View Full Version : Rupture of cruciate ligament, surgery & training
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09-13-2009, 04:43 AM
Wednesday I had knee surgery because I got a rupture of the cruciate ligament in my left knee due to a wrong movement when doing irimi nage ura. Everything went well, I can walk and cycle as before (albeit slower and with much caution) and don't feel really handicapped. They gave me some crutches in the hospital but I put them into a corner in a room and forgot about them. On Tuesday I'll take up rehabilitation exercices.
Yesterday I went to the dojo to WATCH my kids' class and felt a horrible urge to step onto the mat to which I resisted heroically. I did some research on knee surgery and aikido and found very different results. There are people who re-start to train after some weeks, there are others who take a break between 9 and 12 months, and there are others who never take it up again because they don't arrive anymore to sit in seiza, to take ukemi etc.
In the leaflet they gave me at the hospital there are some general remarks, but they are more about competition sports. But when I come to a general conclusion I understand that after 3 months you FEEL perfectly well again, can move as before, got back your muscles and agility BUT the transplant is still not yet well enough stabilised and when doing breakfalls or violent tai sabaki/ tenkan it might tear again.
Did any of you experience the same accident? I suppose it is common among aikidoka. And what about surgery and the time for recovery? How long had you to wait before taking up aikido again?
Thanks a lot in advance for sharing your experiences!
I don't have any medical advice, but wanted to wish you a speedy and full recovery. Please have patience before restarting your training, and please take care during your rehabilitation process.
09-13-2009, 09:35 AM
...and listen to what your doctors tell you... :o
09-13-2009, 09:55 AM
I had my right ACL repaired....it ruptured many years ago (before I began aikido). About five years into aikido I was having my miniscus shaved as that was "flappy" too (my knee would lock in flexion) and the surgeon said I had no ACL left at all. I had the ACL surgery done later. He used a some muscle fiber from my hamstring to fashion another ACL. Drilled a hole in my femur and tibia, ran the "new" ACL through and stapled it at both ends.....Bottom line was I was off the mats for six months. He told me it could be six to nine months. If your quadraceps are in any way atrophied after the surgery then you must make sure you rehabilitate them so they support your knee before you get back on the mats. I was very zealous about my physiotherapy because my aikido "career" was riding on the surgery working out. Once I had full range of motion again I went at the stairmaster and the stationary bike really hard. I was in a dojo that was in a community center so I was able to go to the gym while my wife went to train. It worked out well. I came back to the dojo stronger than when I left and to this date (the surgery was 1998) it feels really good (I get a twinge once in awhile). The lesson, I think, is listen to your surgeon, your physiotherapist and commit to your rehabilitation. Ten years from now you'll be looking back and thinking six months off was only a short time and it was worth it!
09-13-2009, 12:55 PM
Eva, I'm an oldtimer from this and did a lot of research. In terms of post op rehab, every surgeon has his preferred protocol based on variables including the type of graft tissue used, how the graft was attached, and his own experiences with post op patients. So follow YOUR surgeon's advice.
In general terms, the initial and safe and essential work is reducing swell and restoration of normal range of motion in the knee (restoring flexion and extension) - typical rehab activities, under guidance of a physical therapist might include stationary biking, straight line (no torquing) quad and hamstring strengthening, plus very careful stretching for range of motion.
Later on - number of months vary per surgeon - lateral "cutting" movements are added plus plyometrics to get balance, proprioception, and pivoting skills back once the graft has healed adequately AND the strength and range of motion have been brought up to par.
Your "training" now is to do the rehab as best and fully you can, month after month; I also recommend showing up at the dojo to watch classes. But I strongly caution against trying to get on the mats early by "doing less" or "being careful" - until the doc clears you, its not worth it.
09-13-2009, 12:58 PM
And BTW, there is no reason to stop doing aikido because you can't go into seiza.
09-13-2009, 02:29 PM
All I can say is don't rush it. I had ankle surgery last summer and missed over half of my senior swim season recovering, but its worth it now. Just be very, very patient. You'll be quite glad you did when you do get back out there. Best of luck!
09-13-2009, 02:42 PM
My knee surgery was not as significant-just torn posterior horn of the medial meniscus. I was off the mat 29 days. Took about 3 months before I could get all the way down in seiza. I also wore a knee brace for some time-probably more mental than actually needed. Rehab is absolutely essential. Depending on the surgeon, a knee brace might be indicated since cruciates stabilize forward or backward translation depending on which one you tore. I still try to avoid a lot of suwariwaza.
09-13-2009, 02:43 PM
P.S. I did a lot of standing weapons work during the 29 days off the mat with the knee braced.
09-13-2009, 03:00 PM
As others have said - be patient.
