ACL Tears (REHAB TIPS AND BEST EXERCISE!)


What’s up guys? Jeff Cavaliere, ATHLEANX.COM. Today we’re going to talk all about ACL injuries
in a continuing effort to bring you guys a little bit inside of my life of what’s going
on. My best friend here Charlie, he had an ACL
tear. He’s recovering from his surgery. I’m going to take you all inside the knee. Why this happens, what you can do about it
and most importantly what you can do soon after it happens to you to help speed up your
recovery like we’re going to be doing with Charlie. Alright guys, so my best workout lately has
been carrying this guy around, all 80 pounds of him, because he tore his ACL. I know how debilitating this injury can be
especially if you’re an athlete out there. But don’t worry, you’re in good company. Because it’s not just Charlie that’s got this
going on. It’s one of the most popular injuries that you can possibly get orthopedically. So learning how to deal with it, especially
if you’re watching this having dealt with this injury in the past, is going to be helpful
alright. So, Charlie I’m going to put you down big
boy. He’s already falling asleep in my hands. The most important thing about our knee is
it’s impacted no matter what we do, every single step we take. If you’re an athlete, you’ve got a lot more
than just steps you’re taking. You’re taking a lot of cuts, and you have to be agile. You have to be able to push and change direction.
Well a lot of times the ligaments that run inside of our knee are the only support we have against those
forces that are caused by the change of direction. And unfortunately, sometimes the forces are
greater than the strength of our ligaments and we have issues. So, first of all I want to show you guys what
the ACL does so you can get a better understanding of it. Because the thing that always amazed me was
there are no mistakes when it comes to our anatomy. Everything is placed exactly where it should
be, for an exact reason because it serves a very specific function. So, if you were to look at your knee as you
would with this rubber band, here’s going to be your ACL. This is going to be the top part of your knee
joint, your femur, and this is going to be the bottom part of your knee, the tibia. If you were to put a rubber band over your
thumb, ok, and then make a fist, and then from here wrap it around your index finger
of your tibia. When I then put them together, we’ve now created
a knee joint, right. It runs from the back side of the femur, ok. Behind our knee and the upper part of our
leg and it runs and attaches across to the inside front of the tibia. So what happens is, we know first of all,
if I try to pull the tibia forward on the upper bone in our thigh, the femur, it doesn’t
like that. We’ve got some resistance there. The ACL is trying to prevent that from happening.
It also will prevent, this is one of the things that people don’t realize, is the internal
rotation of the knee. So if the foot is planted and the leg turns
out to the side, right. You want to change direction, plant your foot and then turn to
the right to push off that way, you’re getting a relative internal rotation
down at the knee. And you can see that there’s tension on that band. If I were to try to externally rotate my leg,
right, there’s less tension on the ACL. So understanding the placement of the ACL
in the knee will tell us everything about it’s function and what we need to worry about. So, what happens when this ligament that runs
again, from back to front, tears? Well we don’t usually just get an ACL tear,
as some of you guys out there can imagine. We also get damage to the medial collateral
ligament, that usually winds up getting torn too in a very severe ACL injury. And we get damage to the meniscus that sit
on top of the tibia here because once we lose that control of internal rotation we get a grinding of the two bones together,
that’s just basically grind and tear the surface. And my friend Charlie, he actually had a meniscus
tear as well that had to be repaired. So the most important thing that you can do
when you have an ACL injury is to control the inflammation. Right now with Charlie we’re not doing anything
but trying to keep him limited on his walks, make sure that what he does is just enough
to be outside to get some weight bearing. Because we know that early weight bearing
is definitely going to be useful and more able to accelerate your recovery than some of the older approaches that casted
you and didn’t want you to move at all and restricted your motion. We want to get some weight bearing but you’re
definitely going to want to make sure that you’re getting in control of the inflammation because the worst thing with inflammation
is it shuts down the whole operation. As soon as your body senses inflammation, even in the knee in cases of just inter articular
fluid, right, we can get that from time to time, water on the knee. You’re going to get a shutdown of the function
of the muscles around it, and most importantly the quadriceps. Once the quadricep stops to function, you
don’t really have the good ability to straighten your knee and when you lose that you can actually start to develop scar tissue
and have your knee shorten in a contracted position. And if you don’t have full knee extension
that’s a whole other issue in and of itself. But first and foremost you’ve got to control
inflammation. So once we do that and we start to progress
ourselves to work on the range of motion, we’re going to be able to get full knee extension
first, then start worrying about the flexion in our
knee, second. Alright, remember full knee extension first, then start worrying about
that. And you can work on full knee extension by
literally pushing down on your leg, trying to get it to straighten out. But really what you guys watch our channel
for is strength and conditioning. And where are we really doing strength wise
to help with this ACL to hopefully make it come back stronger and faster? Well we want to make sure that we’re doing
closed chain exercises versus open chain exercises. You guys have heard me talk badly about the
knee extension a lot. And I feel for good reason. In a case here for the ACL, there’s a lot
of stress placed on that, shearing force placed on the tibia in a knee extension that we just
don’t want to really subject it to. Plus, I always feel like, you want to strengthen
yourself in the position that you likely got hurt in, and that was likely with your feet
on the ground. Ok, 70 percent of the ACL injuries come from
a non contact injury. It’s just planting, cutting and your feet on the ground. We want to be able to strengthen that knee
with the foot back in the condition it was when it got hurt to try to hopefully prevent
that from reoccurring. So, what I’m going to have you doing is squats.
And I think the best version of the squat that you can do is going to be a front squat. Because if we can put that center of gravity
a little bit in front of our body, by bringing that weight in front of us and having a more
upright stance, as opposed to a back squat where we’re going
to be sitting our hips backwards more. You’re going to have a much less perceived
stress by the ACL in that position, which will allow you to load up quicker, strengthen
your quads and return to action faster, with a stronger more functional leg than you
might if you’re focusing on back squats. So if you haven’t torn your ACL, I hope you never
do. We actually have a video on testing your intrinsic
knee strength to see how well you might be fortified against a possible knee injury or
ACL tear. You’re going to want to watch that video.
I’ll post it here as well. So there you have it guys. The ACL, what it
is, how it functions, what you have to do if you hurt yours and last thing I can tell
you most of all, It’s a bitch if you do so you want to make
sure you don’t do it in the first place. Guys, if you want to look like an athlete,
you’ve got to train like an athlete, doing that in my book means training safely and
pushing yourself to the limits, but do it in a way that is biomechanically
correct in allowing your body to become a bigger, stronger version of yourself while
also fortifying it against these types of injuries. If you haven’t already guys, head to ATHLEANX.COM
right now, grab our 90 day Training Program. Start training like an athlete. Get bigger,
stronger faster, more ripped but at the same time, let me as a physical therapist guide
you so that you can become a more functionally
strong version of yourself as well. Alright, guys, give Charlie a little bit of
love. He’s going to get better real soon. In the meantime, I’m getting one hell of a
bicep workout holding this guy up and carrying him wherever he needs to be. But he’s my best friend and I’ll do whatever
it takes. So, I’ll be back here in just a couple days. Whatever you guys like to see, leave it down
in the comments below, and I’ll make a video for ya’. See you guys.

