I'm on about 10 weeks post op and 11 weeks post injury.
I've spoken a bit about my physical therapy. The quick story is that my rehabilitation has been around re-training how I walk and move and preparing my body for future activity. Especially in the activities that I love to do - JiuJitsu.
There has been little that I've done in actual knee rehab. I've worked more on hip flexibility and hip flexor and abduction/adduction. Gluteus Max, Min and Med strength. More stable and balanced quadriceps and hamstring strength and finally lower leg strength and flexibility.
The therapist said yesterday that all of my work has been focused on eccentric muscle contractions. "What does that mean and why is that my focus" I asked?
Eccentric contractions - means the lengthening of a muscle during the contraction phase. Think about trying to do a curl with a weight that is just too much. Your muscle is working to maintain a contracted state, but is forced to elongate. There have been many studies that have reviewed the effectiveness of eccentric training - it results in greater strength gains, muscle hypertrophy and greater tensile strength of the muscle and connective tissue.
Why am I doing eccentric contraction types of training? My injury was labeled a deceleration injury. My injury occurred while I was trying to resist a takedown (leg sweep) by trying a counter sweep. I was basically using an explosive contraction of my right quad and then hamstring while the muscle was actually getting elongated in the opposite direction.
Eccentric contractions like the type above or maximum static contractions (holding a specific position such holding a submission attempt in jiujitsu or a type of balance position as in gymnastics or yoga) require a different type of training than your standard weight training.
Ever since I was a kid, I've been interested in physical training. I've always done some kind of physical training and wanted to learn more about it. When I became interested in Jits, I looked into different methods of strengthening my body and hopefully my technique. I purchased a copy of Martin Rooney's Training for Warriors and did as many exercises and workouts that I could. I focused on exercises that complement the sports and activities that I enjoy. I thought I was pretty fit.
Since my injury, I learned that training in that warrior fashion has provided great endurance and strength and kept my weight down. But I was running and jumping before I truly knew how to use my muscles properly.
My training since my injury has been much different. My training has focused primarily on my therapy, but it has applications well beyond the immediate post-operative phase and into maintenance, strength training and conditioning.
What does eccentric contractions in my rehab training look like:
1) Super slow motion contraction and relaxation movements. Do this in any movement with varying resistance. I've been doing this in various squats and lunges. The relaxation phase should be at a count that is double the contraction phase.
I started with minimal resistance - truly. Maybe 1lb and 2lb ankle weights and hands up in the air (throw center of gravity off). Moving up to 10lb and 15lb medicine balls.
Try doing two super slow mo set of of Multidirection lunges. 15 repetitions for each direction. 5 count contractions and 10 count relaxations.
2) Negative training. This needs a spotter and some kind of mechanism to stop the resistance. But the idea is to use a weight in an exercise that is very close to your one rep maximum and lower that weight at a super slow mo count - as slow as you can. In JiuJitsu, pulling-in type of motions is valuable. Try doing pullups - Go to the top of the pullup and have someone place a little weight between your crossed feet. Hold that pullup as long as you can. Try that for as many repetitions as you can.
I will provide more details of my therapy training in a future blog. Meanwhile, I was so interested in learning more about this kind of training, I ran a literature search and actually found an article: Ratemess, N. "Weight training for jiu jitsu", Strength and Conditioning, Oct 1998.
I think I will do a blog/journal club on what I find in that article and how it relates to what I am learning in therapy.