Latest / The ACL Athlete Podcast / 207 | 10 Key Strategies For Better Sleep After ACL Surgery

Transcript

207 | 10 Key Strategies For Better Sleep After ACL Surgery · The ACL Athlete Podcast

• 0:18
  SPEAKER_00: Welcome everyone to the ACL Athlete Podcast.
• 0:22
  SPEAKER_00: This is the podcast where we talk about everything related to the ACL, whether that's the injury itself, the rehab process, return to sport, and more.
• 0:31
  SPEAKER_00: I'm your host, Dr.
• 0:32
  SPEAKER_00: Ravi Patel, performance physical therapist and coach.
• 0:36
  SPEAKER_00: Between myself and fellow guests and experts, you'll learn through the lens of the patient, the healthcare professional, and the coach.
• 0:43
  SPEAKER_00: The goal of this podcast is to equip you, the athlete, with the education to make the best informed decision about your care and your ACL journey.
• 0:54
  SPEAKER_00: Thanks for joining.
• 0:55
  SPEAKER_00: Now let's dive into today's episode.
• 1:01
  SPEAKER_00: What is up, team, and welcome back to another episode on the ACL Athlete Podcast.
• 1:06
  SPEAKER_00: So today we are diving into sleep.
• 1:10
  SPEAKER_00: All things around post-op sleep.
• 1:13
  SPEAKER_00: It could be even also applied to post-injury as soon as you have the injury or have the surgery.
• 1:20
  SPEAKER_00: I just want to talk through some how-tos about this, some guidance around this, but just know that this is not medical advice.
• 1:27
  SPEAKER_00: It's purely educational.
• 1:29
  SPEAKER_00: So consult with your healthcare professional to get specific guidance in your specific case.
• 1:35
  SPEAKER_00: Now, the reason this has come up is because I've recently had some people reach out asking about sleep.
• 1:42
  SPEAKER_00: And while it may seem straightforward, it is also something that can be a little daunting, right?
• 1:48
  SPEAKER_00: Like you fall asleep, you're post-op.
• 1:50
  SPEAKER_00: Am I going to mess something up?
• 1:51
  SPEAKER_00: What's the best way to do this?
• 1:53
  SPEAKER_00: And I know all of you guys are coming here to get the most information to equip yourself with the best recovery possible.
• 2:00
  SPEAKER_00: So I'm going to give you guys the lay of the land here when it comes to sleep and helping it apply to your situation, or if you're a coach or clinician listening, being able to help guide your own athletes through this because we know sleep is super important and it gets hit really, really hard as soon as you have this injury and as soon as you have this surgery and your post op.
• 2:24
  SPEAKER_00: It's for the healing process.
• 2:26
  SPEAKER_00: Sleep is going to be super beneficial, of course, as we know it, to recover for your own mental sanity, your energy, and all the things in this process, right?
• 2:37
  SPEAKER_00: Especially as you are starting to build strength, as you're trying to retain muscle and strength, we want sleep to play a big role because that's where our body is going to do a lot of the rebuilding.
• 2:48
  SPEAKER_00: So we want to set ourselves up for success from the get-go.
• 2:52
  SPEAKER_00: And it's just a challenge, if I'm being completely honest, after this surgery.
• 2:57
  SPEAKER_00: And from here on out, I'm just going to reference it as post-surgery.
• 3:00
  SPEAKER_00: But if you're post injury or maybe you hit a road bump in this and your knee is flared up and you want some guidance because you're having trouble sleeping, this should apply across the board.
• 3:11
  SPEAKER_00: So, with that said, especially after post op, that's when we are really trying to be as intentional about the way we sleep and being careful.
• 3:19
  SPEAKER_00: And so, with that said, we're wanting to make sure we set ourselves up for success.
• 3:24
  SPEAKER_00: And as I was sharing, like it's going to be uncomfortable because you literally just had major reconstruction of the knee.
• 3:31
  SPEAKER_00: So there was some bone drilling going on, some screws put in, a graph potentially taken.
• 3:38
  SPEAKER_00: Um, you might have had some things cleaned up, repaired.
