Everything I Did Wrong During Knee Surgery Rehab — And What To Do Instead
It has taken me almost 15 years to feel normal after ACL reconstruction surgery and partial meniscus removal. Given that I’m 30-years-old, that’s almost half my life.
And yet, I’m an athletic person.
After surgery while still in high school, I went back to playing soccer, volleyball, and running cross-country. Now I cycle between HIIT workouts on a bike, weightlifting, and core strengthening 3x/week.
But after having 3 kids and an at-your-desk-for-8-hours-a-day job, I noticed more and more knee pain. At first, squats didn’t feel the same. Then it ached to play hopscotch or kneel down to tie my kid’s shoes. Then going down stairs hurt for hours afterward.
If it was this bad in my late 20s, what would it be like in my 80s?
At 28, I decided that my lifestyle wasn’t working for long-term knee health, and spent the next 1.5 years revamping it. Today, my knee no longer aches. I can run, jump, squat, lunge, kneel, and twist without being in pain later.
Here is everything I wish I had known over the last 15 years, the hard-won insights from my orthopedic therapist, tons of research, and success on my own rehab journey.
1. You can’t just push through exercises that give you pain.
When I felt pain hours after squatting, I assumed my muscles were weak, and more squatting would eventually strengthen them. I only needed to grit through the pain until the muscles got stronger, right?
Wrong!
And worse, this can even cause a muscular imbalance if a stronger muscle group overcompensates for a weaker one.
Instead, I needed to (a) figure out what muscle groups were weak, and therefore not working properly during the exercise and (b) replace painful exercises with no-pain ones that targeted these weaknesses.
For example, for weak hamstrings, bridge holds were my go-to. For weak glutes, sidestepping with a resistance band and Superman were my favorites.
2. The root causes of pain could be from your core to your ankles.
🤯 Really? The ankles?
My right ankle was not flexible enough, causing my knee to contort inward, especially when going down stairs. Daily stretching for a few months regained the flexibility.
My right core and glutes were weak, and I felt massive pressure inside of the right knee when lunging — whereas the left knee felt normal. Getting my right glutes to be stronger and thus take more load during lunging has completely removed the pressure.
And by the way, hamstring strength is more important than quad strength. (Again 🤯!)
3. Learn proper form. Most exercise programs don’t teach you.
Remember those bridge holds I mentioned in #1? They are a great example of how tiny changes in form can target completely different muscles:
- Keep your legs close to your butt — awesome for the glutes
- Move your legs a few inches further from your butt — burn in your hamstrings
Instead, most exercise programs expect something like this — during a warmup:
Without these moves coded into muscle memory through tons of repetitions, I find myself just rushing to get from one move to the next. 👎
4. Single-leg exercises are worth their time in gold.
Years of unconsciously slightly favoring the left side of my body had accumulated muscle loss on the right. For example, I had much less glute and hamstring strength on the right, causing my knee to be “stuck” in this inward rotation.
I fixed the inward knee through a year of single-leg exercises — by strengthening the right glute and hamstring, and by focusing on “toes forward, knees out, hips in” form.
The data confirm that single-leg exercises accelerate gains in strength, power, and stability. They were the single secret ingredient that helped me achieve symmetry.
5. If you want your knees to handle ___, you must train ___.
Here is how I’ve been filling in the blank:
- Balance — Better balance increases agility and decreases reaction time, pain, and the likelihood of re-injury. Until recently, I had never before balanced one-legged on a pillow with my eyes closed.
- Torque — Torque is how I originally tore my ACL (twist, fall, pop! AAH the horrors of reliving that moment!). The anti-rotation press with resistance band is one of my favorite torque-friendly knee exercises.
- Power — Prior to this recent rehab journey, I told myself “I’m getting old and shouldn’t be jumping around with my kids like I used to” because of the pain. Yes, very old at 28. Today, I incorporate single-leg leaps and jumps into my routine.
The key for me to stay motivated throughout knee rehab was to understand this cold, stark fact: according to LA Fitness, it takes 4–6 weeks of strength training to gain 1lb of muscle. Most of knee rehab is building muscle.
Be in it for the long-haul. Lifelong.
And, I highly recommend physical therapy and personal training.
I am cheering you on.
