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Vastus Medialis - Knee exercises post ACL

azzurribikeazzurribike Posts: 58
Anyone have any suggestions on best exercise for recovery of wasted muscle post ACL surgery. In particular the VMO.
I used to play Hockey but now I ride.... one day like the wind :)

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  • NJKNJK Posts: 194
    Anyone have any suggestions on best exercise for recovery of wasted muscle post ACL surgery. In particular the VMO.

    You need to concentrate on exercises that work the last 20-30% of straightening your leg. E.g leg extension machine set sup so you are not doing full extension just last 20% or so. You might want to progress to this from using ankle weights first sitting in a chair. Sorry a bit brief.
  • PLEASE ignore last post.

    Seated leg extensions (inner or outer range) are bad news early after ACL surgery. Because the joint bis not loaded by bodyweight (called open chain exercise) there are far higher forces on your ACL graft and you risk stretching it if these are done too early.

    Talk to your physio.
    VMO is always the first part of the quads to waste and the hardest to get back. There are plenty of exercises you cn do, but you need good, professional rehab advice.
  • NJKNJK Posts: 194
    ajkelly wrote:
    PLEASE ignore last post.

    Seated leg extensions (inner or outer range) are bad news early after ACL surgery. Because the joint bis not loaded by bodyweight (called open chain exercise) there are far higher forces on your ACL graft and you risk stretching it if these are done too early.

    Talk to your physio.
    VMO is always the first part of the quads to waste and the hardest to get back. There are plenty of exercises you cn do, but you need good, professional rehab advice.


    Before you get on your high horse which you already have it was a brief post with a progression to leg extension to develop VMO. The OP hasn't said how far into rehab he is and i would have thought that the physio would have started with rehab exercises well below that similar to leg extension.

    Then again if you just have had the surgery and in the initial stages of rehab i wouldn't reccomend this exercise.
  • felgenfelgen Posts: 829
    hmm I was going to comment on this, but will leave my professional opinion out of this thread.
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  • NJKNJK Posts: 194
    felgen wrote:
    hmm I was going to comment on this, but will leave my professional opinion out of this thread.


    I wish i hadn't answered so quick either :D
  • Remember that you knee is stabilised with you quands AND your hamstrings. I made the mistake of concentrating all my rehab on the quads and ignored my hamstings. This put me behind by 6 weeks as I kept pulling the hamsting muscles due to their weakness.
  • felgenfelgen Posts: 829
    Anyone have any suggestions on best exercise for recovery of wasted muscle post ACL surgery. In particular the VMO.

    I dont know about anyone else's advice, but I would want to know a lot more before offering advice.

    I would want to know:
    1) Was it primary procedure or re-do?
    2) What was the graft substrate? Hamstring? Bone-patella-bone? unilateral/contralateral graft? Cadaveric graft?
    3) What graft fixation was used? Transfix? Interference screw? EZ-lok?
    4) What was the fixation hold like any problems/restrictions?
    5) How long since surgery (grafts actually get weaker before they get stronger though a process where the structure changes to perform better as a ligament rather than a tendon- you are most likely to damage it at 3-6 months - the tendon will be weakest and you will be getting better with your rehab though may still be off with the proprioception. In fact I am sure I read that in-vitro testing of the native ACL showed it could only withstand about 1000N of force before failing, which shows you really must get your proprioception working properly as soon as possible to be able to protect the graft as unmoderated forces in the knee could easily exceed that.
    6) How long between injury and surgery, did you do ACL rehab in between or were you fast-tracked?

    Thats all I am going to say, and I would just go and see someone who can examine you, work out what stage you are at in rehab, and has access to specific rehab instructions from the surgeon - some are aggressive, and some aren't - thats their preference, but I guess surgeons do what they are happy with.

    And if that doesnt answer your question, well thats because I think that you should't consider one muscle group. So what if VMO is weak - you need to consider all the muscles and how they work together to prevent re-injury.
    Steeds:
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    2)Nelson Pista Singlespeed
    3)Giant Cadex MTB
    4)BeOne Karma MTB
  • sylvanussylvanus Posts: 1,125
    I don't have the level of technical knowledge of some of these answers but I had an ACL graft done in March (hamstring graft) and I'd completely back up the advice that you should make sure you have very good physio advice - almost as important as the surgery itself.

    However one thing I am sure of is that you should ignore the advice to use ankle weights - it could completelty destroy your graft. The general rule I was given was that your feet must be anchored / placed for any leg exercise for the first few months - ankle weights etc are potentially far too untable.

    If you need to pay for private physio then do so - its well worth the money...
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