• 3:41
  SPEAKER_00: So we've got a lot of work going on in there, right?
• 3:43
  SPEAKER_00: And it's not too far from just carpentry work.
• 3:47
  SPEAKER_00: Instead of it being a house, it's literally in your knee.
• 3:50
  SPEAKER_00: And it's something where I've observed this surgery.
• 3:53
  SPEAKER_00: There's a lot going on, and that's where it makes sense why your knee is so angry after, right?
• 3:59
  SPEAKER_00: It's having this acute response.
• 4:01
  SPEAKER_00: It's like, what the heck just happened?
• 4:03
  SPEAKER_00: Some tissues have been impacted, and now it is going through this acute process of healing and this alarm system.
• 4:12
  SPEAKER_00: And so now we are trying to just really get on the road to recovery.
• 4:18
  SPEAKER_00: And so, from a comfort standpoint, our goal is to try and manage our pain and swelling as much as we can.
• 4:24
  SPEAKER_00: But of course, after we are post-op, and I remember this myself, you're just kind of feeling weird, right?
• 4:31
  SPEAKER_00: You wake up after this surgery, it happens in an instance, and you have your post-op anesthesia, you're kind of feeling that weirdness, like out of it.
• 4:41
  SPEAKER_00: Your leg is wrapped up, you possibly have a brace on it.
• 4:46
  SPEAKER_00: There's a nerve block that is typically taking place, whether it's in your quad, your femoral nerve, or your adductor, or maybe it was spinal, or maybe you didn't get one at all.
• 4:55
  SPEAKER_00: But with that said, there's typically a nerve block that plays in to help minimize the pain immediately post op.
• 5:01
  SPEAKER_00: And then don't forget just about this general pain and swelling that you're just gonna be feeling immediately after the surgery, and also just some fear, apprehension, anxiety around it.
• 5:14
  SPEAKER_00: That's normal, y'all.
• 5:15
  SPEAKER_00: And I felt that way.
• 5:17
  SPEAKER_00: It's typically people's first major surgery, and you're also like, I don't want to mess anything up.
• 5:23
  SPEAKER_00: Am I gonna do something wrong?
• 5:25
  SPEAKER_00: And lifting your leg, like it just feels like a foreign thing on your body, right?
• 5:31
  SPEAKER_00: And any of you guys who have had the surgery and are listening to this, you're like, yeah, this feels pretty accurate.
• 5:37
  SPEAKER_00: And I re I felt this way with both of my ACLs, right?
• 5:41
  SPEAKER_00: Two different kind of experiences, if you will, but similar feelings of this just general post anesthesia, how the leg felt, right?
• 5:49
  SPEAKER_00: And the other thing that you'll be anticipating is some sharp pains that'll come and go when you move the leg.
• 5:54
  SPEAKER_00: Randomly, if you just move, it just feels like a sharp little nerve or a little pain shooting sensation that shoots into your knee and in your leg.
• 6:04
  SPEAKER_00: And you're just trying to be careful moving your leg around.
• 6:07
  SPEAKER_00: Now, I'll probably scare some of you if you are preparing for this and you haven't had the surgery yet.
• 6:11
  SPEAKER_00: But trust me, all this is normal.
• 6:13
  SPEAKER_00: You're not doing anything wrong.
• 6:14
  SPEAKER_00: It's just what comes with the post op process and what to expect.
• 6:19
  SPEAKER_00: So I'm not gonna sugarcoat that at all.
• 6:21
  SPEAKER_00: If you had an amazing process and you've been through this, then that's great.
• 6:25
  SPEAKER_00: But in reality, the first 24 to 48 hours, especially, you're just trying to get through it, you're trying to just take it hour by hour, right?
• 6:34
  SPEAKER_00: And so with this, coming back around to sleep, right?
• 6:38
  SPEAKER_00: You're like, I just want to sleep, man.
• 6:40
  SPEAKER_00: Just tell me how to sleep.
• 6:41
  SPEAKER_00: So let's talk about how you can optimize your sleep and safely do that with some guidance around it.
