John,
I have recently suffered a torn ACL injury; therefore I am unable to do full body workouts. I was wondering if you could help me get on the right track for an upper body workout while I am recovering from my injury. I do not want to get out of shape and still want to do a WOD but it’s hard to follow without being able to use my legs for a lot of sections of the workout. As an NFL veteran, I am sure you have seen this type of injury and how to work around it. I was wondering if you could put me in the right direction and provide me with an appropriate guideline.
Thanks,
Jon S.
Jon,
I have torn my ACL…my patellar tendon and had 3 arthroscopies to clean out torn meniscus, scar tissue and a bone chip. I know something about not being able to train your lower body due to injury.
I would stick with the basics: upper body push and pull. Bench press, floor press, seated dumbbell press, pull-ups, chin ups, push ups, lat pull downs and every movement you can create to isolated the arms, chest and back. This is a great time to focus on those big upper body movers and put in some concentrated work.
And above all else, continue to train the good leg. Leg raises, hamstring curls, isometric contractions, single leg glute bridges, four-way hip movements with stretch bands and single leg step ups are a great place to start. For years, they have done extensive studies on the carry over of training a healthy limb and its effect on the injured limb.
I wouldn’t put too much focus on metabolic conditioning just yet. You will have plenty of time to bust your ass and get your heart rate up when doing your rehabilitation post surgery. I would take this time to make sure I was strong and stable in all the places we tend to overlook when doing “functional training”. Keep your upper, mid and low back strong, as you will need to in your rehab when learning to squat and deadlift again.
Remember, surgery is more physically/emotionally taxing than anyone cares to admit. Ask any athlete that has been hurt and required to have a few surgeries and they will tell you, each one is harder and harder to come back from.
With that in mind, make sure you nutrition and supplementation is on track. Things like water, fish oil, vitamin C & D3 and a diet free of crap are fundamental to speed healing. Start doing these things now; if you wait till after surgery it will be too late.
I know things have changed light years from when I had my ACL repaired in 1996. Back then, they used the middle 1/3rd of my patellar tendon and the rehab and recovery was lengthy and painful. I never understood the destruction of a healthy body part to fix another. In 2011, they use cadaver ligaments and space age stuff to fix ACL’s. Without inducing the massive trauma of cutting into the patellar tendon, the knee heals pretty fast and I have seen people back to full speed in 6-8 weeks, instead of 6-8 months.
The last clean out I had was after I left New England in September 08. I went up to San Francisco to have surgery and rehab with the great Kelly Starrett of Mobility WOD fame. Twenty-four hours out of surgery, I was at San Francisco CrossFit doing a Kstar-inspired metcon involving pulling myself off the ground by a rope, push-ups and DBs. We capped the day with a friendly challenge of me trying to good morning more weight than Kelly could back squat. I won that day.
And just for some reference, nothing adversely affects your ability to recover like anesthesia. The faster you can get the anesthesia out of your system, the better you do.
*Now for the legal stuff…I don’t suggest or recommend you start training 24 hours after surgery to flush the system of any lingering anesthesia. Please follow the advice of your doctor and make sure you are healthy and ready to engage in physical activity before starting any training regiment.
However, personally, it has always helped to speed healing.
Sorry you got hurt. I hate to hear about injuries, as I have had several, and they are never easy. Be smart with your rehab and let your body dictate the rate of recovery. Push too hard and you can set yourself back. Push too little and never make it back.
John
You leave any other comment other than “well said”.
This article couldnt have been posted at a better time. I managed to tear my right lateral meniscus a few weeks ago playing hockey. Im thinking that I should obviously follow the same suggestions that youve layed out for an ACL tear as well until I get my scope done…
Would you make any modifications would you make for someone whos had scope on both knees and training via CFFB? I tore my left meniscus racing motocross a few years back as well. Im a Firefighter here in Toronto and Crossfit Football is probably the best progam Ive found to meet the demands of the job. Id really like to be able to continue following it.
Thanks for the info and excellent programming John!
As an addendum to this, and with no intention to hijack anything, what are your thoughts on whether or not it is necessary to even replace the ACL at all once it is torn?
And can you advise on whether or not there are ways to train through cartilage issues without surgery?
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timing=impeccable; i just had my distal biceps tendon reattached. for 2.5 weeks was doing mobility and 1-armed wods + lower body strebgth. now after surgery five days i am feeling ready to get back to it, am going to focus lower body, of course w a few 1armed mini-metcons.
dude this just REALLY inspired me!
thanks!!!
