[Nathan]

Updated rehab for next 7-10 days

This is your next 7–10 days. We’re sticking to the A/B split to manage volume and keep the knee calm.

Main focus:

• Build knee bend gradually (90–110°)
• Keep full extension
• Improve walking
• Add small amounts of load
• No swelling spikes
⸻

DAY A – LOAD DAY

2–3 short walks (3–5 mins)

⸻

Morning

• Ankle pumps – 20–30
• Ankle circles – 10 each way
• Heel prop / extension – 2 × 60–90 sec
• Quad sets – 2 × 10
• SLR (IR / ER bias banded) – 2 × 8
• https://youtu.be/U3qRc1NfOrM?si=5d8W3bNaJwfRT_ZO⁠
• TKEs – 2 × 12–15

⸻

Midday (main session)

Flexion (pick one)

• Heel slides (seated OR lying) – 3 × 6–8
• 2–3 sec hold

Foot

• Pronation reps – 2 × 8–10

Strength

• Sit-to-stand – 3 × 5–6
(heel → midfoot → big toe, just touch chair, 3s down)

• Step-ups – 3 × 4–6
(midfoot, control the way down)

Hip

• Standing abduction – 2 × 10
• Standing extension – 2 × 10

Optional

• Bike – 5 mins (light)

⸻

Evening

• Heel prop – 1–2 × 60 sec
• Quad sets – 1–2 × 10

⸻

DAY B – RESTORE DAY (+ GYM)

2–3 short walks (slightly easier than Day A)

⸻

Morning

• Ankle pumps – 20–30
• Heel prop – 2 × 60–90 sec
• Quad sets – 2 × 10
• TKEs – 2 × 12

• Pelvic tilts – 2 × 8–10

⸻

Midday

Flexion (one only)

• Heel slides (seated OR lying)– 2 × 6–8
• 2–3 sec hold

• Adductor pullback – 1–2 sets (you can add in a foam roller, pelvic floor ball, as you get better at controlling the knee we can remove support)

https://youtu.be/YyW5VUS27vc?si=BHeWPzGkpHRecqWv

• ⁠• 90/90 knee rolls – 1–2 × 6 each side (staying in this position, allow gravity to assist in the knee flexion)

https://youtube.com/shorts/wckmwWP2G_I?si=2L-E3o2OxwPJyq2t

• Pronation reps – 2 × 8

Hip

• Side-lying abduction – 2 × 10–12

Control

• Weight shifts – 4–5 × 10 sec

Optional

• Bike – 5 mins easy

⸻

Gym (upper only)

• Seated work
• No leg drive
• Keep it controlled

⸻

Evening

• Heel prop – 1–2 sets

⸻

PROGRESSION OVER THE 7–10 DAYS

We’re not adding loads — just improving quality.

Sit-to-stand
• Slightly increase depth
• Reduce hand support
• Keep 3 sec control down

Step-ups
• Improve control on the way down
• Don’t rush
• Only increase height if very clean

Walking
• Move toward 1 crutch
• Then no crutch indoors if no limp on 1 crutch

Bike
• Build to 5

⸻

NON-NEGOTIABLES

• No swelling increase next morning
• Keep full extension
• No limp when walking
• Quality over volume

IMPORTANT REMINDER

Don’t be fooled by how good it feels.

You’re in the phase where:

• graft is actually weaker than at surgery
• body is rebuilding it
• load tolerance is improving, but still limited

So we stay patient and build it properly.

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[Nathan]

This will vary a lot……

Anything from 6-20 reps for me depending on the exercise.

Most upper compounds 6-9
Upper isolation 10-15

Lower compounds 8-20
Lower isolations 12-20

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[Nathan]

This is very common bud. Depending on your dose it might be worth split your dose.

Sub Q pre bed and IM preWO

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[Nathan]

Exactly the same as the guys here use the best I can and keep it consistent all the way through

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[Nathan]

Really felt today I stepped forward a touch more with my strength as one crutch felt more stable and easier, my flexion felt better. Still a long way to go but when you have a day where you can clearly tell you have moved forward abitit builds a little more confidence. Like 2 days ago I wasn’t confident I would be off crutches by week 7-8 but now today I am,

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[Nathan]

The days are racking up. It’s slow, its repetitive, it’s frustrating, it’s still panful, I still don’t have loads of flexion. Still swollen but I’m working. And it’s improving slowly. I’m aiming to be off my crutches by week 8 I’m in to 1 crutch for half of the day in the house. Coming up to week 5 so I have 3 more weeks as a goal to build tolerance and strength so I can be crutch free.

I’d like to light bike work by then too. But again we shall see how things progress. What’s the scar tissue and swelling goes down I will have more ROM. Just patience

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[Nathan]

I think 12iu GH is plenty enough IGF-LR3 for a 6-8 week block would be something to trial for yourself and see if you get a nice response.

PWO for me would be the way to go. But pre has been argued also due to half life. But I would prefer PWO into the trained muscle. Be aware of hypoglycaemia risks so 100% have your PWO ready to eat

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[Nathan]

Agreed

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[Nathan]

Busy day today and my knee is feeling it. In person check in and pull then physio and jus a long day having my leg down. Which means by the end of the day it’s very sore and swollen. So a couple of days trying to freshen up reduce swelling. And just take it steady and not rush

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[Nathan]

Trained push today which was great to be fair.

Low incline smith x 3
Flat machine press x 3
Shoulder press x 2
Pec dec x 3
SA cuff lateral x 2
Tricep push down x 3

I can’t plant my feet and brace hard into the floor. So loading isn’t crazy. I’m also very de trained and feel very natty. It’s going to take some work getting back into the groove with everything. But once I’m more capable I will start ramping things up from an assistance point of view too

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[Nathan]

Exactly 👍

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[Nathan]

Hey bud so before you start chasing LH and FSH numbers on bloodwork you need to understand that that won’t give you an accurate picture of fertility at all.

Because you are taking HCG, which is exogenous LH, and HMG, which contains exogenous FSH, your bloodwork is going to show elevated or present LH and FSH regardless of what your body is actually producing naturally. Sometimes it doesn’t even show on bloods either. Because it’s not bioidentical. So sometimes doesn’t flag even if the protocol is working.

The only meaningful marker here is another sperm test and the timing of that matters.

A full sperm maturation cycle takes approximately 74 days from the point where a sperm cell is first produced to the point where it is fully mature and present in an ejaculate. I’d give it about 2 weeks after that so around 90 days from when you started the HCG and HMG protocol before a repeat sperm analysis is going to give you meaningful data on whether it is working.

Testing earlier than that is not going to tell you anything useful and chasing LH and FSH numbers on bloodwork whilst running exogenous versions of both is misleading.

Stay the course with the protocol, give it the full 90 days minimum, and then repeat the sperm test. That is the only result that actually matters here.​​​​​​​​​​​​​​​​

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[Nathan]

A little more progress with flexion today so I’m happy even though it’s still very slow. Going to train locally tomorrow push. When I’ve done my check ins and round 1 rehab. I’m just very much looking forward to getting off crutches over the next 4 weeks and having some independence

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[Nathan]

I like COR fridged overnight texture is good 👍

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[Nathan]

Knees a little sore today after a solid day of rehab and another session in the gym. I’ve done more walking today and the leg/knee feels a little fatigued.

I am progressing still daily as I should it’s still frustrating, but that because I want more progress. Quicker than I want but I know I can’t force it.

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