• 6:46
  SPEAKER_00: And the the thing about this is we need to talk about like what the goals are, and we need to make sure, okay, how can we make sure we go through this in a very simple fashion?
• 6:58
  SPEAKER_00: And so, with that said, we want to make sure we comply with our post op precautions, right?
• 7:03
  SPEAKER_00: The restrictions that we might have, whether that's sleeping in a brace, you might be locked into extension, there might have been some other procedure in addition to your ACL that was done.
• 7:12
  SPEAKER_00: So, with that said, like usually there are surgeons, specific precautions given to you that you might have to adhere to, right?
• 7:20
  SPEAKER_00: Some people are non-weight bearing, but there might be even specific ways to keep your knee locked in a position.
• 7:26
  SPEAKER_00: So those are things to just kind of keep in mind.
• 7:29
  SPEAKER_00: From a goal standpoint, the biggest thing here is to make sure you set yourself up for success.
• 7:34
  SPEAKER_00: We're trying to let this knee heal while giving it the TLC that it needs.
• 7:39
  SPEAKER_00: Your goal is to essentially hit like a quiet knee post stop.
• 7:44
  SPEAKER_00: And what that means is building towards full range of motion, full knee extension, getting your knee from 90 to 120 to full flexion.
• 7:53
  SPEAKER_00: Of course, this might be limited based on your precautions.
• 7:56
  SPEAKER_00: You might be having to work on your quad contraction, which is typically a very, very big goal for us with extension, minimizing pain and swelling, and then of course, getting you back to walking normally.
• 8:07
  SPEAKER_00: And those are really the big focuses, if you will, without getting bogged down in any other minor priorities that we might have.
• 8:17
  SPEAKER_00: Now, with that said, let's go through this list.
• 8:20
  SPEAKER_00: There's 10 different things that I want to talk to you guys about that I think will be super beneficial for this, and to walk you through being prepared for sleep, post op, post injury, all the things.
• 8:31
  SPEAKER_00: So you are set to go.
• 8:33
  SPEAKER_00: So you're gonna start off on your back whenever you're post op.
• 8:37
  SPEAKER_00: And of course, that's probably unlikely how most of you sleep.
• 8:41
  SPEAKER_00: I don't sleep that way.
• 8:42
  SPEAKER_00: I sleep on my side and kind of on my stomach, but that's what is recommended, that's what we recommend because it's just gonna put you in the best position.
• 8:49
  SPEAKER_00: It helps to keep the knee straight and avoid any unnecessary pressure on the incisions, keeping it in this bent state, especially if you're on your side or your stomach.
• 8:59
  SPEAKER_00: So that's why being on your back is so beneficial.
• 9:02
  SPEAKER_00: I know some people like to use the recliner, as this can help put them in a good position to elevate and to be able to lean back, um, be able to get out of the seat a little easier versus a bed.
• 9:15
  SPEAKER_00: Eventually, as the incisions heal, you'll be able to do some side sleeping.
• 9:20
  SPEAKER_00: And this might be where you sleep on your uninvolved side with a pillow in between the involved and the uninvolved leg.
• 9:27
  SPEAKER_00: So that means that your ACL operated side would be on top, your uninvolved or non-operated side would be on the bottom.
• 9:35
  SPEAKER_00: And so that's the way you would try to do that once you are in a good point, but you are typically going to be starting on your back and then eventually being able to progress towards your side if that's something you do.
• 9:47
  SPEAKER_00: And then your stomach will still take a minute just because we want to make sure we're not putting too much pressure on those incisions, everything is healed up well, and it's also not impacting too much of like your knee flexion because being on your back also helps to just naturally let gravity pull us into extension.
• 10:05
  SPEAKER_00: So then if we prop our leg up, it sets us up for success to get that extension.
• 10:10
  SPEAKER_00: Now, a question I'll always get: should I worry if my foot turns out to the side or my leg turns out to the side or bends while I sleep?
• 10:18
  SPEAKER_00: No, that is just something that can naturally happen.