[…] Training with a Torn ACL – TTMJ […]
[…] Training with a Torn ACL […]
[…] Training with a Torn ACL […]
Hey, I have suffered from the acl tear. From football. I was in outstanding shape and happy with my body and mass, like you said the recovery is mental and physical. But I became depressed knowing I can’t play my senior year and my body has went to shit from no confidence or drive and its hard. Very hard. Can someone give advice on how I could get the great upper body again. And I have had surgery. So I’m limeted to mobilize! Please help:(
This article came up on a google search….full ACL Reconstruction surgery scheduled in a couple weeks….will be needed! Thanks for the opinions:). But alas I have a doc that worked on many collegiate athletes in the area and the patellar tendon is still the “gold standard”!!!! So be happy even with pain you got the gold laying in your knee…
Don’t do the patellar tendon. Why destroy a healthy tendon to fix a ligament? The rehab and tendonitis makes this a year on the shelf. A donor graph is the only way to go. The patellar tendon graph is an old way of thinking.
Sorry but you need to find a better doctor that works with pro athletes. College athletes? No so much.
Can you tell me exercise, as I have ACL tear 20 years back (current age is 40) in my left knee. I do have some swelling some time without any reason and after few days swelling goes away. While sitting on foot light pain persists.
My weight is 94 kg and height is 170 cm.
I dont want to go for surgery.
Just to clarify…the BPB autograft (your own tissue) is still the gold standard for high demand/cutting sport/pro athletes. James Andrews, Richard Steadman, Walt Lowe, Brian Cole, Leigh Ann Curl, AJ Cosgarea, Mark Sanders, Mark Miller, Les Matthews, Craig Bennett, Neil ElAttache, David Altcheck and just about every other top orthopedic surgeon in the world uses BPB for their high demand, college and pro athletes. BPB has the highest tensile strength in motion that matters to folks like us and is the proven method of getting people back to the field.
You get bone to bone healing with your own tissue which means faster integration and vascularization. The bone to bone healing is what provides the shorter recovery track. Hamstring autograft has no bone, so it takes longer to fill in the drill holes that the graft has passed through vs. BPB that they plug into. Also you lose posterior stability in your knee and your explosiveness with hamstring…the hamstring graft also has less rotational strength and is prone to laxity over time, meaning less stability and eventual failure of the graft.
Cadaver is the WORST thing you can put into a high demand athlete. It takes 12-18 months before full vascularization so in that window the graft is very likely to tear under the stress one of us hard chargers will put on it. Also you lack donor site morbidity (the surgical insult to the knee) so you “feel better” faster although you are not healed and can stress the graft too much…then pop and you’re in a revision situation. There are plenty of peer reviewed journal articles starting the incidence of retear the first 12 months post status with cadaver grafting in athletes is exponentially higher (up to 50%) vs. hamstring (5%) and BPB (less than 1%). The only way cadaver is a choice for a credible OrthoPod with someone that really puts the knee through the paces is if they have no natural tissue left to use for a graft.
The real reason of faster recovery in pro sports that use BPB is better surgical techniques and rehab progression. For surgical techniques the anteriomedial aka anatomic reconstruction is way better vs. the old transtibial technique, which means drilling the femoral tunnel through the tibial tunnel hole and passing the graft through. The latter leads to improperly placed grafts that require huge workaround to make a knee seem functional – like significant notchplasty to avoid impingement of the graft. TT also leads to rotational instability. The AM technique drills both tunnels independently and allows for the ACL to be placed in it’s natural footprint, this leads to a more natural feeling knee and a more stable knee.
I love your site and your philosophies, but get more informed on this one before you start telling people what they should and shouldn’t do and what doctors are doing to pros…on this one, you’re wrong.
What happened to my post explaining why bone-patellar-bone autograft is still the gold standard for pro athletes/high demand competitors vs. inferior graft choices such as hamstring or cadaver?
Necro-posting aka neuro-trolling gets kicked to spam. And a necro-post is when you comment on a blog that was written a long time ago. So put some ointment on the butt hurt b/c your comment didn’t get approved.
You wrote, “BPB has the highest tensile strength in motion that matters to folks like us and is the proven method of getting people back to the field.”
Folks like us??? Do I know you?
Nevertheless, have you had an ACL done? Doc Steadman (recently retired) worked on my knee three times and I am very familiar with the ACL procedures.
I still don’t agree the the destroying of a healthy tendon to to fix a joint is the best course of action. I have seen the minimally invasive surgery using a cadaver having a quicker recovery with none of the problems associated with the destroying the patellar tendon. I had the patellar graph used on my ACL and the pain/swelling and tendonitis in both knees (the left one from favoring) was by far the worst part.
I am sure surgical techniques have improved but the rehab is still the rehab unless there is new technique that has been invented in recent time. The biggest issue is managing the swelling and tendonitis in the knee the graph was taken from.
http://www.stoneclinic.com/blog/2013/7/1/donor-tissue-acl-reconstructions
Here is a write up by Kevin Stone. Kevin worked with Steady and Kstar worked for Kevin Stone. He is pretty cutting edge and here are his thoughts.