Lower leg strength training with ACL tear

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Urza285
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Lower leg strength training with ACL tear

Post by Urza285 » Wed May 16, 2012 12:32 pm

Does this forum and site have any advice on how to go about that? More specifically for the WS4SB workout routine?

I'll be checking back on this while at the gym.

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JasonJones
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Re: Lower leg strength training with ACL tear

Post by JasonJones » Wed May 16, 2012 1:35 pm

I'll post something when I get home. In the meantime please post how bad (what grade) the tear is.
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Urza285
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Re: Lower leg strength training with ACL tear

Post by Urza285 » Wed May 16, 2012 2:59 pm

One is a complete tear, but was replaced by an artificial replacement make from part of my hamstring. The other is a partial tear, don't know how bad though, with a meniscus tear.

I'll probably just play it safe and replace squats with leg presses.

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Re: Lower leg strength training with ACL tear

Post by robertscott » Wed May 16, 2012 3:07 pm

ooh I'm not sure how much safer leg presses would be than squats...

this article might help

http://www.t-nation.com/free_online_art ... _knee_pain" onclick="window.open(this.href);return false;

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Re: Lower leg strength training with ACL tear

Post by KPj » Thu May 17, 2012 4:09 am

robertscott wrote:ooh I'm not sure how much safer leg presses would be than squats...

this article might help

http://www.t-nation.com/free_online_art ... _knee_pain" onclick="window.open(this.href);return false;
Good article. I'm not sure either but not spent a great time looking into it. I know that, even limited ROM leg press trains the rectus femoris quite a lot, which I suspect isn't the best option for those with knee issues (arguably good for those chasing big quads with no underlying issues to deal with). Plus, you don't get as much hamstring and glute activity, which is really what people with knee problems want to get at.

Urza - Was this as a result of some kind of abrupt impact or is it overuse/accumulative?

My short answer is to maintain a vertical shin, whatever exercise variation you go for but this is a very broad recommendation, need to know more, really.

KPj
Thanks TimD

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JasonJones
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Re: Lower leg strength training with ACL tear

Post by JasonJones » Thu May 17, 2012 11:05 pm

The thing to remember about cruciate ligaments is that they stabilize joints that have a very large range of motion (you've got some in your neck, fingers and feet as well). The ACL keeps the tibia from gliding anteriorly (or forward) and some medial rotation, but it doesn't necessarily restrict the range of motion of the joint in the way we'd use it in exercise. A person 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.

Restrictions from ACL injuries are going to be mainly sport and activity related, as the knee joint is now less stable against rotational forces.

From an exercise perspective, the only thing you really need to avoid is putting pressure anteriorly on the proximal end of the tibia, and posterior pressure on the distal end of the tibia. So the leg extension is out, (and I'd recommend against hanging upside down from a chinning bar by one leg.) You'd also want to avoid significant loads where knee flexion is great enough that the hamstrings compress against the calves, as this moves the pivot point further up the femur and away from the patella, increasing knee torque. Avoid squatting really deep, really heavy, but no reason you can't still go below parallel if that's a safe ROM for your hips.

Squats vs. leg press: I could point you to an academic paper that posits something about the difference in open and closed chain exercises and the compressive force on the knee joint that concludes that the squat is a better exercise for ACL rehabilitation, but I think the fact that the leg press is sitting in a chair extending your knees and a squat is an actual human movement that you need to be able to do to be remotely useful as a functional human being probably makes a better case.

At any rate, an ACL tear means a deficit in knee stability. Squats are going to increase that stability. Any bilateral exercise done where you can safely minimize rotation is going to increase that stability. Strength is stability, so train for that.

The thing I would be most concerned about is limiting rotation coming up or down the chain from the hip or ankle. Collapsing arches and weak ankles will rotate the knee, as will diminished glutes and tight pirifomii (piriformises? piriformix?). If your feet "toe out" when you walk, or rotate externally when your squat starts to get low, make friends with a tennis ball. If your arches suck, get some orthotics.

Sorry I didn't post this earlier, it's midnight my time and I'm just getting around to it now, if that gives you an indication of my work load… but I understand moneys get you the honeys, yes?

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Re: Lower leg strength training with ACL tear

Post by robt-aus » Fri May 18, 2012 4:00 am

ironman: further evidence. mighty moose ? the canadian connection? dr (hon) jones? mr. knows stuff?

anything but novice...

a random exercise nerd from the internets thinks your work is golden
maybe an honourific will provide company...

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Re: Lower leg strength training with ACL tear

Post by KPj » Fri May 18, 2012 4:33 am

I like the humour in things like "Mighty Mouse" - for us that know a little about Jason. However I think it should be something a newbie will take as, "this guy is worth listening too", which Mighty Mouse doesn't necessarily say lol.

Not that I have a better suggestion but, I just think it should be something that will make a newbie pay attention ("novice" has the opposite effect, really).
Thanks TimD

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Re: Lower leg strength training with ACL tear

Post by josh60 » Fri May 18, 2012 8:55 am

KPj wrote:"novice" has the opposite effect
Since Jason seems to have only virtues, how about "no-vice"?

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Re: Lower leg strength training with ACL tear

Post by JasonJones » Fri May 18, 2012 8:23 pm

:red:

Thanks guys. I'll earn a better title just like everyone else, it'll just take me a while as I labour meticulously (neurotically?) over each post for so long…
josh60 wrote:
KPj wrote:"novice" has the opposite effect
Since Jason seems to have only virtues, how about "no-vice"?
I assure you my track record on the sugarholics.com and mymomthinksimcool.ca forums proves otherwise :pale:
don't you know there ain't no devil
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Re: Lower leg strength training with ACL tear

Post by robt-aus » Sat May 19, 2012 2:49 am

i'm reporting these to thatsnotarealwebsite.dev.nul

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Re: Lower leg strength training with ACL tear

Post by Jungledoc » Sun May 20, 2012 4:16 pm

Jason, a few members have titles given on merit, not just on verbosity. Kenny Croxdale and Stephen Johnson are the 2 that I can think of (I suggested Stephen's after he parried brilliantly with a trollish member a couple of years ago). So a special title isn't out of the question, but we'd have to come with just the right one.
Our greatest fear should not be of failure, but of succeeding at things in life that don't really matter.--Francis Chan

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Re: Lower leg strength training with ACL tear

Post by Oscar_Actuary » Mon May 21, 2012 3:31 am

KPj wrote:Not that I have a better suggestion but, I just think it should be something that will make a newbie pay attention ("novice" has the opposite effect, really).
You could give JJ the title of "Most Inept Wannabe", and his posts would nullify it. IOW, you'd have to be a moron to not know this guy's got it going on. That said, most of us have something to bring to the table, so I'd suggest we don't get to caught up in crowning him "god on Exrx". That's not to suggest there is not a huge gap between his contributions and most of you other clowns, but more that it looks like "oh boy, we actaully have a bright star here posting". AKA, lets act like we've been here before and let him get his 1000 posts or whatver you need.

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