• 10:21
  SPEAKER_00: Of course, if it does, just go to reposition that because your body is gonna naturally fall into a most comfortable state when we sleep.
• 10:29
  SPEAKER_00: It's kind of relaxed, right?
• 10:31
  SPEAKER_00: But when you're aware of it, correct it, see if you can get it back into a good position so it's not in a bent state.
• 10:36
  SPEAKER_00: But it's normal to do that, especially with people's different hips and just the way that they might be laying and things like that.
• 10:43
  SPEAKER_00: So I wouldn't stress too much about it.
• 10:45
  SPEAKER_00: At the end of the day, we still do need to make sure we get the sleep versus just having the perfect position to sleep in, right?
• 10:54
  SPEAKER_00: Because if you're in the perfect position but you're miserable and you can't sleep, that's almost more counteractive to what we're trying to do versus being able to let our you know foot flare out to the side or bend a little bit and get better sleep, right?
• 11:09
  SPEAKER_00: But I'm not saying we're trying to just let that knee stay in a bent position.
• 11:12
  SPEAKER_00: We're gonna try and find the sweet spot with all of it.
• 11:14
  SPEAKER_00: So position will be key here of being on your back.
• 11:18
  SPEAKER_00: And then swelling management is going to be the next point here.
• 11:23
  SPEAKER_00: So you'll want to elevate the leg, not just the pillow underneath the knee.
• 11:28
  SPEAKER_00: And that is the normal resting state that feels good for the knee.
• 11:32
  SPEAKER_00: When someone injures their knee, they actually want to keep it bent because it's a better resting state for it.
• 11:37
  SPEAKER_00: And so when you have the surgery, of course, they're gonna kind of put you straight typically.
• 11:42
  SPEAKER_00: There might be a slight bend in it, you might be locked in a brace.
• 11:45
  SPEAKER_00: Just to let you guys know, just because your brace is locked at extension at zero doesn't mean that the knee in that brace is perfectly at zero, too.
• 11:54
  SPEAKER_00: There might still be a little bend in it because those braces aren't so perfect to keep us in just perfect zero or hyperextension.
• 12:02
  SPEAKER_00: Now, with that said, that is something where the bending of the knee is gonna be super important.
• 12:07
  SPEAKER_00: We want to make sure we limit that or avoid that as much as possible.
• 12:11
  SPEAKER_00: And that's where I remember my first ACL.
• 12:15
  SPEAKER_00: Whenever I came home, I actually started putting a pillow underneath my knee because it felt great, right?
• 12:20
  SPEAKER_00: It stayed in a slightly bent position.
• 12:21
  SPEAKER_00: I was like, cool, this feels great.
• 12:23
  SPEAKER_00: And then later my PT was like, you gotta stop this because this isn't good.
• 12:27
  SPEAKER_00: It's gonna impact your extension.
• 12:29
  SPEAKER_00: And so I ended up stopping it.
• 12:31
  SPEAKER_00: It didn't feel great, but it was something that I needed to do to make sure I get my knee straight.
• 12:36
  SPEAKER_00: And so the goal here is the whole leg needs to be straight and ideally elevated above the heart.
• 12:44
  SPEAKER_00: So this is going to help a lot with the swelling.
• 14:52
  SPEAKER_00: For pillows or support, this might be using a wedge pillow or stacking pillows to be like a ramp with a comfortable incline.
• 15:00
  SPEAKER_00: Think of like a slightly inclined hill or think about a treadmill, right?
• 15:04
  SPEAKER_00: Like you can get that thing super highly inclined.
• 15:07
  SPEAKER_00: Just think about like a lightly inclined treadmill.
• 15:10
  SPEAKER_00: That's what you want to do, is just kind of get that knee above the heart.
• 15:13
  SPEAKER_00: You don't need to have it like a super steep hill where that, you know, treadmill is on like grade 15 or something.
• 15:20
  SPEAKER_00: Just think about like an easy grade treadmill, and that's kind of the incline that you want to have versus one where you're allowing like a pillow to let that knee bend, even though it's inclined, if that makes sense.