My perspective is from the "train through the pain" school - back in the teens and 20s, injuries seemed to heal and I could return to training and competition pretty quickly. Now, however, that ankle is always sore, the neck is always sore. The crushed T12 (landed poorly after a missed handstand on parallel bars) from which I started back judo training only a week later, the right hip, the neck, the shoulder - all hurt, most of the time. Sometimes I wonder why I'm not really grumpy all the time.
Take your time - 6 months and even a year off to recover and rebuild from surgery will give you a better chance to return stronger and fitter than when you got injured, and when you get old, you will be less like a "walking wound" (or walking wounded) and more like a free-moving agile person who doesn't limp during aikido practice...
09-13-2009, 10:00 PM
Just an fyi, by husband and my sensei can't really get into seiza. Hasn't really affected their training at all. My husband works from suwariwaza until he gets uncomfortable and then he is allowed to stand. Good luck and I wish you a speedy recovery. :)
09-14-2009, 02:20 AM
thanks a lot for your many and very useful replies!!!
I'll see the rehab people tomorrow; let's see what they say. But I slowly progress towards making peace with 6 months off the mat.
Great idea to practice weapons standing, although I don't see that I'd be able to do much more than suburi...for kata you always need tai sabaki and tenkan, which are the worst enemies of the transplant, as far as I understood. So it will be watching.
Have all a nice day!
09-14-2009, 04:53 AM
please don't tenkan yet!
09-14-2009, 08:31 AM
As I sit at my computer with my de-rotational knee brace itching like the dickens...
Take your time. I partially tore the ACL on my right knee (in addition to a handful of other minor problems in the knee all combining) a number of years ago. I was in that wonderful place where the doctors (yes, I got 3 opinions) couldn't agree as to whether surgery was necessary or best. I went conservative and spent a *lot* of time in physical therapy. I got a very good custom brace (which I spent a long time battling insurance over -- they would have covered the brace automatically if I'd had the expensive surgery, but since I didn't they didn't want to pay for the brace while I let nature handle it -- in other words, they would have covered massively expensive surgery and PT including a brace afterwards but didn't want to cover the brace if I skipped the expensive surgery aspect -- the "rules" just didnt' cover the concept). But I digress... Lots of good advice in this thread -- the most important bit being listening to your doctor and physical therapist. I eased back in. I listened to my body. and that knee is now a lot better. Unfortunately I injured my other knee very recently doing what seems to be essentially the same thing. This time around I got a non-custom-molded brace from Don Joy that is almost as good as my expensive custom brace for a lot less money and zero irritation from the insurance company. And while my new injury is apparently quite minor, the first thing I did was schedule myself a few weeks of coverage for my classes so I could sit out for a while.
But... Bottom line is take it easy. Take the time to let your knee to heal. Move in gradually, pay attention to your body's signals, and keep up a good relationship with the person doing your PT. And tell them what you're doing -- explain the movements, show them, and let them help you. Don't endanger the rest of your training life for a few weeks or months of training now. Later on down the line you will be glad you took the time to heal correctly.
09-14-2009, 09:07 AM
Bottom line here,
Physical therapy like a maniac.
When your Dr. tells you its ok, rehab, rehab, rehab.
December I had a total knee replacement, and I my ukemi is just fine.
Good luck !
09-14-2009, 12:32 PM
I tore my ACL maybe about 10 or 11 years ago. The surgery went well and I was young and fit. I was off the mat about 3 months, and limited in my movement about 3 months. Rehab was key to building back leg strength, felixibility, and balance.
09-14-2009, 02:34 PM
And BTW, there is no reason to stop doing aikido because you can't go into seiza.
True statement. One of my teachers cant go into seiza at all and does not, as far as I know, take Ukemi anymore but he is one amazing teacher and he can throw us young'uns around just fine. ;)
I have some knee issues that slow me down occasionally but I jsut do what I can and know and aknowlage my limits.
Be careful with your recovery and rehab. If you want it bad enough nothing is impossible. :)
09-14-2009, 07:12 PM
I tore my ACL a couple years back. I'm relatively young and very active and my recovery time was fairly long. While I could walk (with crutches) and do physical therapy as soon as the anesthesia wore off, it was about 3 months before I was allowed to run, and about 7 months before I was allowed to do pivoting or cutting motions. My surgeon did not want me doing that without a brace, and didn't fit the brace until my leg muscle strength/size was back to within 10% of my good leg.
All in all, it was nearly a year before I could get back on the mat. A very long year. And even after that, it was a long process - there was a lot to relearn and it also too a while for the mental block of worrying about my knee to go away. Shikko and suwariwaza were the hardest to get back to.
So be prepared for a long journey. And definitely listen to the doctors - it is true that after about 3 months your leg will feel okay, but it's not a good idea to go back to martial arts until you get the okay.
On the plus side, by about two years after my injury, I'm back to 100%. I'm training for a marathon, biked over 100 miles yesterday, and do Aikido a couple nights a week and my knee doesn't bother me at all. It does feel a little weird when it rains or the weather changes, but that's not limiting.
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