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Knee rehab to prehab

Updated: Sep 19, 2023


Gym equipment for ACL HTO knee prehab

One of the things that ultimately forced me to seek the Second Opinion was that every time my knee gives way completely, it takes around two months to get back to something akin to normal (for me) function, which is really frustrating when you’re trying to live a more-active lifestyle. I have a long-term condition that means weight piles on really easily and is an absolute b*gger to get off once it’s there, which is one of the reasons I fell in love with running in the first place. It has literally been the only thing that has helped me keep my weight down consistently and that I can squeeze into my day pretty much wherever I am. Plus the total game changer of consciously eating to fuel a long run, rather than desperately trying to keep calorie counts down, is brilliant but that’s a whole other blog…


Anyway, since the April blow out, I have been slowly building things back up: From not being able to put any weight through the knee at all; to a painful shuffle from car to restaurant/cinema and back over the last days of the break; then defiantly going for a slow river-side walk with a friend the following week (minus brace - yes I’m an idiot but I was annoyed!). I’ve been trying to keep as active as possible, gradually adding a little more each week as the knee has allowed.


By week four I’d started swimming once a week. My knee wasn’t keen on that at first - I could really feel it wobbling around - but it didn’t get any worse so I persevered, increasing my distance from 10 lengths, to 20 then 30. That was then combined with the weekly walk and gossip with my friend, before bolting on a gym session from six weeks out (a 30-minute walk or static bike ride, followed by basic, no-impact upper body, lower body and core work).


That’s done a pretty good job of getting me through to the summer holidays, with the kids’ school ball and a dress to fit into as the focus to keep me on track. I literally had a ball! 🪩💃 Stuck my heels on (to heck with the knee), had a few drinks so I couldn’t feel anything and danced the night away. Yes, the knee was very grumpy next day but it was worth it, and you’ve got to grab the good times where you can 🥂

Anyway, with a first surgery date now in mind (more on that to come), I felt like I’d come to a bit of a dead end with the above routine and was feeling unsure how I could mix it up a bit to maintain motivation throughout the summer. So I started googling knee prehab stuff and found this fab link from Royal United Hospitals Bath NHS Foundation Trust’s physio team. Not a huge amount I haven’t seen before but some of it I’d forgotten about/not done for ages so figured it was worth throwing into the mix.

I started on Thursday this week. 30 minute treadmill walk (up to 6-6.5kph now 🙌🏻), followed by leg presses (switching to single leg and feet at 11 or 1 o’clock to get VMO), deadlifts, relevés, single leg toe-taps plus core and upper body. Having been happily leg pressing away with two legs, my knee was much grumpier when working as a single entity - and at less than half the weight. The lack of balance on single leg toe taps was also a revelation (what proprioception?!) but it definitely feels good, mentally at least, to have more of a challenge.


The knee has been quite sore as a result but it was like this whenever I stepped things up earlier so I’ll try again and see how it reacts. Obviously, if it keeps getting more and more painful, I’ll have to rein it back in but hopefully I can start to make some proper progress before the first surgery this Autumn.

At that point, I’ll probably have to give up eating until I can start moving again 😂


I jest but it is something I’m worried about; getting a healthy balance between fuelling good recovery (inc bone union) without piling on the pounds or pushing to get back to more activity than I’m ready for to avoid weight gain. One to ponder. For now, back to the gym it is. May as well get ahead of the game if I can.


Which brings me to music. I posted about music choices in a previous blog but that’s quite old now. Anyone have any suggestions for good tracks to get me through a boring workout, particularly those 30min treadmill walks that are deadly (but better than cycling!)? Answers in the comments or via insta @acl.hto.knee_che


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