ACL reconstruction rehab / erg question

[_PBH_]

My 14 year old daughter tore her ACL (and MCL) a couple weeks ago playing basketball. We are currently looking at surgery in December (bad time of year to try to schedule a surgery!!). It sounds like she will be undergoing a bone-tendon-bone graft.

She's having a hard time with the realization that her freshman year of softball, which is her preferred and best sport, is already over before it even begins (February 2019).
We are being told to expect a 6 month recovery time. Ugh. This hurts.

We (my wife and I) have never had to go through this. I do not know what types of exercises physical therapy will include. I'm guessing that stationary bike riding will be a part of the regimen? I'm also guessing that at some point rowing may come into play? I'm sure that our physical therapist will educate us on all of this after surgery when it's his turn to take over her care.

I have a concept2 model D rower at my home. I'm thinking that for Christmas I will purchase a BikeErg to add to the mix, but I don't want to add encouragement with something that my be a poor choice for rehab.

Have any of you gone through ACL reconstruction? Any advice on rehab with home exercise equipment?

thanks.

[lframari]

I went through it twice over 20 years ago. They have improved the technique dramatically.

The biggest thing is to make sure she maintains her range of motion and mobility. The strength will come back later. The Bike Erg will be very good for the mobility as will the rower. I would say the Bike Erg will the first item and the rower will come later to help build strength. Since you will have two of the three Ergs, the skier could help work other muscle groups with very little strain on the knee. (Like I said earlier I only own the rower but look for excuses to purchase the other products.)

They have you up and moving around in a very short amount of time. Many people that I know that had an ACL tear along with myself find that one of the biggest hurdles the patient has is trusting the knee again. Once she gets out and starts playing sports again that fear (if she does have it) will go away.

She is not alone going through this, a number of my friends have either had the surgery or one of their offspring has had it. Women are much more susceptible than men. See the article below.

https://www.verywellhealth.com/acl-tear ... ls-2549223

Best of luck in her recovery.

[Cyclist2]

My teenage daughter had both knees done (one; snowboard, two; frisbee game), plus a meniscus clean up. As mentioned, getting the range of motion back is the primary goal of rehab. On the first one she, being a typical teen, didn't really do the work they recommended (it hurts!) and hence, that knee still gives her problems. The second time she was a little older and wiser and that knee is as strong as it ever was. Once the knee can flex properly, the exercises to get the strength back don't really matter. Bike or rowing is good, walking, really anything.

They now have a machine that you sit in that does all the flexing for you to get the ROM back. My brother in law, more recent ACL surgery, used that.

I'm sure they will prescribe some physical therapy. The therapist will have lots of experience with ACL injuries and will set her up with the right equipment/exercises to get her back. Listen to your therapist and ask lots of questions.

Good luck. Comfort her like the caring Dad you are during surgery and after because it will be traumatic for her (I was crying more than she was when I saw how frightened she was headed into the OR), but don't let up the fatherly nagging to put in the work to get the knee back to full ROM and strength. Tough love, believe me!

[mjlawton]

Although I am much older than your daughter (almost 59), I have had both ACL's repaired with meniscus tears as well (one repaired at age 42 from skiing injury at 23, one repaired at 54 from netball injury). Both of mine were repaired with my hamstrings...not familiar with bone tendon bone graft. I was skiing on my first one after 5 months. The second one I had a bit slower rehab due to some back issues, but I now do almost everything I want to, including triathlons. The only things I don't do are basketball and soccer as they have too high of a chance of re tear in my mind. I do play pickle ball as well which is a bit less demanding on knees than tennis. I did strength training, plyometrics, and biking for the most part in my rehab. Never used rower, but I just started rowing last month and have no problems. The continuous motion machine somebody else referred to after surgery was very helpful for me to maintain as much motion in knee as possible. It is very important to do all rehab and follow up visits as recommended. A friend's daughter just came back from ACL surgery to play soccer again within less than a year of surgery. If your daughter is motivated, she can most likely resume her athletic pursuits. Bike is definitely used in rehab (starting with just going part way around instead of full circle), but I am not sure if some use rowing in rehab or not. Hope this helps. Good luck to your daughter!

