A few weeks ago I was working with a client virtually who was 10 weeks post-op. We had started working together around week 3, and to date, he had been absolutely dominating the recovery process.
In addition to his physical therapy appointments, he met with me virtually 1x/week to determine the best plan of attack for his workouts with the Neubie… and then he would get after it. By incorporating our recommended workouts with the Neubie into his routine 3x/day, he regained full strength and range of motion before 8 weeks post-op.
But, around week 10, they started to increase load at his physical therapy appointments. In particular, they started trying to increase the weight of his exercise on the knee extension machine, which was leading to a little bit of anterior knee pain. Each day he returned to do the knee extensions, his anterior knee pain would increase.
Now, as I said before, this client met with me 1x/week, and by the time we met next, he had reached a point where the pain was even carrying over to his every day activity. He no longer had the ability to fully straighten the knee without pain.
Despite doing everything right and crushing the first 8 weeks of the recovery process, he had experienced a setback in week 10.
Setbacks can be difficult, but with the right strategies in place, you can overcome them quickly and come out on the other side stronger.
Setbacks are a completely normal part of the ACL recovery process. In fact, in some ways, knowing how to manage setbacks is the name of the game. Throughout the recovery process, your physical therapist will be constantly “upping the challenge” at appropriate times to see what your body can handle.
Each time the challenge is increased, your body may respond with a gentle reminder (pain) that your knee has experienced a pretty significant trauma just several months prior. Know that even the most successful ACL recoveries are faced with setbacks at times, and stay positive as you seek to overcome your own.
If you feel you are beginning to have a setback, think about when the right time is to dial things down a bit. In the example with the client above, I would say they may have waited a little too long to take action.
It’s ok to push into a little bit of pain while exercising during the recovery process, but if pain levels increase to levels greater than a 2/10, consider stopping the activity until you can gain a better understanding of why its happening.
A period of rest and ice is a general recommendation during a setback, which is used to temporarily reduce pain, stiffness, and inflammation. But I’d encourage you to go one step further – seek to understand WHY the setback occurred. Most times, a setback occurs because we are not yet utilizing our muscles appropriately during the painful exercise.
So, use the time to determine what muscles may be contributing to the problem and fix it. That way, not only can you use the time to temporarily address the problem with rest/ice, but you can also decrease the odds of the problem returning—meaning you will come back stronger. One really cool way that the Accelerate ACL program identifies muscle deficiencies is by utilizing “mapping mode” on the Neubie (video linked below).
If you follow these 3 tips, you will be able to minimize the downtime associated with setbacks AND get back on track with more knowledge, strength, and confidence.
How did he respond to his setback?
Initially, the physical therapist recommended that he shut things down for 7 days and ice the knee. Fortunately, he allowed him to continue doing his Neubie workouts with Accelerate ACL.
During our weekly virtual session, I guided the client through a process called mapping (example video here), which can be used to help determine which muscles may be contributing to the problem. In his case, we ended up finding the VMO and tibialis anterior. He was instructed to go through a series of exercises while stimulating those muscles with the Neubie throughout the week.
By the time we got together the following week, the client’s knee pain was no longer a problem. He had ramped things back up at physical therapy and said “I think the areas we identified during mapping were really helpful.”
Through this process, we were able to not only survive the setback, but make sure he came back even stronger and more knowledgeable on the other side.
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