100 thoughts on “ACL Tears (REHAB TIPS AND BEST EXERCISE!)

  1. I injured my knee 2 years ago and didn't see a doctor until this year in July. Found out I completely tore my acl and had torn my medial meniscus. Had arthroscopic surgery, no physical therapy needed but it's been 3 months since the surgery, I tried to run on it but ever now and then I feel pain from the shock absorption. I'm in the Army National Guard and have a physical test next week that requires me to run a 2 mile in less than 16 mins. Should I just continue to let my knee heal on it own or should I opt to get a acl repair?

  2. I truly hope Charlie gets recovered asap. My dogs are my truly best friends also. Best of luck to you Charlie, & thanks for the vid Jeff.

  3. hey jeff! im 14yr old and have been working out for a while. could you make a video about what teen should not do when it comes to lifting/training? could you talk about the "growth plaets " and the "growth stunt" myth? thx! 

  4. Jeff i was wondering if you could do a hip bursitis/injury rehab video because i have struggled with that a lot and it doesn't let me do much cardio sometimes because impact also hurts. Please if you read this, perhaps offer some help?

  5. I injured my ACL 14 years ago, and this is never ending pain story. I will try to workout my legs and maybe it will be pleasure for me 😉 can you show how to workout back with every weight or without weight? 

  6. How would this compare to PCL injuries?  I had a grade 2 pcl sprain, and some subsequent chondromalacia patella to go along with it that required a scope to remove damaged cartilage. I imagine doing some of the same strengthening would help, but are there any other specific things you would suggest.

