Difficulty Maintaining Activation of Hamstrings After PCL Tear

Question

You know the cringe factor that causes you to shiver or grimace when you think about fingernails on chalkboard? The flinch, the drawing back sensation-- the stability issues and gristly-cartilage noises I get in my right knee [if I haven't been working out] after my PCL tear trigger this, and my inability to 'trust' my knee, combined with 'the muscles deactivating somewhat shortly after a workout', are causing problems with me returning to full activity like 'normal walking'

The PT I went to prescribed a lot of exercises-- nearly all of which seem to be just strengthening my quads. For example, the resistance band leg exercises when I'm standing on the blue Theraband pad just seem to strengthen my quads in a manner that provides stability by making the leg a pillar, rather than strengthening the stabilizing muscles you use when reflexively maintaining balance.

My best luck so far? High intensity deadlifts/squats. However, after I've got them activated, I don't seem to be able to maintain normal use. So much as thinking about the instability causes me to flinch in fear and fall back into planting and directing my steps with my left leg. It's also really hard to do the exercises every day-- feels very machine-like and lifeless.

So I need some way to get the muscles activated, strengthened, and keep them activated.

I feel like I'm forgetting how to walk 'normally'.

Answer 1

I'm not sure if this is the best answer for you, but from my own experiences I'd recommend three exercises that I've really found terrific:

Single leg Romanian deadlifts. Long name, lots of radness. In particular I like it because it tends to quickly isolate and showcase imbalances. There's a lot of "little" muscles working in order to pull this lift off. Nail the form before you crank up the weight: even just doing it unweighted is a challenge for most people.

Good mornings. I see no need to go heavy on these. 1/3 of your 5RM squat weight would be plenty as a top end, and I'd work up slowly to get to that. Empty bar, then a bar with some 10's, etc. These will give you wicked DOMS, as the eccentric portion of the exercise is pronounced.

Pistol squats. These are tough, but you can use step ups as a way to bridge into them.

The pistols and the single leg deadlifts require a lot of single leg strength, coordination, and balance. I've never had your injury but I've had others, and if I'm able to do both of those things well I'm in top form. The good mornings are good for hamstring strength in general, but honestly it sounds like you'd benefit more from the single leg versions where recruitment shoots up and you're really forcing each leg to (pardon the pun) stand on its own.