The one thing you’re always trying to avoid managed to happen: you got injured. We know that you probably have dozens of questions about your recovery, so to ease your mind and get you back in the gym ASAP, we asked Michael Camp, DPT, CSCS, PES and owner of Bethpage Physical Therapy what to expect after seven common injuries. Follow this comprehensive injury recovery guide so you can return to action right away. 

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ACL RECONSTRUCTION SURGERY

COMMON CAUSES
Dr. Camp says: It’s usually a valgus stress force, which is where the knee buckles inward combined with a twisting motion. Planting, jumping and twisting, can all causes a valgus stress force.

WHEN YOU’LL NEED SURGERY
Dr. Camp says: Usually an MRI or CAT scan will identify the injury. Then, the surgery could be delayed because sometimes the trauma causes severe swelling and the knee isn’t really able to move yet. Therefore, the doctor sends them to therapy to start trying to get the knee to get in a full extension position.

Doctors usually don’t like to do surgery until the joint is locked straight. They recommend PT for two weeks if there is severe trauma. If the leg can be extended, then surgery will be a week after the injury.

SURGERY LENGTH
Dr. Camp says: 45-90 minutes.

WHAT THE SURGEON WILL DO
Dr. Camp says: The ACL ligament prevents the tibia from moving forward on the femur. They replace that ligament from a cadaver, your own patella graft, or the hamstring. Some doctors in California are taking from a cadaver Achilles. UFC fighters are getting that done and it seems to be getting stronger. The degree of recovery is a lot faster than the other options.

POST SURGERY PROTECTION
Dr. Camp says: You get put in a Bledsoe brace, which has degrees of freedom, for 4-6 weeks. After surgery, you’re locked at 0 degrees and the goal is to protect and repair. Then, every week, the range of motion gets increased. The doctor will move the brace to 30 degrees of flexion then every week it will change until 90 degrees flexion is reached.

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BICEPS TEAR SURGERY

COMMON CAUSES
For boxers, it’s usually a hook shot or jab thrown too quick. For bodybuilders, heavy back work and dumbbell curls. There are two places the biceps can tear from: the origin, by the shoulder, or by the elbow where it inserts.

SURGERY LENGTH
60-90 minutes.

WHAT THE SURGEON WILL DO
If the biceps is torn near the elbow, then it has to be anchored between the radius and the elbow using screws.

POST SURGERY PROTECTION
The elbow is set at 70-80 degrees of elbow flexion in a locking brace. Each week you slowly increase extension.

REHABILITATION
The first six weeks contain very restricted activities. You’re not allowed any active elbow flexion or extension or supination. You can start retracting your scapula. You’re working on building stability in the shoulder first. After six weeks as you gradually start unlocking the brace, then you can start returning to more activities to strengthen the biceps. The rehabilitation will typically take 12 weeks.

Torn Labrum Surgery

COMMON CAUSES
A throwing athlete is a common sufferer of a torn labrum. Also, falling onto a shoulder or years of repetitive heavy lifting can cause a tear.

SURGERY LENGTH
30-45 minutes.

WHAT THE SURGEON WILL DO
Imagine a bowling ball. Cut it in half. The humerus (upper arm bone) should move in that half of the bowling ball. The inside of the bowling ball should be smooth but with a torn labrum, there are chips inside of that bowling ball. As the humerus tries to move along there, it gets caught up in the tears of the labrum. The doctor can either go in there and either smooth it out or stitch it and put it back together.

POST SURGERY PROTECTION
Two or three weeks in a sling.

REHABILITATION
For the first few weeks following surgery, avoid positioning the arm into excessive internal rotation or lifting the arm fully up overhead. Physical therapy will be eight weeks for a guy that is just looking to get back into a gym training routine. You’ll do rotator cuff exercises, TheraBand exercises using external, internal rotation, band pull aparts. cable face pulls, P and F patterns, and static pushup holds. On average, you’ll be back at 100% between 12-15 weeks.