  7. Hi Jeff,
    I've had two ACL reconstructions on my left knee. They were back to back contact injuries (20011 & 2012) yet, I continue to struggle with postural issues. For example, I unconsciously bear more weight on my right leg and I feel a lot of tension on my right hip and outer knee. For example, I was doing the Fantastic 4 workout and my right hip flexor was killing me two days after.  I am working on correcting these postural issues but my right hip continues to feel extremely tight. Also, I notice a slight anterior tilt of my pelvis and its quite annoying. Your tip on squeezing the but cheeks prior to squatting really helps me align myself but I still notice that I shift to right. Any tips on fixing these things?

    Thanks!!!

  8. Jeff, I love your videos and have been watching them for years.  I don't recall seeing you do anything on Osgood Schlatter's disease.  From what I've seen and experienced, I've had to greatly change the way my leg training is done to relieve quad/knee strees (changing to low bar squats and shifting more to glute activation in leg training).  I'm not sure if there's anything else that can be done since it's a bone growth issue but would you mind doing a video on that to help us athletes that have that problem?

  9. the Starting Strength book recommends you don't do front squats because it places the knee in a worse position..whos right?

  10. Great info, wish you would have made this last year when I tore both my M and A CLs as well as my meniscus in three places. Your right, it's a bitch.

    My daughter and I both love running 5 and 10 Ks but struggle with shin splints. Would you please consider making a vid on runners preventing and recovering from them and other shin type issues.

  11. This video is more than a week old, but in a related bit of news, now a fully customized knew replacement can be made relatively cheaply using 3D Printing.  You may find this interesting Jeff:  http://www.gizmag.com/3d-printing-custom-knee-replacement-conformis/34322/pictures#3

  12. great video I had my surgery 6 monthes ago and  I am getting the same slightly painful cracking in the back of my knee when fully flexing my left leg. What are some good hamstring workouts because it is very weak. Thanks

  13. HI. I have ACL complete tear.. 4 Years ago,can I do Rope Skipping exercise . and also as i have delayed the operation , is it necessary to go for surgery. Please suggest.

  14. Jeff, Thanks for the great insight and all that you do as a sort of public service. I have two torn shoulder labrums, not diagnosed as major tears ( visited Dr. Altchek at Hospital for Special Surgeries) but certainly annoying enough to remind me that it is there as I workout. My ROM is limited in some cases but surprisingly I can handle arms and back exercises with relative ease. Im 36 and he also told me I have osteoarthritis. I currently take Glucosamine/Chondroitin/MSM/ Hyaluronic acid and fish oil to relieve some of the symptoms.  

    Can you please do a video where you share what exercises for shoulders you recommend for those with labrum tears. I think this is a very common injury and everyone would greatly benefit from your expertise. 

    Thanks again brotha.

  15. Hey jeff. I've just recently torn my acl in my right knee. I'm waiting on a date for my operation. Meanwhile would it be stupid of me to train single leg?

  16. Just got an all-time PR on squat after my 3rd ACL tear (which was years ago, but that's not the point). 395. Felt GREAT! Can't wait to get 405 in a few weeks. Knee feeling better every day!

  17. As a DPT student these are the type of videos you make Jeff that i love, PLEASE make more anatomy and injury prevention videos!!! Thanks!

  18. I have a small tear on my ACL and my doctor says that the inner part of my knee cap has gone a bit rough. Because of the injury I can feel my right (Preferred) thigh has gone a lot smaller around the knee. The doctor prescribed some weightless exercise like lying down flat, flexing my foot back and raising my whole leg.
    Can you recommend something please.
    Appreciate it.

  19. I also have a microfracture along with Acl and meniscus tears. I cannot put weight on the injured knee for 6 weeks post-op (2 weeks done already!). Since I cannot bear weight on my knee, what exercises do you recommend to get quad strength back? Unfortunately my insurance does not cover more than 4 p.t. appointments per month, so I really would like to try to keep up on my strength as I feel 4 visits is extremely insufficient. I appreciate your time!

  20. What I have is a pulled muscle in the back part of my leg up to my thi when I stand up to walk it hurts it feels like a muscle is being pulled what do I do to fix it . But when I'm Landowne I can stretch and move my leg when I sit down for a while I can't move or stand up to walk very good , have to walk with my legs bent and I can't walk very fast

  21. Can you give us more tips on this. I had my surgery 3 weeks ago. What are other exercises to condition and strengthen my knee?

