89vision's Kneehab and row to strength log

[89vision]

08-29-2010 Bw: 189

Bike 20 min level 6
Kneehab

Leg press 4x10x165

Pull ups 7,7,5

Lateral raises 3x10x15's

Dumbell bench 2x5x 60's

Facepulls 3x20x50

Don't know why my pullups sucked so bad, really thought I would be able to get 10 without too much trouble. Even after 3 sets of weighted pullups the other day I was able to get 7 BW, maybe I wasn't warmed up or just tired. Didn't feel like it though, especially since I didn't do CSRs the last session. Bench was hard though. :icon_neut

Realized I hadn't done facepulls in a while, and I went up 5lbs, and these bitches were hard. Threw in lateral raises and DB bench for fun. I like DB bench, just wanted to see what I could do without trouble and risking my leg. 60's weren't very hard, but not sure I feel safe yet laying back/sitting up with big DB's without two feet yet.

Gonna try and do some shrugs from time to time.

 

[89vision]

08-30-2010 bw: 192

Bike 20min level 7
Kneehab

CSR 6x4x110
2x15x55

OHP 3x5x86
2x10x65

Skullcrusher 3x8x50

Close grip bp 20x50lb

 

[89vision]

08-31-2010 bw:193

Bike 20min level 8
Kneehab

Shrugs 4x10x130

Skimped some on the PT, didnt do extensions because I am tired and my knee hurts.

 

[89vision]

09-1-2010 bw: 192

Bike 20min level 8
Kneehab

Bench 3x5x161

CSR 6x4x115
2x15x55

Rear delt flye 3x15x70

Widened my bench grip by about an inch per side, felt good I think. Thought about pushing myself back into the bench instead of pushing the bar up, made my last better than the second. It might help me keep upper back tightness.

Some doms from the shrugs yesterday

 

[89vision]

09-02-2010 bw:192

Bike 20min level 7 at school gym

Shrugs 4x10x140

 

[89vision]

09-03-2010 bw: 184 at 9 am at doctor. This is probably my most accurate actual bodyweight, maybe a couple extra lb when fully hydrated. *191 at 4 pm, only 1 meal

Bike 20 min variety setting level 5
Kneehab

CSR 6x4x120
2x15x55

OHP 3x5x90
2x8x65

Skullcrusher 3x8x52

Close grip bp 30x52

 

[89vision]

09-04-2010 bw: 193

Bike 20min level 9
Kneehab

Leg press 4x10x170

Face pulls 3x20x50

 

[89vision]

09-05-2010 bw: 191

Bike 20min level 10
Kneehab

Curlz 3x8x55

Shrugs 3x10x150

 

[89vision]

09-08-2010 bw:190

Bike 20min level 10
Kneehab

Bench 3x5x165
Butt came off bench on 2 reps in the second and third set

CSR 6x4x125

Rear delt flye 4x15x75

Curlz 2x8x56

Skipped two days at the gym and PT because of the holiday and other crappy lame shit.
I feel like I'm about to stall on bench very soon, which is disappointing because of how light it is and I have been doing 2-3 lb jumps. Also I should be recovering fine I've been sleeping alot and I'm not even doing hard things like deads/squats.

 

[pliftkl]

Is the kneehab that you are reporting specific knee rehab injuries, or is that referring to the bike work as the kneehab? I thought my therapist had me on one legged squats pretty quickly after the surgery (certainly in the space of a month), but it was a couple years ago so I might be misremembering.

Good luck. Rehab sucks, but it's short in the grand scheme of things. I was told by my doctor that the most dangerous time is 3-6 months post surgery, because at that point you feel strong, but your knee isn't.

 

[89vision]

I assume you mean exercises not injuries..
And yes they are specific rehab exercises from my PT. Two legged resisted squats, resistance is from a bungee type cord. Also leg extensions, raises, resisted walk/lunges.
Did you have ACL replacement? No one legged squats except as a test to see where I am at. At 3 months I am supposed to be able to one legged squat for a certain time to judge overall stability/strength.

3-6 months is definitely the most dangerous for the graft because confidence and muscle strength are higher, but the graft has weakened and is revascularizing.
For that period I am going to be very careful and stiff arm anyone who approaches, haha.

 

[pliftkl]

Two legged resisted squats, resistance is from a bungee type cord. Also leg extensions, raises, resisted walk/lunges.

Interesting. I don't think i did any two legged squats. Being able to do a certain number of one legged squats was actually my "graduation" test to get cleared to run. My doctor explicitly warned me away from leg extensions.

Did you have ACL replacement?

Yes. I did a hamstring autograft (I think that's the phrase for self donating?). If I had it to do over (which I hope I won't!) I'd opt for a cadaver graft rather than risking the strength of the hamstring.

No one legged squats except as a test to see where I am at. At 3 months I am supposed to be able to one legged squat for a certain time to judge overall stability/strength.

