Daily Mobility Exercises by Dr. Kelly Starrett Forums General Post Acl-Reconstruction Mechanics

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    • #70799

      Hey all, 

      I had ACL reconstruction eight days ago, today. I’m following my PT to a dime, but I have a few concerns about the my new knee mechanics. I play a sport that requires a lot of external rotation at the hip, and almost everyone, myself included, attempts to add to that range by externally rotating at ankle, causing a lot of knee valgus. Now, we aren’t loaded in this position, but it reinforces a bad mechanic.
      Myself, I guess I’ve always let my right foot flare out when I run (thank you, friends, for pointing this out to me after I severely injured myself), and I’m looking to correct the mechanic. I’m also concerned that this new injury is actually reinforcing this position. My brace keeps my leg locked in extension, and I often find myself cheating range out of my hip, therefore turning my foot out as I walk. 
      I don’t think many PTs are aware of this problem or its potential long term effects. I’m trying to force the knees out as much as possible when I squat, but I feel blocked laterally. In fact, I’ve always been blocked a little on the right side; I have a very difficult time keeping my big toe down while I attempt to spread the floor. I noticed that while my IT band feels relatively lose, whatever muscle group inserts above the lateral portion of the anterior knee is very tender.
      Should I try to squat big toe-down and continue to loosen the pieces I know that I need to open, or should I let the toe come up, and perhaps try to open my ankle a little more?
      If it matters, I couldn’t do a butterfly to save my life, but I can basically touch my head to my knees. Well, I could, before somebody took out a piece of my hamstring and used it to reconnect my upper leg to my lower leg.
      In short, I know a lot of the pieces I need to open (or maybe I don’t, let me know), but I need some mechanical advice.
    • #74149

      Why do you need to add to your range by putting your ankle in a poor position?
      It may not be a loaded position, but reinforcing bad mechanics isn’t good either.
      Your body can buffer any deviation in technique for a time until it can’t any more. No warning your done game over.
      Here are some episodes that address it:
      Pro Episode # 38 – MWod Pro-User Request Friday: Femurs Straight, But Feet Ducked? The MWOD Approach
      Squat Quick Test: Is it your Ankles or Hips?
      Episode 343: Stop Walking Like the Duck You Aren’t

      You are aware of the compromises in position you are making so now you need to address them.
      Impacts up/down stream of the  deviation in position will be a problem down the road if not addressed.
      Have you mentioned what you have noticed to the PTs?

      Have you started looking up/down sream of where you are seeing the issue?
      For running instruction go to the Helming Athletics site or on the Cody App. if you have an Iphone.

      Yes, you want to keep your big toe on the ground when squatting.
      Have you addressed your feet at all?
      Pro Episode # 59 – Reclaiming those Gnarly Feet
      Episode 337: Long Ruck Feet Or Ultra Marathon Feet?
      Ankle rom?
      Are you missing rom at the knee?
      Community MWod Video: The Knees-In Squat
      Pro Episode # 39 – Voodoo Floss Primer: The Knee
      Pro Episode # 35 – MWod Pro-User Request Friday: The IT Band Primer
      Pro Episode #5 – Knee Stability and Laxity

      If something is restricted  you need to address it. There may be several impacting factors.

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