Recovering

I have started to make real progress today:
-I can lift my leg off the ground, i.e. my hips are activated.
-I can then quad extend about 15 degrees, so my quads are slightly activated.
-I can ham curl about 30 degrees.
-And I can walk without crutches in a straight line!!!

Forget 225lb bench presses, I can move my leg!

I've been tracking my vitals as well (pre surgery/post surgery):

heart rate: 59/71
body temp: 98.1/99.1
body weight: 203/197
left knee size: 15"/17.5" (2.5" of swelling!)

I am constantly sweating, I can feel that my metabolism is in overdrive trying to heal this puppy.

Here's a pic of me in the jobst pump, a great tool that i recommend.

The Night After

Man, I am in a world of pain. Right now my left leg is a 60lb dead weight. My quad is completely inactive and I have no control over the leg. I can hamstring curl to about 80 degrees.

I came out of surgery feeling well. I had pretty good range of motion and could do straight leg lifts and flex quad. Or maybe that was just the morphine talking.

My wife and my folks visited me in the hospital and I was pretty chatty... then they left and everything went wrong.

The nurse came in and left me a jug to pee in. I told her I'd be fine and able to make it to the washroom. They tied me into the continuous motion machine and shot me up with some Demerol and I was off to sleep congratulating myself for my diligent pre-hab and how well it paid off.

I woke up shortly thereafter with an unconscious amount of pain, and I had to go to the bathroom. I was pretty happy to have the jug, I could barely sit up to use it let alone walk to the bathroom.

I paged the nurse to get some more painkillers but she wouldn't have it, I was 2 hours away from my next dosage. I laid there sweating, in and out of sleep for that period. Eventually they came in and gave me another dosage but it was pretty useless.

I was in so much pain all night, until they took me out of the continuous motion machine. As soon as they took me out I was out of pain. So I have all kinds of thoughts on the continuous motion machine, which I will ask the physiotherapist about on Monday. I had good range of motion already, I wonder if the machine moved me past that range of motion into an area that caused swelling. Or I wonder if I was always going to have swelling and be in a world of pain that night.

So my workout now is the following:
1. Standing ham curls, holding on to a chair, 3 times per day
2. Lying flat quad contractions - lie on bed and squeeze your quad, as often as I remember
3. Seated ham curls - foot on floor slide towards yourself
4. Calf stretch
5. Gentle hammy stretch
6. Breathing exercises (helps clear out the anaesthetic)

I use the following rehab tools:
1. Bregs Polar Care Cyrotherapy Unit - continuously ices my knee to help fight swelling
2. Jobst pump - compresses up and down my leg to break up swelling and ensures blood flow to the calves

I'm on percocet for pain, and I'm fumbling around on crutches with a severe case of armpit rash.

Diet - I'm following Berardi's Nutrition & Injuries
1. High calories @4500
2. Tons of veggies & protein
3. High fiber carbs

I have the following shake twice a day:
1. Protein
2. Water
3. Banana
4. L-Glut
5. L-Arg
6. Greens+ Daily Detox

I also have a fiber supplement to help me wtih regularity, the percocet blocks me up.

ACL Prehab Strategy & Comments

I used a number of resources in developing my pre-hab strategy:

1. Personal trainer. I paid for an assessment & 3 sessions with a personal trainer. This was worth its weight in gold. A quick assessment revealed a few things:

• I had a torn ACL in my left knee (duh!)
• I had a tight ITB and some patella-femoral cracking in my good knee
• I had very weak glutes
• I had weak hamstrings
• I had tight ankles and limited ankle mobility
• My shoulders were pronated

2. www.t-nation.com, a gold mine of training resources.

As I had already used my patella in the first surgery, my ACL reconstruction was going to be a hamstring-graft this time around. So I had to get my hamstrings strong, as well as my quads.

The Chad Waterbury 10-10 program was solid in that it:

1. Had lots of hip-dominant movements to grow hamstrings & glutes
2. Had a lot of back exercises (chins & rows) vs chest to help rebalance my shoulders

I assume weak glutes/hammies is a common problem and Chad seems to have designed the workout accordingly. Zercher squats, good mornings and others are not common gym exercises and be prepared for a lot of stares from the upper-body only workout crowd.