• 15:33
  SPEAKER_00: So we essentially want to make sure it's not one of those where there's the bend in the knee with the sleeper, there's just a pillow there, or it's one of those wedge pillows where there's like an incline and then it lays flat where you could just bend the knee and then the calf rests on the wedge.
• 15:50
  SPEAKER_00: Instead, what we want is it to be just essentially like a ramp, and you'll essentially want that pillow to prop your leg up where it runs from underneath the leg and underneath the knee to the calf and avoiding bending at the knee.
• 16:05
  SPEAKER_00: And I know I'm kind of like stressing this point here, but it is crazy, y'all.
• 16:09
  SPEAKER_00: The amount of people who don't know this, and then they've been sleeping like this, and they're the ones who are having difficulty getting extension back.
• 16:17
  SPEAKER_00: And this is a huge, huge player in being able to really focus on that extension early post-op.
• 16:25
  SPEAKER_00: And look, I get it.
• 16:26
  SPEAKER_00: You're gonna have some pain, and sometimes you're gonna want to put something underneath that knee.
• 16:30
  SPEAKER_00: That's okay from time to time.
• 16:32
  SPEAKER_00: Don't get me wrong to give yourself a break, but do not stay in that state.
• 16:36
  SPEAKER_00: We want to try and keep that knee as straight as we can without the cost of it being just excruciating.
• 16:42
  SPEAKER_00: If that's the case, then you know we do need to kind of find some options there.
• 16:46
  SPEAKER_00: But with that said, it's just typically a little bit of discomfort that we need to just kind of work into and have some options if it is something that really does bug you a lot.
• 16:57
  SPEAKER_00: But with that said, swelling management is going to really help get that knee extension back, get the fluid out of there, get your quads going.
• 17:04
  SPEAKER_00: Massive.
• 17:05
  SPEAKER_00: And then the other thing, too, is that you will have a wrap typically around that knee, around those surgical sites.
• 17:12
  SPEAKER_00: You might have some like gauze put down or some cover to help with any blood, and then being able to have that thing wrapped up with like an ace wrap or some type of wrap typically to cover and protect the leg, compress it a little bit.
• 17:26
  SPEAKER_00: And so what you will typically do is kind of keep that on for a little bit in that first week, and then eventually, whenever the incisions are fully healed and the scabs will not open, where you know you won't kind of you know nick them and they kind of open back up, you're gonna want to use a knee sleeve.
• 17:46
  SPEAKER_00: Now, this is not required, but this is something that I am a huge fan of because it is going to help keep compression around that knee.
• 17:54
  SPEAKER_00: And it's gonna help that knee from preventing any fluid from really building up or pushing some of it out.
• 18:02
  SPEAKER_00: So there are those stockings where you can get from your ankle all the way up to your thigh that you can get off of like Amazon or other places.
• 18:10
  SPEAKER_00: There's also these like neoprene compression sleeves that you can get for just your knee.
• 18:14
  SPEAKER_00: All those are great.
• 18:15
  SPEAKER_00: If you're like, what's the best?
• 18:17
  SPEAKER_00: The ankle to the thigh is gonna be best to really push the fluid up the system.
• 18:21
  SPEAKER_00: But the knee sleeve will also be really great, especially if you're thinking about you using that out and about.
• 18:27
  SPEAKER_00: Something that I encourage all of our ACLers to get because swelling is just something you'll deal with.
• 18:33
  SPEAKER_00: And it'll be just helpful to make sure we stay on top of that with a knee sleeve.
• 18:37
  SPEAKER_00: And we got to just make sure that the incisions are fully healed because you don't want to go messing with the scabs and opening up any wounds again.
• 18:45
  SPEAKER_00: So that'll be helpful from a swelling management standpoint, especially as you sleep, totally fine to sleep with this.
• 18:51
  SPEAKER_00: If you feel like your skin is getting irritated, then maybe just take a break from it in the night.
• 18:57
  SPEAKER_00: Um, make sure you wash this thing.
• 18:59
  SPEAKER_00: I've had some athletes where they haven't washed this thing and it smells disgusting.
