Blog: e3rehab.com/blog/okcaclr 3 Clarifying Points: 1. Quad sets and SLRs do strengthen the quads to some extent (minimally with a very low ceiling), but they are often prescribed for extended periods of time despite their inability to progressively load the quads. Use them initially for their intended purpose and then move on. 2. The phases are very rough guidelines. There are a lot of individual factors at play here. 3. The isometric knee extension angles might not be perfect because of how the machine is set up, but the suggestions remain the same. I would actually measure the angle for testing and training in the clinic. Since I recommended such a wide range (60-90 degrees), you can always err on the side of caution (staying closer to 90 degrees).
Theses ACL videos are awesome! I was taught to avoid knee extension exercises early on in my rehab/therapy experience (Teching, Fitness Training, and University studies) at all cost because of shear forces and to some extent, compressive forces. At the time I wasn't sure what these forces were as most schools don't cover arthrokinematics in depth, unless you are going to grad school and diving into the research. I'm learning that these forces are just a part of all joint movements as they produce torque about said joint. Not sure if therapists bought the idea that closed-chained exercises were superior to open-chain exercises or that the shear forces created by knee extensions were sufficient to cause osteoarthritis down the road. Anyway, I wasn't familiar with the research but I did happen to see these exercises in ACL rehab a lot so it just created a lot of confusion on the topic. I thank you and Dr Sam Spinelli for speaking on the topiic. Keep up the good work!
0:43 that exercise, whatever it's called, hits the rectus femoris though. People forget that it crosses the hip and is both a quad muscle and a hip flexor muscle.
Great video. I've had an ACL reconsrruction of my left knee years ago and my right knee has been replaced and a year later I shattered my femur right about the knee. I'm have had 3 surgeries on each knee. When I do leg extensions with my right knee I get some pain in the knee cap. Should I stay away from extentions or limit them to 45-60 degrees at most? Thanks, Mike
What is isontics, I’ve looked it up but I still don’t get it. Can someone elaborate and give me an example. I know what isometrics are but what is isotonics.
Is it safe to perform prone or seated hamstring curls post ACL repair(not reconstruction) and meniscus repair considering that no graft has been taken from hamstring. Would request you to make a video for the same.
Its been 6 weeks i got subtle horizontal medial meniscus tear on posterior horn in both knees.I am an advance level bodybuilder. What sort of exersices i should do and will I be able to resume my all leg workout with full intesity again. Kindly guide.thank you so much
Thank you so much for this informative video. So performing leg extensions right away won’t loosen the screws/anchors used for patella graft ACL? I would appreciate your reply. Thank you
Based on the evidence, leg extensions can be performed safely after ACLR when programmed and progressed appropriately, but we recommend discussing this with your surgeon and physical therapist as this should not be taken as medical advice.
Any suggestions if dealing with knee clicking/locking when doing extensions on surgical knee? Weight doesn't matter will happen with empty vs loaded at nearly full extension.
Thank you for this guideline!! Is it worrying if a patient went on to do full range of motion leg extensions at the 8 week mark? I felt like I had to take things into my own hands since my physio was not prescribing anything that was working my quads..I've been told that my recovery is very quick and did not think twice about doing leg extensions at a full ROM
How soon after acl plus meniscus repair is it safe to do leg extension ? I'm at 10 weeks and have been cleared to bear weight and go flex past 90 since week 4
hey bro.. im doing now leg extension without machine.. I've got may aclr surgery last 14.. so after 5 days im adding leg extension to my exercise.. 3x a day in 2 reps. i feel relax and no pain at all.. hope it will help
Is it normal if when doing these you feel clicks in your knee on the operated knee. I am 3 months post aclr surgery and my knee clicks and feels snappy even if I straighten my leg in the air without any weight let alone with weight.
I recently had my acl and meniscus reconstruction, and during weighted leg extensions/ leg holds, my knee makes a noise for about 2-3 times in the starting, and then it stops. It is ok if that happens?
