, if you have meniscal injury, it could be painful.

Any sports, or dance that involves cutting or changing directions suddenly must be avoided with an injured ACL if it is fully torn and to avoid further injury if it is partially torn.

having said that, altough squat motion brings the ACL into action for a very small angle of the knee motion, and it may no hurt immediately, with heavey weights and no ACL the joint might wear off much more than for someone with healthy ACL and might increase the risk of arthritis down the years.