Fractured Clavicle

COMMON CAUSES
Trauma, a fall, or bench pressing too heavy.

WHEN YOU’LL NEED SURGERY
Sometimes, a simple stress fracture won’t require surgery. The doctor will stay immobile for 2-3 weeks then you can start gentle range of movement. If the clavicle is split in half, sometimes they have to put screws in it.

SURGERY LENGTH
60 minutes

WHAT THE SURGEON WILL DO
For a severe fracture, they just have to position the bone together and use one or two screws.

POST SURGERY PROTECTION
2-3 weeks in a sling.

REHABILITATION
No therapy for at least four weeks because doctors are afraid that movement will snap the bone. Then, 5-6 weeks of physical therapy.

You’ll be doing soft tissue work and passive range of motion where the physical therapist moves the shoulder for you. Progression is safe range of motion, gradual strengthening of rotator cuff muscles and minimizing scar tissue development in incision area. You should be at 100% in 15-16 weeks. 

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Lumbar Fusion

COMMON CAUSES
Lumbar fusion is usually the last resort. The vertebral body is not really compressed on the other vertebrae. The disk is not longer really there because it has deteriorated. It's encroaching on the nerve root and the person has severe symptoms of pain down either extremity and they have to get the pressure off the nerve root. The most common area is L4 or L5.

SURGERY LENGTH
2 hours, depending on what the doctor finds.

WHAT THE SURGEON WILL DO
They go in, replace the disk, cut out the scar tissue around the nerve root and they fuse those levels.

POST SURGERY PROTECTION
You wear a back brace for 4-8 weeks depending on the quality of the bone.

REHABILITATION
In the beginning, its gentle soft tissue massage to the lower back, slowly working on stretching the legs. Throughout the first six months, you can’t lift anything heavy, no twisting or bending. Once you start to improve range of motion, make sure the veterbrae that aren’t fused maximize their movement. After six month you will be at 80% and should do lat pulldowns, seated row machines, and core exercises. After a year, you should be 100%.

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Torn Pectoral Muscle

COMMON CAUSES
Bench press in lifters, wrestlers when they’re grabbing, football players during a hit.

SURGERY LENGTH
90 minutes.

WHAT THE SURGEON WILL DO
Your pec inserts onto your humerus. When you pop it, the tendon usually pops off the humerus. So, they clean out the tendon, trim it and achor into the humerus bone.

POST SURGERY PROTECTION
Usually it’s a sling.

REHABILITATION
Range of motion is very limited in the beginning. In the first week, no reaching overhead, reaching out, no grabbing anything heavier than a quart of milk.

During the first three weeks, do forearm exercises and working with the therapist to achieve range of motion the doctor allows. After 6 weeks, start working on rotator cuff movements and triceps pushdowns with a theraband.

After 8-10 weeks, do adduction movements, bands or cable flyes, cable crossover, static pushup holds, a physioball walk out, physioball walk out with a pushup. Around 12-15 weeks we start doing some type of dumbbell press work. You should be 100% after 6-8 months.

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Hip Labrum Tear

COMMON CAUSES
Running, heavy squats with bad technique, repetitive movement performed too many times.

SURGERY LENGTH
60 minutes.

WHAT THE SURGEON WILL DO
As in the shoulder labrum tear, the tendon will be stitched and smoothed.

POST SURGERY PROTECTION
Some doctors will give you crutches to avoid weight bearing on the leg. That can last 2-3 weeks.

REHABILITATION
A day after surgery, doctors recommend an open chain exercise such as cycling for 10 minutes. With said, there should be no hips flexion past 90 degrees and no external/internal rotation of the hip.

Twelve weeks is the guideline for returning to the gym or start running. Pool movement is important for the hip because you’re more buoyant in the water and can more work without feeling the stress.  You should be 100% after 16-18 weeks.

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