Ben Tollitt – 30,11,1994 (22) – Right leg ACL

Ben Tollitt - ACL Injury

Normal ACL rehab stages are:

Stage 1, pre-operation:

  • Control swelling
  • Restore full mobility of the knee.
  • Maintain strength of the quadriceps and hamstring muscles. Using contraction device (such as painpro)
  • Regain normal walking patterns, no limping

Home treatment:

  • Apply the PRICE principles of rest, ice compression and elevation.
  • Wear a hinged knee brace to protect the knee from further injury.
  • Perform patella mobilizations.

Exercises:

  • Knee mobility exercises including heel slides, knee flexion and prone knee hangs.
  • Ankle mobility exercises.
  • Quadriceps and hamstring isometric exercises (static contractions with pain pro muscle building setting).
  • Hip strengthening exercises including bridging and adduction.

Stage 2, post op (week 0-4):

  • Control swelling.
  • Improve bending of the knee up to 90 degrees.
  • Improve straightening of the knee to full.
  • Continue quads and hamstrings contractions with pain pro on muscle building setting
  • Walk partial weight bearing in crutches. Get rid of crutches after 2 weeks

Home Treatment:

  • Apply principles of P.R.I.C.E.
  • Wear a Knee Brace to protect the knee from further injury – your surgeon will advise on how much movement the brace should allow.
  • Continue to perform patella mobilisations.

Exercises:

  • ¼ squats.
  • Bridging.
  • Step ups.
  • Static bike – high seat with NO resistance, in pain free range of movement.
  • Hamstring curls – only if patella tendon graft is used, not Hamstring graft.
  • Calf Raises.

General body weight exercises and movements with limited strain.

Stage 3, post op (week 5-12):

  • Control swelling.
  • Improve bending of the knee up to 120 degrees.
  • Maintain full straightening of the knee.
  • Improve quads and hamstrings strength.
  • Continue walking with a “normal” pattern, increase proprioception and balance.
  • Remove Brace at 6 weeks.

Home Treatment:

  • Continue to apply cold therapy post exercises.
  • Continue to perform patella mobilisations.

Exercises:

  • ½ squats.
  • Lunges.
  • Leg Press.
  • Step downs.
  • Static bike – high seat with NO resistance, in pain free range of movement.
  • Sit to stand.
  • Single leg balance exercises.

Build up the exercises during this stage from body weight to exercises with resistance and weight like normal gym work just not full on yet.

Stage 4, post op (week 13-20):

  • Continue to control swelling.
  • Regain full movement of the knee.
  • Continue to improve quads and hamstrings strength.
  • Continue to work on balance and proprioception.
  • Start jogging and progress speed straight line only.

Home Treatment:

  • Continue to apply cold therapy post exercises.
  • Continue to perform patella mobilisations.

Exercises:

Exercises that are typically introduced at this stage, in addition to the previous stage’s exercises are:

  • Hopping single leg.
  • Double leg jumps.
  • Static bike.
  • Jogging – start slowly and ensure there is no limp before going quicker.
  • Increase running speed slowly and progressively over a period of weeks but only in straight lines no twisting or turning.

Gym work should now be resisted weights work and from this point build up the amount of weight can be lifted

Stage 5, post op (week 21-24):

  • Introduce twisting, turning and cutting movements.
  • Introduce ball work (if required).
  • Continue to improve balance around the knee.
  • Achieve at least 90% strength in the quads and hamstrings in comparison to the other uninjured leg.
  • Improving confidence.

Home Treatment:

  • Continue to apply cold therapy post exercises.
  • Continue to perform patella mobilisations.

Exercises:

  • Box Jumps
  • Start to gradually introduce twisting and turning movements.
  • Start to introduce striking a ball (if required).
  • Start to perform functional sports specific drills.

Along side this continue gym work

Stage 6, post op (week 25+):

Return to sport

Improvements I made and stages I bettered during rehab:

Stage 1:

Was able to bike

Do weights in the gym

No pain

No swelling

Full quads muscle strength

Stage 2:

More than 90 degrees knee bend

Fully straight leg

Walking after 5 days

Better than normal quad strength

Doing single leg volleys standing on operated leg

Brace removed week 1 not week 6

Stage 3:

At week 6 (instead of week 13) was told I could jog)

Full knee bend not just 120 degrees

Full muscle strength back with good amount of hyperextension

Stage 4:

 

Twisting and turning week 16 not week 21

Full sprinting

Performing football ‘Hoff circuits’ week 16

Joining in with non contact pre season training week 17 not week 21

Stage 5:

Full training with the team not just returning and building it up

All through my rehab I was 5-6 weeks ahead of schedule.

Why the device helped

It helped me with many of the systems it had to offer. The muscle building setting helped massively as I was performing muscle contractions with the device rather than on my own so it gave me extra help in getting muscle strength back quicker and better than it was before. When I could then do gym weights I used this setting whilst performing workouts for extra help.

With the recovery cell repair settings they helped massively by placing the pads on affected areas like knee, quads, hamstring, etc it allowed me to recover quicker on back to back days of work and also on days off so that I healed quicker but was also able to perform in the gym during my rehab to a higher standard more often.