• 19:04
  SPEAKER_00: And it's also like, let's not get this thing infected, right?
• 19:07
  SPEAKER_00: Let's protect these sites.
• 19:10
  SPEAKER_00: So the next thing up is pain management.
• 19:13
  SPEAKER_00: Use your pain medication as the guidance that has been given by your physician and by your ortho and follow that as needed, right?
• 19:21
  SPEAKER_00: I like to still use ice as well for this.
• 19:24
  SPEAKER_00: So, you know, 15 to 20 minutes every one to two hours during the first few days.
• 19:29
  SPEAKER_00: And as swelling and pain decreases, you can reduce the frequency to three to four times per day or as needed.
• 19:37
  SPEAKER_00: With this, some of the guidelines are make sure to use a barrier.
• 19:40
  SPEAKER_00: Don't just put like ice cold stuff like right on the incisions or on the site.
• 19:45
  SPEAKER_00: The skin will get irritated.
• 19:47
  SPEAKER_00: So make sure there's a barrier to help protect it.
• 19:49
  SPEAKER_00: Always place like a cloth or a towel between that ice pack and avoid that on directly on the skin to avoid some frostbite.
• 19:57
  SPEAKER_00: And then just make sure you monitor the skin condition.
• 19:59
  SPEAKER_00: Check for like if it's like too red or irritated, then you might need to take a break or just give it a little bit longer period of time, or maybe the barrier between needs to change.
• 20:09
  SPEAKER_00: The other thing with the pain management is that with the medication that you're taking, stay ahead of it.
• 20:16
  SPEAKER_00: Don't feel like you can just beast it and be better than it.
• 20:19
  SPEAKER_00: Just stay ahead of it because once you are in too, too much pain, you're already in a place where it's gonna have to play catch up.
• 20:26
  SPEAKER_00: Stay ahead of it, be humble.
• 20:29
  SPEAKER_00: I promise you it will be worth it.
• 20:31
  SPEAKER_00: And if it's gonna help you sleep, it is worth it.
• 20:34
  SPEAKER_00: But of course, like use your own guidance and under the guidance of your ortho and who you're working with here.
• 20:41
  SPEAKER_00: Protection is another piece here for the sleeping.
• 20:45
  SPEAKER_00: This is something that's important for the surgical sides.
• 20:48
  SPEAKER_00: Just make sure that you have some sort of wrap and and usually that gauze is on there as well to help with any blood.
• 20:54
  SPEAKER_00: And then there will be that point where you'll need that less, as I mentioned earlier, because the wounds are kind of scabbing up.
• 21:00
  SPEAKER_00: So then it might be free during the day.
• 21:03
  SPEAKER_00: Just make sure to protect the area from like the sheets or blanket, preventing any irritation or rubbing a scab off, if you will.
• 21:11
  SPEAKER_00: Because you want to let those things heal that'll allow you to start kneeling and start to just kind of progress things forward.
• 21:17
  SPEAKER_00: And last thing you want to do is be dealing with like scabs that are opening like three months post-op, right?
• 21:21
  SPEAKER_00: It's just kind of annoying, it's delaying some of the process.
• 21:25
  SPEAKER_00: So just make sure to manage and take care of those things.
• 21:28
  SPEAKER_00: Um, and then you can always wear the wrap as you sleep, the ace wrap, or maybe you might have that compression sleeve once you're in a good spot to put that on, or maybe you might put some loose clothing on to provide a protective layer between the knee and maybe the blanket or covers that you're using as well.
• 21:47
  SPEAKER_00: But you just want to kind of protect the site, take care of it.
• 21:51
  SPEAKER_00: Infection, everyone thinks that it's not gonna happen to them, but you'd be surprised the number of people it does happen to.
• 21:57
  SPEAKER_00: And so we just want to make sure we take care of this thing and do our due diligence with that.
• 22:03
  SPEAKER_00: Sleep environment.
• 22:04
  SPEAKER_00: So setting it up for success prior to surgery is really, really key.