It has been 32 days since my surgery stiill there is 5 degree lack in extension ..is this normal ....what exercises i should include to acheive full extension
Different schools of thought….current studies show open chain leg extensions can be good for overall Quad development. Jeff prefers closed chain movements where feet are planted on the ground…..try them out for your self and see if they work for you. There is no other way around it
Blog: e3rehab.com/blog/okcaclr
3 Clarifying Points:
1. Quad sets and SLRs do strengthen the quads to some extent (minimally with a very low ceiling), but they are often prescribed for extended periods of time despite their inability to progressively load the quads. Use them initially for their intended purpose and then move on.
2. The phases are very rough guidelines. There are a lot of individual factors at play here.
3. The isometric knee extension angles might not be perfect because of how the machine is set up, but the suggestions remain the same. I would actually measure the angle for testing and training in the clinic. Since I recommended such a wide range (60-90 degrees), you can always err on the side of caution (staying closer to 90 degrees).
We can't thank you enough for this great simplified direct information... keep up the good content
This is easily the best post I've seen on this topic. Thank you. 👍
Theses ACL videos are awesome! I was taught to avoid knee extension exercises early on in my rehab/therapy experience (Teching, Fitness Training, and University studies) at all cost because of shear forces and to some extent, compressive forces. At the time I wasn't sure what these forces were as most schools don't cover arthrokinematics in depth, unless you are going to grad school and diving into the research. I'm learning that these forces are just a part of all joint movements as they produce torque about said joint. Not sure if therapists bought the idea that closed-chained exercises were superior to open-chain exercises or that the shear forces created by knee extensions were sufficient to cause osteoarthritis down the road. Anyway, I wasn't familiar with the research but I did happen to see these exercises in ACL rehab a lot so it just created a lot of confusion on the topic. I thank you and Dr Sam Spinelli for speaking on the topiic. Keep up the good work!
Thank you very much for the positive feedback! Definitely a group effort with Tony Comella and Nicole Surdyka as well!
hi sr
my acl surjry four month completd
Rom 120%
aftr exrsize knee Rom 125
u r vidios very helpfull for me
0:43 that exercise, whatever it's called, hits the rectus femoris though. People forget that it crosses the hip and is both a quad muscle and a hip flexor muscle.
Great info. Thank you.
What about training the hammstrings timetable after a hammstring graft?
May I ask how long it takes for MCL to bend and step on a fixed bike after being damaged
How might these protocols differ for someone who used a patella graft? Will the effected patella slow this process?
Great video. I've had an ACL reconsrruction of my left knee years ago and my right knee has been replaced and a year later I shattered my femur right about the knee. I'm have had 3 surgeries on each knee. When I do leg extensions with my right knee I get some pain in the knee cap. Should I stay away from extentions or limit them to 45-60 degrees at most? Thanks, Mike
I love it
Sir 1 year ago I did acl.surgery I have knee extenshion now it will dificult ??
So physios are doctors in the USA?
What if someone has done Meniscus repair with an ACL Reconstruction? Will their rehab start a month ম
I have the Same. Surgery in One month. When did you start to workout ? How Long did you use your crutches?
What is isontics, I’ve looked it up but I still don’t get it. Can someone elaborate and give me an example. I know what isometrics are but what is isotonics.
It is concentric + eccentric move ☺️
How to strengthen Hamstring muscle after ACL reconstruction
Please you can versition spanish ...yours videos are excellent
Is it safe to perform prone or seated hamstring curls post ACL repair(not reconstruction) and meniscus repair considering that no graft has been taken from hamstring. Would request you to make a video for the same.
Its been 6 weeks i got subtle horizontal medial meniscus tear on posterior horn in both knees.I am an advance level bodybuilder. What sort of exersices i should do and will I be able to resume my all leg workout with full intesity again. Kindly guide.thank you so much
I had that done, was doing leg extensions fairly quickly after that, after one month was loading up the weight, haha
How much weight should I put on during leg extension exercise
Thank you so much for this informative video. So performing leg extensions right away won’t loosen the screws/anchors used for patella graft ACL? I would appreciate your reply. Thank you
Based on the evidence, leg extensions can be performed safely after ACLR when programmed and progressed appropriately, but we recommend discussing this with your surgeon and physical therapist as this should not be taken as medical advice.