That sounds like what I was did, but the therapist had me practicing these for a couple months before the test. They were harder than I thought they would be, and even with the work I'd put into it, the test was painful.

 

[89vision]

My doctor explicitly warned me away from leg extensions.

I don't think leg extensions are a good description, it is actually a kind of leg press. The band goes around my foot and I am seated with my leg extended, then I bend at the knee and return to extension. I haven't been cleared to do anything but the banded resistance training. I would like to be able to start strengthening my hamstring, but I am going to listen to the PT. I see the same one every time, and I trust her. The practice is a reputable one that handles surgery and post op care for high level athletes.

opt for a cadaver graft rather than risking the strength of the hamstring.

I worried about this also, and was told that only small percentage of strength loss would occur even with the removal of 2 tendons. I believe I read somewhere that the tendons can actually re-grow some at the insertion points lessening the overall strength loss, but don't quote me on that.
Regardless I was lucky, they only needed to remove one of my hamstring tendons, so I should keep more strength than the average hamstring graft patient.

Being able to do a certain number of one legged squats was actually my "graduation" test to get cleared to run.

I have a similar "test" at the end of my formal physical therapy.

Are you happy with the process overall? Do you favor that leg or protect it more than the other? I am slightly worried that I will always be a little timid to not damage the knee again. At least for the first year, I want this thing to heal up good!


Every time I type, therapist, I hear Will Ferrel as Sean Connery in my head saying:
The Rapists for 500 Trebek... :icon_lol:

 

[89vision]

09-09-2010 bw:189

Bike 20min level 11
Kneehab

Shrug 4x10x160

 

[pliftkl]

Are you happy with the process overall? Do you favor that leg or protect it more than the other? I am slightly worried that I will always be a little timid to not damage the knee again. At least for the first year, I want this thing to heal up good!

I'm very happy with the recovery. I took the rehab pretty seriously, and the knee is strong. I don't notice any differences between my knees in terms of strength or mobility. I resumed grappling about 7 months after the surgery. Once I was cleared to squat at the gym I was back to pre-injury strengths within 2 months (and that was with a very easy ramp).

 

[89vision]

09-11-2010 bw:188

Bike 20min level 12
Kneehab

Facepulls 3x20x50

Rear delt flye 3x15x75

Leg press 2x10x170
2x10x200

Skullcrusher 3x8x55

CG Bench 55x25

Good day yesterday at PT. Starting one leg squats with one leg back on a chair like bulgarian split squats. I find it interesting that she is having me do them lowbar squat style. Hips way back, shoulders forward some, and she wants my knee to NOT move forward ANY. I forgot to ask her, but I will soon, what she thinks about high vs low for knee health for when I get back to squatting. I always felt pretty comfortable doing lowbar but I started SS highbar and was just sticking to learning one at a time. This would be a good reason to switch, although one of my concerns is quad strength if I'm doing only low bar and deadlifts, I know the quad needs to be strong for my knee as well. I would like to be able to front squat and clean in the future so that might be my answer.

Relating to the front squat, I cannot rack the bar properly or get the bar behind my head on OHP due to poor shoulder flexibility. I asked my PT about it, she had me lie down on my back and put my arms overhead. She kind of chuckled because my hands were a good 3-5 inches off the ground. I cannot touch the ground with them, this demonstrated the issue. She recommended laying in this position after working out for 5-20 minutes. Also doing the same position but with my upper back on an exercise ball, and extending my thoracic arch and holding that for time. I asked about dead hangs as I have read that it helped, she confirmed but noted that it's very aggressive and not to overdo it. 1-2 minutes or less. I am going to implement this virtually everyday and see how it goes.

As far as today goes the skullcrushers strain my elbows a bit, might lower the weight some and go for 10-15 reps instead of 8. I wish I had a better tricep exercise to do.

 

[89vision]

09-12-2010 bw:186

Bike 20min level 12
Kneehab

Pullups 4,4,4,4

Dips 10,10,10

Single leg squats are a trip. My right glute is sore for the first time since my last deadlift session before surgery.

 

[miaou]

Just noticed this log. Good luck with rehabbing into a full recovery. It sounds like bigjohn has you covered in terms of knee rehab advice.

I read in your pre-op log you were having issues with your overhead shoulder ROM. How is it these days?



EDIT: I just read the second page of the log (I thought there was only one page). Leg extensions do sound a bit weird for an ACL reconstruction rehab. What you are describing sounds like a banded extension, not a leg press (unless there is some hip flexion along with knee extension, which you didn't mention).

I see the shoulder details now. I also saw a video of your SOHP. Your problem is lack of scapular mobility. Although it is not entirely clear by the videos, I am guessing you might have an exaggerated kyphotic curve (you definitely do in your SOHP), which causes the scapulae to slide a bit forward. This also means you probably have lengthened and weak/inhibited lower traps, probably weak serratus anterior, and quite possibly imbalances in your rotator cuff muscles. So basically, when you try to get your arms in an overhead position, you can't move your scapulae properly. I'd say, have your physiotherapist assess you for overall postural issues, muscular imbalances and muscle activation issues.