In my phase III HFT program I added in a lot of leg movements as well such as clam shells, planks with glute & hip lifts, walking lunges, and overhead squats. This helped develop my quads and further develop my hips.

Here's my overall comments on my program:

Phase I - the diet was very hard. I was often spacey and couldn't sleep. I had to switch my last meal until right before bed to help me sleep. The circuit workouts were brutal - I often felt like I was going to barf on the last workout.

Phase II - This phase was relatively easy for me. The workouts weren't as tough as the first phase, all though challenging.

Phase III - I almost died a few times. This workout is tough on the nervous system. I'm also helping start a company right now and I often don't sleep enough, work hard and travel which probably didn't help. A few memorable highlights:

• I dropped a 135lb overhead squat when I lost balance (nervous system dying on me)
• My last workout in New York, lying on the ground for about 5 minutes after I finished my last set of 3x14 squats
• Working out at 6am before going to apply for a US TN visa and sitting there in a bath of sweat waiting for an immigration officer with a body that would not recover

But so far its all been worth it. My stats are great:

1. Lost 7lbs of fat
2. Added 12 lbs of muscle
3. Bench press went from 185 to 225lbs for 4 reps
4. Back squat - 225 for 4 with ass to the ground technique, not half-squats
5. Deadlifting - 305 for 4
6. Overhead squat - 135 for 4
7. Military press - 135 for 4

Prehab - Phase III - Muscle Explosion

At the end of phase II of the Chad Waterbury 10-10 revolution I had a choice, go to phase III and lose more fat, or try to pile on more muscle before the surgery. Losing fat would have advantages, I'd be healthier, lighter and more mobile going into the surgery. Gaining muscle would help as well given I would lose a lot of muscle in my left leg.

I went with the latter. This time I decided to sculpt my own workout based on Chad Waterbury's High Frequency Training program. This workout is hard but paid off with huge results. I put on another 6-8lbs of muscle.. possibly more as it looks like I've burned fat. I went ~from 195 to 202lbs.

Workout

Day 1 Morning - 4x4, 60s rest, alternating
BB military press & Front Squart
Chins & DB tri ext
Standing calf raise & hanging leg raise

Day 1 Evening - 2x12, 75s rest, alternating
DB Incline Bench & BB Back Squat
Chins & Tricep Pressdown
Donkey Calf/Single leg squat/reverse crunch

Day 2 - Off

Day 3 Morning - 4x3, 60s rest, alternating
Deadlifts & Dips
Rows & Reverse lunges
Seated calf raise & lying ext rotation
Hammer Curl & front planks w/ rear leg raises (glute flex)

Day 3 Evening - 2x14, 75s rest, alternating
DB Romanian Deadlift & Decline DB Press
Rows & Single leg, leg press
Calf raise & standing cable ext rotation
BB Curl & side plank w/side leg raise (hip extender flex)

Day 3 - Off

Day 4 Morning - 4x3, 60s rest, alternating
x band walk warm-up
chins & good mornings
Incline db press & bb back squat
donkey calf & reverse crunch

Day 4 Evening - 2x14, 75s rest, alternating
band skating strides
chins wide & big ball ham curls (single leg)
bb miltary press & front squat
Standing calf raise & hanging leg raise

Day 5 - off

Day 6 - Morning - 4x4, 60s, alternating
Bench & Dumbell Romanian Deadlift
Row & Overhad squat
Seated calf & cable external rotation
Reverse curl & cable hip extender leg raises

Day 6 - Evening - 2x12, 75s rest, alternating
DB BP & Sumo deadlifts
Rows & walking lunge
seated calf raise & external rotation
BB Bicep Curl & clam shells

Day 7 - off

Diet
Eat a lot! I was consuming over 4000 calories a day. The diet was same structure as the past two phases, but I added a lot more carbs into the diet.

