Cathy Said:

ACL Rehabilitation for Hamstring Graft?

We Answered:

One barrier could be persistent edema. I recently had a young gal with this surgery who was stuck at 90 degrees by the 4th week. Suddenly, her swelling went down and she was able to demonstrate full range of motion without any difficulty...it was night and day. So if swelling is an issue, this should be addressed first. Use of a a compression wrap, elevation and cold packs may be in order.

The other consideration is a possible build up of scar tissue. Not so likely in the hamstring grafts, but I'd still say it's possible. If this is the case, I'd consider a dynamic splint such as the JAS flexion splint. You'd use it at home 3 times a day to supplement your therapy.

Best wishes.

Isaac Said:

Can anyone help me find links for scapular stabization exercises? ?

We Answered:

Try these

www.nata.org/jat/readers/archives/jt03…

www.stottpilates.com/WarmUp/en/EN_p_sc…

Alfred Said:

Waiting 6 weeks after surgery to start Physical therapy?

We Answered:

I don't know about your situation, by I found this story that was on a sports injury website. Maybe it'll give you some kinda time-frame for you. My personal view is at the "Source" section.

This is from the site below.
Followup from my sons surgery
by: GMG

The issue with cartledge damage was why my son went forward with the surgery. He had no damage at that point but his Dr. said it could happen if he continues to dislocate the patell. Said it could even chip bone.

My son had the patella release with the ligament "tightening" in November 08. Everything was good until the pain block wore off. First night was tough, but he did not wake me to give him pain meds. After that it was OK. The bath/shower thimg was tricky. Missed about 4 days of school. He was on crutches for 6 weeks in a brace that locked his movement. First 2 weeks it was locket at ~ 70 degrees. Then he was given about 30 degrees of movement and gradually increased until the 6 week mark when the brace was discarded with the crutches (yea!). PT started after 2 weeks. He could not even lift his leg an inch at first when laying down. PT was twice a week and at first involved muscle stimulation. PT continued for 4 months when he had about ~85% % stength. He started soccer again in March 09 wearing a J-brace. By then his flexability was more than most people but not as much as the non-injured leg. Limited practice and a lot of icing after each. Swelling occured and would go back down with icing. He started playing (club soccer) w/ contact (games & scrimmage) again in April 09. In early May the DR. pulled fluid off and gave him a very small dose of cortizone. Things went better with swelling. The DR. wanted him to focus just on soccer w/ no gym, backyard basketball and no strngth training. (It's hard to hold a 15 yr back). By the season end (May) he was about 85% as a player compared to pre-injury, but part of that is endurance. Now in July we went to a physical trainer who evaluated his stength and movement. He will start next week to improve strength and flexability as he still favors the non-injured leg. The Dr. has released him completely and expects it will be late fall before all strength returns including muscle size. He does have a clicking sound occaisonly in the knee, but the Dr. says that is of no concern and is either scar tissue or cartlidge. This occured b4 the surgery as well. Overall, things have gone well and NO MORE dislocations (he had 3 last fall). Our Dr. was a knee specialist who came very highly recommended. http://www.sports-injury-info.com/questi…

Vincent Said:

Physical, Occupational, and Speech therapists for son? Do I keep in touch with them with progress?

We Answered:

Hi there. My daughter had early intervention for speech (born with cleft lip/palate), and we had her ST come to the house til she turned 3. I still keep in touch with her (my daughter is now almost 6), she loves to hear how well my daughter is progressing.
You can most certainly keep in touch with the therapists, even if for just a short while until your son makes his transition to other services. The therapists would, I'm sure, be pleased to hear about how he's doing.

Byron Said:

okay so i have a physical therapy class and i have to write a protocol?

We Answered:

Consider your stages of healing and what are important goals at each stage.

Stage 1: immediate post op...inflammatory/protective phase...what do you think this person should be doing? ...ie, protect the incision, respect the healing phase...do you think they should be working on lumbar mobility at this point or basic functional mobility: how to get out of bed, etc.

Stage 2: week 2-8...subacute...what is happening at this phase (repair phase)...what do you think you need to do to ensure that the surgical site will heal without adhesions but without sending them back into inflammation...

Stage 3: remodeling phase: what types of activities should they be working on at this point?


....I'm not going to do your homework for you, but this will give you an idea of where to start....