ACL Surgery Recovery
So I’ve got ACL surgery, now what? You’ll get specific instructions from your surgeon on what you can and can’t do with regards to your repair. This will include using crutches, ice, stretches, basic strengthening, and medication use.
Beyond the specific rehab for your injury, there is also more you can do to optimize your outcomes for recovery. In this article we will talk about:
- Crossover training
- Motor Imagery
- Nutrition
Crossover training
Crossover training is an effect that exercising a muscle group on one side of the body leads to strength gains on the other of the body. Studies have shown that while your left arm is casted, exercising the right arm every day leads to maintaining the strength and muscle function of the casted arm even if you aren’t doing anything with it! But, those in the same studies that did not exercise would lose a lot of strength and muscle in the casted arm. Although your muscles aren’t doing anything when in a cast, the nervous system is still being trained.
After an ACL surgery muscle loss is going to happen, so working on the opposite side while healing the surgery side will lessen these losses.
Science doesn’t know the exact way this training works in the body, but it is believed that the majority of the effect of the training is happening at the brain level. Training the one side of the body causes the opposite side of the brain to also fire, leading to increased/maintained strength on the untrained side. Keeping the parts of your brain that tell those specific muscles what to do active allows for overlap in those regions of your brain.
These exercises can be as simple as isometrics (pushing against something and getting a muscle to flex without actually moving your joint), but the more you do that involves movement, the better results you’ll get. So we can use this for any injury that requires you not use a part of your body while allowing it to heal. You work the opposite side while the injured side is being protected, and this will lead to your recovery being much faster once you’re are able to move the injured arm or leg.
So this is useful if you had surgery or casted from a broken bone. What if you just pulled a muscle or sprained a joint? You can still benefit from doing these exercises. Muscles around an injury don’t work as well due to pain. So these exercises also help to wake those muscles up. Back to our ACL surgery example, you can do single leg exercises like bridges, leg press and leg raises on the good side, which will lead to faster recovery on the surgery side.
The next step is to get your body ready for doing the movement.
Motor Imagery
Motor imagery is the practice of thinking of the movement without any actual body movement. This can be done in two ways. You can view yourself as an outside observer, almost like you’re watching yourself in a video. Or you imagine being inside of your body, feeling everything that might be expected during an actual situation. Ask yourself, then think about, what has to move and how do you move if you wanted to jump. What does it feel like to push off of the ground, rolling off your toes as you jump into the air? If you’re not sure where to start you can move on your uninjured side and pay attention to what you’re feeling and how it looks.
This is training your brain to practice before you get to those motions. So, this is preparing your brain, getting it ready to learn how to move. If you’re not sure what it looks or feels like, we can use videos to help show you (ie. walking well after being on crutches, bending down well after a low back injury). Using these tools like this will help avoid or change the patterns that would have contributed to the injury in first place!
With ACLs, the common pattern for injury is the knee falling inward when you squat or jump, bike. So you would work on thinking about controlling the knee with these motions.
Nutrition
And finally, what about Nutrition! Healing the body requires nutrients and energy. Our friends at Precision Nutrition have set up a good article on the subject here.
Their basic points are that depending on the point of your healing process your are at, there are certain food and supplements that can help your body do its best job at what it’s doing at the time.
The earlier you can start all this the better! If you are not quite sure what to do, our athletic therapist, physiotherapist, dietitian are ready to provide guidance and specific recommendations based on your specific injury and situation.
What did we miss? Do you have any questions? Let us know in the comments below!
You may also be interested in Common Knee Injuries and Steps to Recovery and Nutritional Therapy for Injury Recovery.
Written by Gil Magne and Robyn Edge
References:
- Adamson, Michael, Niall MacQuaide, Jan Helgerud, Jan Hoff, and Ole Johan Kemi. “Unilateral Arm Strength Training Improves Contralateral Peak Force and Rate of Force Development.” European Journal of Applied Physiology 103, no. 5 (July 2008): 553–59. doi:10.1007/s00421-008-0750-
- Carroll, T. J., R. D. Herbert, J. Munn, M. Lee, and S. C. Gandevia. “Contralateral Effects of Unilateral Strength Training: Evidence and Possible Mechanisms.” Journal of Applied Physiology 101, no. 5 (July 27, 2006): 1514–22. doi:10.1152/japplphysiol.00531.2006.
- Driediger, Molly, Craig Hall, and Nichola Callow. “Imagery Use by Injured Athletes: A Qualitative Analysis.” Journal of Sports Sciences 24, no. 3 (March 2006): 261–72. doi:10.1080/02640410500128221.
- Farthing, J. P., J. R. Krentz, and C. R. A. Magnus. “Strength Training the Free Limb Attenuates Strength Loss during Unilateral Immobilization.” Journal of Applied Physiology 106, no. 3 (March 1, 2009): 830–36. doi:10.1152/japplphysiol.91331.2008.
- Farthing, Jonathan P., Ron Borowsky, Philip D. Chilibeck, Gord Binsted, and Gordon E. Sarty. “Neuro-Physiological Adaptations Associated with Cross-Education of Strength.” Brain Topography 20, no. 2 (October 23, 2007): 77–88. doi:10.1007/s10548-007-0033-2.
- Fimland, Marius S., Jan Helgerud, Gerd Marie Solstad, Vegard Moe Iversen, Gunnar Leivseth, and Jan Hoff. “Neural Adaptations Underlying Cross-Education after Unilateral Strength Training.” European Journal of Applied Physiology 107, no. 6 (December 2009): 723–30. doi:10.1007/s00421-009-1190-7.
- Hortobagyi, T. “Cross Education and the Human Central Nervous System.” IEEE Engineering in Medicine and Biology Magazine 24, no. 1 (January 2005): 22–28. doi:10.1109/MEMB.2005.1384096.
- Kofotolis, Nikolaos D., and Eleftherios Kellis. “Cross-Training Effects of a Proprioceptive Neuromuscular Facilitation Exercise Programme on Knee Musculature.” Physical Therapy in Sport 8, no. 3 (August 2007): 109–16. doi:10.1016/j.ptsp.2007.02.004.
- Lee, Michael, Simon C. Gandevia, and Timothy J. Carroll. “Unilateral Strength Training Increases Voluntary Activation of the Opposite Untrained Limb.” Clinical Neurophysiology 120, no. 4 (April 2009): 802–8. doi:10.1016/j.clinph.2009.01.002.