[Montesko]

Have her do physical therapy but make sure it's a good program. I went through ACL recon. 10 years ago and neglected a good physical therapist and my knee is still not 100%

[mdpfirrman]

Went though four in four years (the entire family). Daughter was your daughter's age and had to wait two years. Her surgeon wanted to wait until she was done growing. This was over a decade ago and I'm guessing the technology has changed (a lot has in the last 10 years).

Stationary bikes are great. Rowing, I would think longer term is great. Don't know if she'll be able to row for a while. I'd consider getting an AirBike. You can get both a great upper and lower body workout on them. Same principles as the Stationary bike but like the erg, no motors to deal with (so they are actually just as cheap or cheaper and last forever). I have the Schwinn AD Pro but the Assault Bike (the one that Cross Fit uses) and the new Rogue Echo are great options. If it weren't for my wife, I would have gotten the Echo.

Biggest challenge is patience with kids. They want to go 100 miles an hour. Better time for her now than when my son did it. He was an elite high school wrestler/soccer player. Was being recruited hard by Air Force Academy for both sports. He was a star striker on the soccer team and stole the ball from a kid at a practice game and the kid got mad and pulled his shoulder from behind as he swept him with his legs from behind. Senior season as a top 10 ranked wrestler and state soccer power's leading scorer was over instantly because a kid took a practice game too seriously. Only time I saw him cry aside from losing family pets was when he was told his sports were over.

Emotionally hard on kids especially. Takes around a year to fully recover. When she's fully recovered, make sure she's working with a great trainer on injury prevention. I talked to an orthopedic surgeon on it (his kid played soccer with my son) and he was one of the nation's leading specialists on prevention for adolescent girls. They tend, it seems, to jump with their knees in. Also, they develop too strong on certain leg parts. I know he was into lunges done properly. That's why you always see soccer teams warming up with lunges back and forth. Some kids don't take the serious. They should.

Sorry she's having to go through that.

[_PBH_]

...Her surgeon wanted to wait until she was done growing. This was over a decade ago and I'm guessing the technology has changed (a lot has in the last 10 years).

Our surgeon believes that my daughter is done growing -- and we (my wife and I) think that he is correct. For this reason he is recommending the bone-tendon-bone (patellar tendon) procedure. This is supposed to be better for athletes -- but should only be done if the athlete is done growing.

Biggest challenge is patience with kids. They want to go 100 miles an hour.

Patience is already being tested...surgery is not scheduled until the end of December, and the wait is already dragging. She broke down on the way home from the visit to the surgeon when the realization hit her that softball for this year is over. She keeps thinking that she might be able to make it back by June, and have a shot at finishing the Little League season. This year (2019) we have high expectations to return to the Little League Softball World Series (2017 Western Region Champions). Right now, she is motivated. But none of us know how her body is going to react, and what delays might come. We just keep trying to be positive right now.

The basketball coach has asked her to come and help out as the team manager. The softball coach has also asked (or rather told!) her to be the team manager as well. So at least she can continue to be part of the team. If she takes it serious, she'll still learn and become a better player from it.

She asked if we could go play catch yesterday. I obliged. I hope that continues throughout rehab.


I just wish we could get this surgery over with, and start working on rehab....this next month is going to kill us...

[mjlawton]

If you are in Utah, as it appears from your profile, just make sure she is careful in the snow both before and after surgery. It is very easy to slip on snow/ice with the instability of a torn ACL. Hopefully the holidays will distract her a bit and the time will fly by before surgery. If the dr. allows, she should try to maintain as much quad strength as possible (even just leg lifts or leg lifts with ankle weights) before the surgery, which will help recovery time. Not sure how the MCL tear in addition to ACL impacts things, but if she is young and fit and is willing to work hard and follow through on rehab, she will hopefully be back on the field before too long. Hopefully she isn't a catcher .