Does this work for patellafemoral pain too? Experiencing pain at around 70 degrees of knee extension
Doc I had a ruptured patellar on my left knee in 2016, I done the rehab has prescribed, my leg still buckle. Any advice?
Any suggestions if dealing with knee clicking/locking when doing extensions on surgical knee? Weight doesn't matter will happen with empty vs loaded at nearly full extension.
Hi, is the surgical leg the leg that is directly in from of the camera?
Im week 11 post op and my pt said that i should be doing leg extension between 15-0 degrees. Is this wrong?
What should I do if leg extensions are painful around the inside of the knee? Can I push through the pain or should I wait?
Dnt do them….any movement should be done pain free. I had this issue and pushed through the pain and pains the price long term
Thank you for this guideline!! Is it worrying if a patient went on to do full range of motion leg extensions at the 8 week mark? I felt like I had to take things into my own hands since my physio was not prescribing anything that was working my quads..I've been told that my recovery is very quick and did not think twice about doing leg extensions at a full ROM
Not likely worrying. Some physios start full ROM immediately.
Hi i am very interesd in know more about illiotibial band syndrome can you talk about that? pleasee
We'll make a video on it eventually!
How soon after acl plus meniscus repair is it safe to do leg extension ? I'm at 10 weeks and have been cleared to bear weight and go flex past 90 since week 4
hey bro.. im doing now leg extension without machine.. I've got may aclr surgery last 14.. so after 5 days im adding leg extension to my exercise.. 3x a day in 2 reps. i feel relax and no pain at all.. hope it will help
@@mikecarlogarcia thank you
how your acl surgery?
@@mikecarlogarcia going good man getting better I'm going on 4 months next week thank you for asking how's yours ?
@@mikecarlogarcia what graft did you use for yours ?
Could this also be applied to those affected with patellar/quad tendonopathy?
Leg extensions can be used for patellar or quad tendinopathies, but this exact progression wouldn't necessarily be required.
Is it normal if when doing these you feel clicks in your knee on the operated knee. I am 3 months post aclr surgery and my knee clicks and feels snappy even if I straighten my leg in the air without any weight let alone with weight.
I recently had my acl and meniscus reconstruction, and during weighted leg extensions/ leg holds, my knee makes a noise for about 2-3 times in the starting, and then it stops. It is ok if that happens?
How long to wait before driving if the surgery is on the left acl ?
I'd ask your surgeon.
Are isometrics still effective 12 months post op? Or should I stick to isotonics?
Isometrics can always serve a purpose! You can do a combination of the two.
@@E3Rehab thank you! I appreciate the advice
Im 3 month and I can’t bent it all the way only like 110 degrees that’s it
I've always heard that doing leg extensions is very bad for the ACL and the knee.
hi can the full room extensions 3 weeks post operation can be dangerous ?
It depends on the relative load. I'd discuss with your surgeon and/or physical therapist.
@@E3Rehab my phisical therapist want me to do them but im afraid they will have negative impact on graft
As a PT would you reach out to the surgeon prior to initiating this exercise as it is unfortunately commonly demonized?
I do my best to always collaborate with other healthcare providers involved in a person's care.
It has been 32 days since my surgery stiill there is 5 degree lack in extension ..is this normal ....what exercises i should include to acheive full extension
Athleanx says that they are bad
He is wrong.
Different schools of thought….current studies show open chain leg extensions can be good for overall Quad development. Jeff prefers closed chain movements where feet are planted on the ground…..try them out for your self and see if they work for you. There is no other way around it
4-12 weeks betwen 90-45 we gonna lift leg after 12 weeks full extension.is that right? thanxxxxx