Pre-surgery: physical therapy pre-hab

When I found out I had a torn ACL, a week after the injury, I began attending physical therapy, 1.5 weeks after the injury, for the duration of 2.5 weeks before the surgery.

A friend of mine had an ACL tear and he alerted me of the importance of pre-surgery PT. His surgeon said he didn't have to do anything in particular leading up to the surgery and said that it was OK to wait two months. Over that time, his tendons and ligaments tensed up from the lack of the range of motion (the bundled-up torn ACL restricting that motion). After the surgery, my friend's physical therapist had to spend 1.5 months forcibly stretching out his knee. He was also on crutches for longer than necessary.

I e-mailed my surgeon the same day I found out it was an ACL tear, asking about the pre-hab. My surgeon agreed that pre-hab would be great and quickly forwarded a script to the PT office that I've been going to.

When I got the 2nd opinion on my ACL tear surgery, it was from a highly-recommended surgeon. This surgeon immediately told me that getting the full knee extension back as soon as possible was important (pre-surgery).

In the light of this information, it strikes me that the surgeon that my hapless two-months-of-no-PT friend had is not that good of a surgeon. So now you know folks, do pre-habiliation PT before your surgery.

As far as my own pre-hab physical therapy goes, I've already been attending an excellent local PT office for an running overuse knee injury. So, I've actually ended up having a good amount of quad strength built up as a result of doing the PT for that. This already put me in a favorable position for recovery.

We worked on getting my knee flexion and extension back. I started with 107 degrees flexion on my first visit and ended up with full flexion (something like 147 deg) in several days of doing heel slide exercises. I also recovered a bunch of knee extension via towel pulls and hanging my knee off the bed with ankle weights on it. I almost got to zero extension (perhaps bits of ACL still in there preventing from me being able to fully lock my knee).

I also was surprised to find that, post-tear, I lost some quad strength. At first, it took me some effort to do 2-lbs straight leg lifts, whereas I was up to 7-8 lbs pre-injury. I could also definitely feel my left leg having much more quad strength than my injured right leg. I progressed back up to 6 lbs in 2.5 weeks. I also performed balancing exercises, ball squats and a bunch of other good stuff.

I hope that all of this pre-hab poised me for a quick recovery. F that, I want a phenomenal recovery. I got a stronger-than-stock ACL now, and I am coming back stronger than ever!