  22. I have a torn ACL since October but I still work out and I will get surgery either this summer or fall because I dont want to stop working out and I have school. Should I continue to work out? Is it bad. Sometimes I feel pain and get swelling. @ATHLEAN-X

  23. +ATHLEAN-X. Good information, but I was expecting to learn about simpler exercises that rehabs individuals post op, everyone isn't able to just walk up and start doing front squats after ACL tears.

  24. Any exercise suggestions for one who completely tore ACL & LCL and dislocated kneecap? I had surgery in January 2016. I finished physical therapy in June 2016. I was doing well, now I am having lots of pain with weight hearing and so much difficulty walking that I amusing one of my crutches on and off throughout the day. I can't believe I'm going backwards. What could I be doing wrong and what can I do right?

  25. Hello, there. I tore my ACL some years ago, and after a short period of recovery, I was able to go back to my activities, such as running. About a year ago, I felt a severe pain while running, and then I was back to the recovery mode. I recovered enough to walk and all, but not to run, as it hurts a lot whenever I start running. I tried some streghtening exercizes, as well as physiotherapy. The physio helped, but the expercises only gave me more pain. In fact, any expercise that included flexing the knee gives me pain afterwards. I then discovered that cycling with clipless pedals andshoes was the only exercize I could do without pain (if I cycle, even jsut 1km unclipped, I already get sores), so I focused on that. In the last months I've cycled a lot, about 600km to 1.00km per month, including lots of climbing. Over 100km rides with over 1.500m of total elevation became an obligatory part of my weekend. However, after a 3 week trip in which I didn't cycle at all, I started having pain when cycling too. It's a different pain, however, not on the ligamente location, but on the front of the knee. I don't know what to do now, especially because cycling ended up becoming a very important part of my life and the thought of losing it, just like I lost running, really makes me freak out. Do you have suggestion for me?

  26. Thanks again for a great vid. It's been two years since you posted this and I'm sure many of us wonder how sweet Charlie is doing? xo

  27. Unhappy triad or terrible triad, can be very debilitating. It's a severe knee injury jeff.. Thanks for this video. That was very informative..

  28. i have grade 3 ACL tear, happened 5 months ago while playing basketball, now m doing good without any surgery, I can run (jog) and walk properly, etc. So, can you suggest me some exercises by which I can maintain my fitness without getting any damage to my ligaments… please suggest me

  29. At 6 months after my acl surgery things go really well, im training almost everyday, BUT i still feel some (light) pain while running on my kneecap. This pain is even worser when im doing single leg jumps!!

    Is this rare? Should i worry?

  30. wtf? how did the dog acl injury? and they really do acl surgery for dogs in USA. They dony want to do one to me in fucking UK

  31. Going through my 2nd ACL reconstruction surgery, and was wondering about some tips to strengthen my legs and get back to activity? I want to work on muscles that will prevent me tearing em again

  32. I just tried this tonight at the gym. I have a hairline tear. helped me alot thanks. trying not to have surgery

  33. Can anyone suggest me any leg exercises apart from front squat to incorporate in my routine?Ι have a partial tear in acl and a mild tear in my meniscus

  34. Hello Jeff, I ve got a high grade ACL partial tear. Should I consider surgery or is physiotherapy a better choice? Can I squat / do lunges I normally do? Or how long should I wait before squatting again? Request you to please do a video on this.

  35. I am 14 and I tore my ligaments playing rugby 🏉. The doctor said that he is not going to operate for another year

    Something about my growth plates and it suuucks😭

  36. On Nov 30 2017 had left knee ACL reconstruction and Tibial tubular osteotomy done. Today is Dec 15 2017. Any advice you could give me would be great. This is the most painful of all the surgeries I've ever had. Ive had a patella tendon rupture to my right knee and this pain is worse. Trying to go cold turkey off the pain meds but it is tough. Thanks for any help or advice you can give. Much appreciated.

  37. Great video I also have problems with my SI hip joint can you make a video on this how to strengthen it well i dont know where to start ? strength flexibility ect> ?

