Episode 24 | A Simple Lesson from my ACL Rehab

What’s up guys, and welcome back to another episode on the ACL Athlete Podcast. Today, we are going over a simple lesson that I learned from my own ACL rehab. I’ve been through the process myself twice, and now I’m a physical therapist who works with people solely with ACL injuries, surgeries, and things of that nature. I wanted to share something about my second go-around with this. And it’s something that I learned from the first, but I also had to learn from my second time going through this. The way that I want to start this off, is with a story from the second time that I was rehabbing. I had my ACL reconstruction on my other knee and I am recovering, I’m going through the rehab process, especially the initial phases. And for me, I can tend to overwork a lot. And think more and more is better when we all know that that is not the case, especially when it comes to ACL rehab. But I had already been through it once. 

I know a lot of us out there think, okay, I’ve been through it once, how can it be any different the second go-around? I’ve learned my lessons from the first one and hopefully the second one, the rehab process itself goes smoother. Unfortunately, we know that that’s not always the case because every single ACL injury is so different. But I felt confident in this process. I was also knowing I was going to physical therapy school. I was very interested in this area, so I thought that I knew what was going on. With that said, I was trying to push at home way too much. I would go to physical therapy, I would do my rehab stuff, and I was progressing really well. My range was coming back, my quads. Pain was starting to get better, decreasing the swelling. And I just thought, you know what? Things are feeling pretty good, so I’m just going to keep pushing it. And I hated being sedentary and also being reliant on other people. I was like, “Okay, maybe I’ll just push more.” This will help increase more freedom and more independence. 

And what happened? I started to have a huge issue on my other side, to my right knee, which was the one that was not operated at the time. I started developing some pretty severe patellofemoral pain. So that’s where you have kneecap pain. And this is on the side that is not operated. Now, I have “two sides” that are bad, but they were just struggling. One was an ACL knee that was recovering from the operation. The other side was just me pushing way too hard. I would try to do more single-leg work just because I didn’t want that to get detrained. I didn’t balance the stress that I was putting on my knees in my recovery.

One of the things that can get missed very often early in this process is because you had an operation or an injury, the opposite leg has to do a lot more of the work. You go from two limbs taking 50/50 of the work and the stress, to now this unoperated limb is having to do much more. And then you pile on top of that, trying to keep the training and the conditioning up. And then also trying to get the range back and all those other qualities in the operated side, that my unoperated side started to have issues. This is when I essentially had a setback and that was really tough to deal with. I just didn’t know exactly what to do. I got really frustrated. I thought that I was on the right track. I was a bit more educated on this after going through this another time. But what I had to do was really be honest with the PT that I was working with and let her know that, “Hey, like I’m having these issues in my other knee,” and we had to course correct. We did, and I had to take a step back. I had to make sure that I was doing the things that I needed to do for my operated side and actually unload a little bit and decrease the stress on my right side where I was having the patellofemoral pain. 

The big lesson that I want you guys to take away from today, I mean, there’s a lot of things that you could take away. But it’s that you don’t have to push so hard early in every single day. You need to have clear communication with the physical therapist, or whoever the coach, or whoever the athletic trainer that you’re working with. There needs to be a clear line of communication and you need to be honest about how you’re feeling because that is going to help so much to redirect and course correct as you need to. This might be where you take one step back to take two steps forward. And I know I’ve said that before, but that’s going to be really important here to be able to make progress. 

And for me, I had to basically figure out positions and loading to the knee that was having pain and still focus on my ACL side. But then that way I can move forward and my actual patellofemoral pain would not be the limiting factor in my rehab. Keep this in mind as you’re moving forward in this ACL rehab process. It’s not uncommon for that knee to start hurting, whether it’s the operated side or even the unoperated side early on because it’s taking on so much of the load. But there needs to be an open line of communication, if that’s the case.

I literally just had an athlete that I’m working with where she was doing a lot. We had to work on offloading and essentially being like, okay, we cannot let this unoperated side get out of hand. Because then, that’s going to take much longer because now we’re taking care of two knees instead of just the operated side, to begin with. So that’s normal, but make sure that a clear line of communication is there. One of the things that I want you to think about is potentially trying to take just some time off. So that doesn’t mean let’s go take a week, two weeks off. But if you’re starting to feel like, for me for example, I had to start putting dedicated days where they were recovery days to make sure that I was allowing that stress and the patellofemoral pain to ease its way out and to make sure I’m not overloading it. It’s always a balance between stress and recovery which often ends up dictating the pain that we’re having. 

So keep this in mind moving forward. More is not always better. You can give yourself the day off periodically, so you don’t have to push hard every single day. And when you start to notice these things, that’s the thing that I want you to just kind of take a step back, see where there might be an issue, and then making sure that you’re consistent but not overdoing it. And then you need to have a clear line of communication with who you’re working with and making sure that you also have a plan that’s specific to you. You shouldn’t just be following the same protocol that Joe over in the corner’s doing, or Roseanne, who is 50 years old when you’re 24 years old, and trying to get back to soccer. 

These are all things that are going to be important. So factor these in, especially if you’re starting to notice some of those pains and aches and swelling starting to sneak in. Ask these questions. The simple lesson here is, you don’t have to push hard every single day. Give yourself a day, here or there, focus on consistency, and making sure that those clear lines of communication are there, and that there’s a plan in place. Don’t be like me and don’t try to overdo it. Give yourself a day and you’ll probably notice that you’ll make strides moving forward. It’ll also help with the burnout feeling because of how long this process can be. 

So that’s it for today, guys. We’ve got a short one. Just wanted to put that out there, especially after reflecting on my own experiences, and I just had an athlete who is in a very similar position. I hope that this can help somebody as they’re going through this process to be able to know: you don’t have to push hard every single day. I appreciate all of you ACL Athletes.

Thank you all so much for listening. This is your host, Ravi Patel, signing off.