• 22:08
  SPEAKER_00: Organize it, make sure that there's a clear path to different areas, the bathroom, getting to the kitchen if you need to, just your daily stuff, so then that way you don't have to be reactive when you get home.
• 22:20
  SPEAKER_00: And think about the side you'll sleep in if you're sleeping in a bed and getting up and out of.
• 22:25
  SPEAKER_00: It's weird.
• 22:26
  SPEAKER_00: You would think like, okay, if I have my right ACL done, I'll sleep on this side of the bed.
• 22:30
  SPEAKER_00: You'd be surprised how much convenient it is for you to have that mapped out and know, like, all right, cool.
• 22:35
  SPEAKER_00: If I have it on this side, then this is what I'm gonna do, and this is the easiest way for me to get up, roll over.
• 22:42
  SPEAKER_00: And that will just like help you so much to reduce that cognitive load and just deal with unnecessary extra movement or pain that you need to.
• 22:51
  SPEAKER_00: And then just make sure your environment is cool, it's dark, it's quiet.
• 22:55
  SPEAKER_00: You need to sleep good, man.
• 22:57
  SPEAKER_00: Get off the technology before you go to sleep.
• 23:00
  SPEAKER_00: I know you're gonna be Netflixing and you're going to be watching all the things on your phone, and you'll probably wake up at odd hours and can't sleep and feeling pain, and you'll want to use your phone.
• 23:12
  SPEAKER_00: Do what you need to do for sure.
• 23:13
  SPEAKER_00: But then if you can, establish some sort of process for yourself.
• 23:17
  SPEAKER_00: So then that way you can get into a good flow of sleep.
• 23:21
  SPEAKER_00: Some other tips that I'm gonna mention here avoid any caffeine, alcohol, nicotine before bed, especially, or if you're trying to recover.
• 23:28
  SPEAKER_00: That stuff is not good for you, especially alcohol and nicotine, as you guys probably know.
• 23:32
  SPEAKER_00: It's gonna impede the healing process.
• 23:35
  SPEAKER_00: And so let's make sure that we just set ourselves up for success here.
• 23:40
  SPEAKER_00: Don't crush a ton of water right before bed because then you'll have to get up a lot.
• 23:44
  SPEAKER_00: Just a little side note here.
• 23:46
  SPEAKER_00: We want to stay hydrated in the day, but you're also having to get up and go to the bathroom a lot.
• 23:51
  SPEAKER_00: So just be mindful of that, especially in the middle of the night, in your first few days post op.
• 23:56
  SPEAKER_00: Keep your ankle pumps going to keep good muscle pump going and blood flow going to prevent any DVTs.
• 24:03
  SPEAKER_00: When you're Surgeon gives you the go-ahead.
• 24:05
  SPEAKER_00: If you have a brace that you have to sleep in or is locked in, ditch that brace whenever you can.
• 24:12
  SPEAKER_00: That's gonna help your sleep so so much.
• 24:15
  SPEAKER_00: I promise you.
• 24:16
  SPEAKER_00: I remember as soon as I got rid of that brace for my first ACL, it was awesome because then therefore I didn't have this bulky thing that was dragging around, hitting these random like places, pressure, just felt kind of locked into that thing.
• 24:30
  SPEAKER_00: And I promise you, while you're sleeping, that brace in reality isn't really doing that much to begin with while you sleep, even quote unquote locked in that extension.
• 24:40
  SPEAKER_00: But I do understand some surgeons are big on wanting to sleep in that.
• 24:44
  SPEAKER_00: A lot of surgeons I work with here in Atlanta, for example, they don't care about it, especially with isolated ACLs or even with meniscus, for example.
• 24:53
  SPEAKER_00: They don't really care for it.
• 24:55
  SPEAKER_00: But every surgeon has their own preferences, if you will, but we have to respect that.
• 25:00
  SPEAKER_00: But with that said, we want to make sure we get out of that brace as soon as we can because that's gonna help us so much.
• 25:06
  SPEAKER_00: But it's important to follow the guidance of the surgeon with being able to do that.
• 25:11
  SPEAKER_00: And then the last thing I'll mention here is ask for help.