That, or find a new physiotherapist because she really should have noticed all of the above already instead of chuckling at your mobility issues.

 

[89vision]

09-14-2010 bw: 190

Happy birthday to me. 25, now log:

Bike 20min level 13
Kneehab

CSR 130x4x6
55x15x2

OHP 92x5x3
45x8

Actually saw someone doing face pulls yesterday. After heavy rowing, good stuff.

@pliftkl, Thanks for checking out the log and sharing your experiences. I appreciate it and your good results are encouraging.

@maiou, I am not doing "leg extensions". That was an incorrect description. I sit in a chair, band around my foot and held by both hands, leg extended fully. I then bend at the knee and bring my knee towards my chest(halfway-ish), then extend my leg again fully. This and the hamstring slides/curls that I just started are the only open chain exercises I do. Well, those and I guess a bike is an open chain movement as well? The ham slide is painful at the donor site and in the muscle, probably where the muscle is like, "where the fuck is the tendon that used to pull me?" But not really bad, and it feels good to start strengthening my hamstring. I hope to be able to do a GHR as soon as possible.

My over head rom still sucks chode, but is slightly better. I am also closer to a rack position than before surgery. My elbows are more forward and the bar closer to my delts than before. I haven't been for the past few weeks, but for 2-3 weeks I was doing shoulder dislocates daily and they helped.
When I asked my therapist about my shoulder flexibility, she asked to see what I wanted to achieve and I showed her how I couldn't get the bar behind my head on OHP. Then she had me lie down to see what it looked like. I stated before that my hands were 3-5" from the ground, but I looked again and its more like 6-8". To help fix this she suggested lying on my back or on a ball with arms over head and just holding this position for time. She wanted me to try this until I see her next time(2weeks) and see if I have improved. In the gym, I have been rowing every lifting day, face pulls, pull ups, and on low weights for OHP letting the bar fall backwards to stretch at the top of the movement.

What would you suggest to help my issues? How do I know if I have rotator cuff imbalances? I will ask her about the things you mentioned. Thanks for taking some interest, I've read a lot of your posts/log and you seem well versed in shoulders in particular. Are you a physiotherapist? Good luck with your continued efforts to make your knees and shoulders healthy, how did you injure them initially if i may ask?

 

[miaou]

What would you suggest to help my issues? How do I know if I have rotator cuff imbalances? I will ask her about the things you mentioned. Thanks for taking some interest, I've read a lot of your posts/log and you seem well versed in shoulders in particular. Are you a physiotherapist? Good luck with your continued efforts to make your knees and shoulders healthy, how did you injure them initially if i may ask?

I'm not a physiotherapist, but I've dealt with postural and mobility issues (and injuries that resulted from them) all my life, and I've done my best to self-educate myself with every resource available. If the physiotherapist I worked with when I was 16 was any good (or if the ortho I visited had made a decent diagnosis), I wouldn't have the issues I'm having today, that's why I'm sensitive about people not getting assessed/treated properly.

Well, I can't really give your a detailed program, unless I know for certain any and all your postural/muscle issues. Here are some guidelines that can't hurt you no matter your condition, and I am sure will benefit your situation: work on your thoracic spine mobility (get yourself a foam roller, or make one out of a pvc pipe). Work on strengthening the serratus anterior (things like "scap pushups" and/or "pushups plus", bilateral or unilateral). It's a great thing you do all that pulling and you will definitely benefit from it, but make sure you get full scapular ROM. On your vertical pulling (rowing), make sure you extend your thoracic spine as much as possible and make sure you fully abduct your scapulae (squeeze together) at the end of the motion (you may have to drastically lower your weight at first). On your horizontal pulling (pullups) make sure at the top you fully put your chest out and shoulders back and down (it may be very hard to do at first if you're not used to it, you may even have to switch to the lat pulldown to get it right). And focus on keeping an upright posture with abducted and retracted scapulae (shoulders down and back) throughout the day as much as possible.

Just working on those 3-4 points will slowly improve your overhead ROM. In terms of rotator cuff imbalance, the main thing is to assess if all the muscles are being activated properly. I had a subscapularis activation issue and, while I am now aware of my subscapularis activation (or lack thereof), it would have been impossible for me to self-diagnose at first. As a rule of thumb, do light internal and external rotations (for high reps, preferably with light resistance bands) a couple of times per week, an focus on keeping a good posture and your scapulae abducted and retracted throughout the exercises (shoulders back and down, so you don't compensate with the big muscles like lats and pecs instead of the rotator cuff muscles). Improving any deficits in your rotator cuff function will improve your scapulohumeral rhythm, and help avoid impingement in overhead motions.



EDIT: yes, those are knee extensions with concurrent hip extension, so they are more like leg presses than knee extensions as the force is applied towards a different direction.