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ACL Rehabilitation and Nutrition

by Steven Bubel MS, CSCS

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One of the most frequently asked questions we get here at Virtual Trainer is how to recover and train after an injury. My standard answer is always the same: I am not a Doctor and do not dispense medical advice. Once you have fully recovered from your injury then and only then do I recommend the workouts found on this site. Even if I were a Doctor, I think it is way to important to have first hand knowledge as to the scope and degree of an injury to be diagnosing and offering treatments over the internet. The net is good, but it isn't that good. However, Steven Bubel of mxconditioning.com has found some research linking the importance of nutrition to the recovery process, especially with ACL injuries. Don't have an ACL injury? Well, I am confident that the same theory would apply to just about any injury. It just makes sense that good nutrition will help you get back to 100%. - Virtual Trainer

It's easy to see how the knee is exposed in MX

photo: Garth Milan

As some of you are painfully aware, damage to the ligaments of the knee - the anterior cruciate ligament (ACL) in particular - is one of the more frequently occurring injuries in motocross. For those fortunate enough to be unfamiliar with the anatomy of the knee, the ACL (along with three other ligaments) essentially connects the tibia (lower leg bone) to the femur (thigh bone) and provides stability to the knee joint. It does so by restraining anterior (to the front) displacement of the tibia relative to the femur (i.e. hyperextension) as well as limiting internal and external rotation. More often than not, injuries to the ACL occur when the knee is extended and forcefully rotated. In motocross this is most likely to occur when negotiating a hard turn.

Symptoms of an ACL Tear
Like I said, an ACL injury normally occurs from some type of rotational stress applied to the knee. Remember, the knee is only meant to bend and straighten. When this injury occurs, the athlete may feel a pop within the knee. They will also experience a feeling of the knee “giving out”. The phrase “Trick knee” has long been associated with an ACL injury.

Other symptoms may include immediate swelling, an inability to fully straighten or bend the knee. The most common symptom however is the feeling of the knee “giving out” or feeling unstable. It is also not uncommon for other structures in the knee to be damaged at the same time that one injures their ACL.

The knee joint showing a torn ACL. OUCH!

The Nutritional Link to Recovery
Once the damage has been done, surgery or no, athletes will experience a loss of muscle mass and strength in the thigh muscles of the injured leg. If left untreated this loss can be permanent. Therefore, if the athlete hopes to return to action, recovery of muscle mass and strength is imperative. The most effective way to restore lost muscle and function is to engage in resistance training. This is well understood in the medical community and why doctors nowadays insist upon early rehabilitation. What is not so well understood, or at least fully appreciated, is the important role that nutrition plays in the rehabilitative process.

In a recent study (1), researchers sought to find out if post-workout nutrient supplementation would, indeed, have the same muscle-building effects in the rehabilitative patient as it does in the healthy population. Twenty-six ACL-injured men and women were divided into three supplementation groups and performed resistance training 3 times a week. Immediately after each training session subjects consumed either a protein and carbohydrate drink, carbohydrate only(think Gatorade), or a placebo. They discovered that, after 12 weeks, the protein and carbohydrate group exhibited significantly greater muscle size and strength in the quadriceps of the injured leg relative to the other groups.

So, if you find yourself unlucky enough to have suffered a knee injury and want to accelerate your return to the track, be sure to follow your doctor's advice, do the rehabilitation, and take a good post-workout shake immediately after each workout.

1. The effect of protein and carbohydrate supplementation on strength training outcome of rehabilitation in ACL patients. Journal of Orthopaedic Research (2006)

That's it for now, until next time, good luck with your training and remember, if you have a question, log on to the Virtual Trainer Expert Forum and have your question answered by a panel of experts. In addition, be sure and check out the Racer X Virtual Trainer archive section. Your complete one-stop information zone for motocross fitness. VT Signature

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