Supplements
-30g of protein & 5g of BCAAs before and after each workout, also with raisins afterwards
-5g of creatine after the morning workout
-coffee before the morning workout (often at 6:30am)
-5g of fish oil
-greens+

Prehab - Part II - Gain Muscle

Now that I had burned off some fat it was time to start adding some muscle. Adding muscle involved Chad Waterbury's patented high frequency training (HFT). The strategy behind HFT is to frequently train muscles that you want to grow, frequently = 4-5x per week. I liked the Waterbury program as it had lots of functional lifts that worked many body parts.


Workout:
Day 1 - 6x3, heavy, 60s rest, alternating
Chin-ups & Front squats
DB Romanian Deadlift & Dips

Day 2 - 3x16, light, 90s rest, alternating
Push-ups (hands on bosu ball) & good mornings
Row with palms-up & Step-ups

Day 3 - 5 x 8, medium, 60s rest, alternating
wide grip pulldown & reverse lunge
shoulder press & single leg deadlift

Day 4 - off

Day 5 - 6x3, heavy, 60s, alternating
Chin-ups & zercher squats
DB Romanian Deadflit & Dips

Day 6 - 3 x 16, light, 90s, alternating
push-ups & good mornings
rows & step-ups

Day 7 -off

Repeat for a total of 3 weeks

Diet
-same as phase I but add fruit at every meal
-add raisins into post workout meal to help upload creatine

Supplements
-Protein before and after workout
-Add Branched Chain Amino Acids, 10g before and after workout
-Creatine 5g after workout
-Fish oil (5g)
-Greens+ (one scoop)

Prehab - Phase I, Lose Fat, Regain Fitness

Having had ACL reconstructive surgery once before in my life, I know it is very serious. Its a lot of pain and a lot of hard work. In my view prehab is as crucial if not more so than rehab. Don't be scared of working out your ligament-less leg.

When I found out I was having reconstructive knee surgery I realized a few things:
1. My 2-3 nights a week of sports was over.
2. I was really lucky as I had very little swelling and pain and therefore could work out heavily.

I decided to start off with some fat loss before doing some muscle gain. I started reading t-nation frequently and decided on Chad Waterbury's 10-10 revolution. The 10-10 revolution is designed to help you lose 10lbs of fat and add 10lbs of muscle, hence the clever 10-10 name.

Phase I was a fat loss phase that lasted 3 weeks. I lost 7lbs in that 3 weeks, and in a hurry as well:
Day 1 - 8 x 3, circuit style, heavy, 30s rest
Chin-ups
Dips
Deadlift

Day 2 - High Intensity Interval Training (HIIT) - bike, 50 seconds slow, 10s all out, 18 min.

Day 3 - 5 x 8, circuit style, medium weight, 45s rest
shoulder press
row
DB Romanian Deadlift
Zercher Squats (look them up)

Day 4 - HIIT, bike, 50s slow, 10s all out, 18 min.

Day 5 - 4 x 15, circuit style, light weight, 60s rest
Good mornings
Inclined DB Bench Press
Woodchops
Reverse Lunge
Wide grip pulldown

Day6, 7 - Off

Repeat for 3 total weeks

Day 5 often left me ready to puke, it was the hardest day by far for me.

The diet was 3 meals and 3 snacks each day with a high protein, high fat macronutrient breakdown. Avg day was:
breakfast - eggs, grapefruit, celery, fish oil, greens+, coffee
snack one - cheese
lunch - chicken breast, broccoli,
snack two - handful of almonds and walnuts
dinner - salmon, broccoli
snack three - piece of chocolate or cottage cheese
Plus protein before and after workouts.

The end result, I lost 7lbs and at least a few inches off my waist.

How to Blow your ACL - 101

I blew my ACL out in roughly September while playing basketball. I blocked a guys shot and landed on his foot, rolling over it, simultaneously hearing the magic 'pop' of my ACL blowing.

This isn't the first time I've blown my knee. On the first play of the first game in my senior year of high school football I lay screaming and kicking on the field after a vicious cut block to my planted left leg left me with no knee ligaments in place.

What was odd this time was that there was no swelling and very little pain, last time I was literally in tears. In fact I even finished the game, and then played twice more in the coming weeks. I knew something was wrong though, I couldn't plant and my v-cuts were more like u-cuts. I finally went in to see the orthopaedic and he confirmed it, I had once again blown my ACL.