• 25:14
  SPEAKER_00: Don't be the hero here.
• 25:16
  SPEAKER_00: Don't feel like you can, you know, tackle all of it.
• 25:18
  SPEAKER_00: This is when you lean want to lean on your support system, have them help you and ask for help.
• 25:24
  SPEAKER_00: So I hope that that's helpful, y'all.
• 25:26
  SPEAKER_00: I did want to touch base on this and just kind of in review.
• 25:30
  SPEAKER_00: Think about your position being on your back, swelling management is going to be elevation and compression.
• 25:35
  SPEAKER_00: Do not put something underneath just your knee to help with whenever you are resting and sleeping.
• 25:41
  SPEAKER_00: Make sure it's from the back of the knee or that whole entire leg all the way towards the heel.
• 25:48
  SPEAKER_00: That way it's just that slight incline, as I had mentioned, pain management on top of pain meds and making sure you're icing, protection, just protect those incisions, keep it very healthy, keep it very clean and dry.
• 26:04
  SPEAKER_00: Sleep environment is gonna be really key here to set yourself up for success.
• 26:08
  SPEAKER_00: Avoid drugs, any caffeine, limit water volume right before bed, ankle pumps in the night, ditch the brace when you can and ask for help.
• 26:18
  SPEAKER_00: The big three from this: if you're like, all right, cool, let me take my big three, right?
• 26:23
  SPEAKER_00: Sleep on your back, keep your knees straight, elevate the leg.
• 26:27
  SPEAKER_00: That will be the biggest things here.
• 26:29
  SPEAKER_00: If you're like Robbie, shoot it to me straight.
• 26:32
  SPEAKER_00: I need this to be just very simple.
• 26:35
  SPEAKER_00: Sleep on your back, knee straight, elevate the leg, and you will be in a good spot.
• 26:41
  SPEAKER_00: So I hope this helps, guys.
• 26:42
  SPEAKER_00: I hope it helps clear up any kind of confusion you might have with sleeping, with ACL rehab, especially with being post-op.
• 26:49
  SPEAKER_00: There's always this kind of fear or anxiety.
• 26:53
  SPEAKER_00: Just know that that ACL is locked in there.
• 26:55
  SPEAKER_00: You have to do something really, really, really dumb for you to injure that knee or do something to impact the surgery.
• 27:03
  SPEAKER_00: But I know that it can be daunting, regardless.
• 27:06
  SPEAKER_00: Even if I tell you that you're just like feeling these pains, these poppings, scared to move it, you know, you can't feel your quad, all these things, right?
• 27:14
  SPEAKER_00: And trust me, I was there.
• 27:16
  SPEAKER_00: I've been there twice.
• 27:17
  SPEAKER_00: You know, all of our athletes they share similar things with us.
• 27:21
  SPEAKER_00: And so, with that said, make sure to just optimize your sleep as best as you can.
• 27:27
  SPEAKER_00: This is where you are going to make a big, big comeback in terms of the recovery process while you're doing all the extension work, all the quad stuff, flexion, getting stronger.
• 27:39
  SPEAKER_00: The sleep is going to be a huge, huge player in this to help you move forward.
• 27:44
  SPEAKER_00: Like people can be rehabbing, doing all the work, but if they're not sleeping great, they're still going to be digging themselves a hole a little bit, right?
• 27:51
  SPEAKER_00: Versus the person who's sleeping really well.
• 27:54
  SPEAKER_00: So I hope that this helps y'all.
• 27:56
  SPEAKER_00: If you need any assistance on this, if you have any questions, please reach out to me.
• 28:01
  SPEAKER_00: You can find me at ravipatel.dpt on Instagram.
• 28:05
  SPEAKER_00: You can email me.
• 28:06
  SPEAKER_00: You can find us through this site.
• 28:08
  SPEAKER_00: We have the show notes where you can contact us and find us.
• 28:11
  SPEAKER_00: Otherwise, I will catch you next time.
• 28:14
  SPEAKER_00: This is your host, Ravi Patel, signing off.