Torn ACL - upper body training with no leg involvement

[Robert L]

Hello coach,

One and a half week ago I tore the ACL in my left knee for the third time in two years during soccer. Since it's such a weak spot I'll be needing surgery to fix it, I have never had any other injury so apart from this I'm completely healthy. There's a lot of water in and around my knee, which means I can't bend it past 90 degrees. I can walk relatively fine but if I try to squat down I am several inches above parallel.

The surgery is november 22. I have found all information I needed on the recovery by searching the board, thanks for that. Now I'd like to know what I can do in the upcoming month. This is what you said about the rehab that also applies to my current situation:

It will be 6 months before you're back to the Olympic lifts if you rehab aggressively. Don't rush the explosive stuff, but squat and deadlift on it light with high reps as soon as you get your ROM back.

I don't have the ROM for squats. Pressing and deadlifting doesn't seem like a good idea on a damaged/unstable knee that needs surgery. So my question: which exercises should I build a temporary upper-body program around that do not depend on stable legs that could get fucked up by a little mistake/adjustment during the lift? Something like this?

Workout A:

Bench press 3x5
Chin-ups BW 5x max. (currently 6)
Abs stuff

Workout B:

Push-ups 2x15 (superior for warming up body compared to dips?)
Dips 3x5
Lying row (dumbells) 3x5
Back extension 3x15


What do you think Rip? Would this work for the upcoming month? Any suggestions, replacement exercises, or a different perspective on what I actually can do with my injury?

Few details:
Male, 21 years old. Novice, about 2,5-3 months into the program. 6'3, 176 lbs. Weight will go up a lot faster now since I won't play soccer for a year.

Thanks in advance coach, I respect and appreciate your work a lot.

[Mark Rippetoe]

Your assumption is incorrect. You can squat. The squat will increase your ROM. What does the MRI show about your ACL?

[Robert L]

Okay that's great news! The surgeon didn't think it was necessary to make a new MRI this time, since it was pretty clear to him after investigating my knee that the ACL was at least partially torn. Since it was the third time in less than two years he strongly suggested surgery anyhow, with the notion that the surgery would show what else could be wrong. He made a MRI in May this year though, the injury prior to the current one. The ACL was pretty raveled with a skewed re-attachment and only so-so recovered from the first partial tore, I think he mentioned a two-third recovery, with an increased chance of tearing it again by playing sports like soccer. He even offered surgery as a suggestion that time already, which I declined.

What do you suggest I do now? Squatting with the bar, high reps till I get the full ROM back and then very slowly increase weights? And what about the deadlift and press?

[Mac Ward]

Male, 21 years old. Novice, about 2,5-3 months into the program. 6'3, 176 lbs. Weight will go up a lot faster now since I won't play soccer for a year.

I used to be your size 2 years ago, 245 now.

Your assumption is incorrect. You can squat. The squat will increase your ROM. What does the MRI show about your ACL?

Rip, you forgot the obligatory, EAT.

Robert, at 176 at 6'3" you are frail and prone to injury. Ask my how I know. At 245, I have more supporting muscle mass around my joints and am less susceptible to injury.

[Mark Rippetoe]

Squat sets of 5 as your pain and ROM permit/improve, stop playing the Most Dangerous Sport in the World, and eat, as Mac says.

[veryhrm]

OP, see if your doctor recommends (and your insurance company (or your self) is willing to spring for ) a CPM machine rental. Esp if you're using patellar tendon graft. Having that thing bend your knee a couple of hundred times while you're laid up is a lot nicer than having to do it yourself and it gets your ROM back faster in the early days.

[Mark Rippetoe]

Are you suggesting this horrible device be used even in the absence of a surgical repair?

[veryhrm]

Are you suggesting this horrible device be used even in the absence of a surgical repair?

Heh. No no, just post surgery.

Oh, OP, also get yourself a cryo-cuff w/ "Autochill" capability (more recently they changed to something called "I/C" which integrates the pump in the cooler lid as opposed to having a separate air pump unit). Ultimate in cold therapy for the lazy (and/or immobile).

IIRC, several years ago when i had this ACL surgery the cuff was already installed on top of my bandages when i woke up. A nurse handed me the cooler jug and told me what it was as i had never heard of it before. Alas, mine had no pump so you'd plug in the hose to the knee sleeve then raise up the jug have gravity pump in cold water. Then you close the valve and can put the jug down and that gets you a few minutes of cool. Then you open the valve and the warm water drains back into the cooler where the ice/ice-water is and you repeat the cycle. Anyway the new electric version does that cycling for you automatically (w/ an airpump pushing the water ) and apparently provides some compression also. Personally i've never really gotten much out of icing, at least not that i've noticed, for this surgery or various sprains over the years. Maybe it's because i never do it for more than a few sessions before getting tired of it. W/ the automated system it would be easier to keep up with.

[Robert L]

Mac, thanks for your post. I'm well aware of this and will definitely eat my ass off. The next 12 months I've dedicated to strength training and strength training only. I'm considering getting a cow pet for the milk. I f***ing love milk.

Rip, thanks again. I did what you said and the squats felt alright. You can feel a barrier at the bottom, but the last set felt quite a bit deeper than the first already. One last question: what do you recommend weight(percentage)-wise and rep-wise for my deadlift and press?

Veryhrm, I had to google that device. Pretty much all hospitals in the Netherlands do the hamstring repair, so I'll be getting that as well. Thanks for the suggestion, but I'd much rather do hundreds of body weight squats to get the ROM back than having a machine do it for me. It's boring enough lying around already, I want to get back to any form of training as soon as possible.

[Gunnhild Bruno]

Pretty much all hospitals in the Netherlands do the hamstring repair, so I'll be getting that as well.

Just to clarify, you're not talking about a concomitant hamstring injury that needs repair, but the harvesting of the hamstring tendons for the ACL repair, correct?