  38. My recovery took about 1 year and 3 months and right after that I jumped straight into football and my knee had some bad pain till the point where I was basically dragging my leg. I got through but the whole season I made sure my knee was the first thing I took care off whether doing some extra stretching or giving some extra exercises to isolate it. My knee still hurts from time to time and and at some points when I break hard it tends to give me a real bad pain in the back of my knee/ hamstring area so if anyone reading this can give me some pointers on how to help it

  39. HI Whilst i was running straight line i felt i crack in my knee not big pain but later on started swelling but i could carry on for the rest of the day with not much pain is anything to worry about
    i am 9 months post op
    once again thank you Doctor

  40. Can you do a video about Achilles rehab and exercises? I partially tore mine a year ago. I’m still not 100%, and I can’t afford care for it. Any help?

  41. I had torn my ACL 8 months before, and during initial days of ACL torn it was really hard for me to walk. I was really limping very very bad. I visited doctor and took the MRI. Doctor after seeing the MRI he recommended me for a Surgery. I couldn't go for a Surgery as I had already Planned my travel for Hajj(pilgrimage). With still with my pain and limping I moved on with my planned travel date. After I came back I was really good in walking and had no problems neither pain nor limping. After one month of my travel I had one more MRI and visited to the doctor. Unfortunately the ACL torn still exist and doctor advised me if you don't have any pain or any trouble and if you are walking good, then I would not recommend for a Surgery. I need your advised how can I move forward with my daily activities and sports and what exercise I need to do. I play tennis, Badminton and Cricket. I really want to start it again. Please advise me.

  42. moderate joint effusion 

    chronic acl tear with no intact ligament in situ

    large bucket handletear of the medial meniscal body with thickening and complex tear of the anterior and posterior horns

    no fracture dislocation

    knee space is normal.

    the patella ,medial and lateral patellar retinacula are normal

    quadriceps and patellar tendoms found normal

    lateral meniscus appears normal

    pcl appears normal

    Hi this is my MRI report from Dr. I can run, walk and jump with no pain . Should I need to operate?

  43. I've had 8 ACL repairs, over both legs. My legs don't line up. Left looks bowed while right is stuck not fully back. Before all this my knees didn't touch in the middle anyways so the left even though bowed is normal for me. What can i do for this problem???

  44. I actually recovered my partial Acl tear with knee extensions. I did a week and a half of rehab which was basic exercises laying on the ground. Then I started doing walks on the treadmill with big uphill, then some horizontal leg press and knee extensions. They felt the best so I did them most. After about a week of 5 days training 2 days rest I could squat almost to parallel. Before I could NOT EVEN squat a little bit. The pain was so bad. Then after I put on some muscle from the knee extensions I could walk with almost no pain, and I could do the ass to grass squat if I grab a rail or something. Now I still have pain but its just a nuisance not anything bad, and I still can't dance in a club or anything that twists it but I can walk for a very long distance, I can do leg press, goblet squat with 40 lb kettlebell. Standing still hurts though if it's for a long time. But anyway I couldn't even walk. Fisrt I wore a knee sleeve/cheap velcro brace and walked with almost a straight leg. I went to a therapist and he put my tibia in place which was out because of incorrect walking and loss of muscle which helps hold the knee.

  45. Glute med, glute/quad/hamstrings timing, Closed chain provides arthrokinematic to avoid open chain shearing of tibiofemoral joint and stressing ACL repair.

  46. Inflammation isnt bad thats the body trying to heal itself let inflammation do its thing then strengthen afterwards.

  47. I've had a complete acl tear for the past 10 years and due to physical therapy and very strong quads the doctors decided that I don't need surgery. Since I've only done gym related sports. Now I've been getting more knee pain and cracking in the knee with the injury so I will take your advice and do front quads

  48. Hey JEFF. nice video thanks for the detailed explanation and the ANALOGY you did using the rubber band was really thoughtful.
    Well I tore my right ACL grade 4 with little bit of loss of meniscus just a couple of months ago, undergoing the rehab process. Though the PT is going great I don't see much of an improvement to the angle in which my leg is getting folded.

  49. Thank you for all your educational content, I've never seen someone so devoted to helping others on YouTube physically and mentally. Found out I torn my acl last week worst pain I've endured. Was wondering what exercises help strengthen quadricep muscles without injuring myself even more. My orthopedic recommended before surgery to speed the recovery process to target the quads. Stationary biking been the best so far but what other exercises help?

  50. I got injured -lateral epicondinitis -right before starting my athlean x muscls gain program over a year ago, and still cannot engage because of the pain, 2 physios, a sports doc, and various other therapies later. Isometrics helped a bit, but just can't get back to normal.

    Would love to see a video for that – the previous video posted leaning back from holding a racked barbell did not address it. Cheers

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