Fitness After Knee Surgery?

I’m kinda new to the website, but found alot of the articles very informative. I was wondering if you had any advice with regards to training and nutrition for someone who is about to under go therapy for knee reconstruction (acl). Any advice about nutrition, training to stay in shape (especially training around the injured leg) and supplementation for quicker recovery would truly be appreciated. thanks!   – Diego

Dear Diego,

Sorry about that knee! I had ACL reconstruction in December 2005, so I know what you’re feeling! I was very unhappy with the anticipated long layoff and rehab period. But if you undertake it as a challenge, you will be fine, just keep at it and work hard on the rehab and you’ll come back as strong and fit as ever. (I won’t sugar-coat it, it was a LONG 2 years before I was running pain free) But I’ve run a problem-free marathon on my new knee, and set PRs in the 5K and 5 mile since then, so it is just as good as the “original” knee.

Nutritionally, there really is not much to do to enhance recovery other than consuming a balanced diet with enough calories, and adequate protein, vitamins and minerals.  Supplementation isn’t going to help you out much, though antiinflammatories will reduce pain and swelling after surgery. If you are prone to weight gain, be careful not to consume too many calories while you are less active. Strengthening the surrounding muscles in the quad and hamstring pre-surgery will hasten recovery and rehab.

On staying fit after surgery: You will have to take a layoff immediately following the procedure, and believe me that your leg is likely to be painful enough that you will not WANT to move more than is absolutely necessary.  Stock up on good books, movies, and something to do that will keep your mind occupied. (I wrote a review article for a scientific journal during my acute recovery, read a lot, and did embroidery). Most of all, work on regaining your range of motion as soon as possible after surgery- as this is key to long term function. In other words, those super-painful bending things are necessary if you want to run, jump, squat etc years down the road. I know, they hurt. Do them anyway.

Once you are past the initial week or two, the pain will lessen greatly, and you will be able to exercise the rest of your body while not using the leg. Many physical therapy places have an “arm bike” or upper-body ergometer, which is a contraption you “pedal” with your arms. It can get your heart rate up, maintain cardiovascular fitness, and relieve some “I NEED to work out” stress. They should let you use it before or after your PT sessions, just ask. I also recommend chins/pullups for a great all-around upper body exercise. I refocused my goals while my legs were unavailable and decided to see how good I could get at pullups. I definitely got much better at them!  If you don’t have a bar, you can probably order one off tv during that first week laid up in front of the screen.

For your legs, you will actually be doing quite a bit of strengthening work as part of your physical therapy routine, so stick to what your therapist tells you and do the homework exercises!!! Inquire to be safe, but usually the more you do the reps, the better and faster you recover function and strength. You may be doing hamstring curls and quad extensions on a machine at the office, and static contractions at home. It is also common to work with a stability ball for bridges, ham curls, etc. To get a bit more of a well-rounded workout, you can always add some core work to your PT routine with ball crunches, pushups and pullups. (Just keep that injured leg out of the way or non-weightbearing on pushups) A set of dumbells allows for shoulder presses, bicep curls, lateral flies, etc. as well.

As your recovery continues, you’ll be able to get back into walking, pedaling a bike, and running, but everyone’s timeline is different. When in doubt, ask your PT or MD what you’re ready for, and always stop if pain results.

Best wishes for a speedy and full recovery!
Georgie Fear RD

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