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The Molinjir 03-02-2005 08:35 PM

Torn Medial Meniscus
 
I just recently tore my medial meniscus, an injury which is apparently quite rare for kids my age (12, within a week of 13), but as I just experienced a large growth spurt, (6 inches or so in the past 9 months), so apparently my chances were higher.
Now the issue is that I am banned from all activities strenuous on my knee (Fencing, Aikido, Soccer etc.) What can I do to keep myself limber? Does Aikido really affect my knees enough to be a problem? Is it possible that I tore it in Aikido?

Thanks in advance,

Paul

Aardvark 03-02-2005 10:48 PM

Re: Torn Medial Meniscus
 
G'day Paul

I have gammy knees, too, and while aikido made them worse for a while, after a few months it actually started to make them better. Obviously I dont know as much as you do about your injury or what your doctors have told you, but I can think of a few things that helped me out a lot.

1. Stretch - if you do stretches before class, you can do those at home too. Keep within your comfort range and do not push too far...your tissues will stretch rather than tear, and help keep you loose and limber.

2. Oneness Rhythm Exercises - only takes a few minutes, not stressful on your body, and a great way to improve your aikido if you cant go to class.

3. Ki Therapy - even if you can't extend too much ki yet, simply touching and pressing gently (no more pressure than if you were holding a pencil or piece of paper against your skin) around your kneecap, the muscles on either side of your knee, and the 2 soft "dimples" at each side of the bottom of your knee cap can help immensely. A few minutes each day should help

4. Seiza - Sitting in the seiza position will help strengthen the muscles of your knees and legs, taking some of the load away from the joint. No need to push it - just try to sit for as long as it is comfortable. This helped very much for my knees, but it may be no good for your condition, so if you do try it, play it by ear.

At the end of the day, whatever you're doing - if its hurting you, you should probably stop or slow down. Your body can take a lot more than you might think, just dont push him too far too fast :)

Its very possible that you hurt your knee in aikido. Aikido can be very hard on the knees, but that doesn't mean you have to stop - your sensei or senior students may have some ideas about how you can manage or strengthen your knees for training.

Good luck!

Aaron

Janet Rosen 03-02-2005 11:46 PM

Re: Torn Medial Meniscus
 
A person with a torn meniscus should NOT go into seiza according to every orthopedist, rehab nurse, and PT I've talked with. Seiza is hyperflexion of the joint and places shearing stress on the mensiscus.

I will not advise a non-adult on return to training but WILL say that you need to follow the advice of your sports medicine doctor/athletic trainer.
Aikido is a high risk knee activity.

philipsmith 03-03-2005 04:50 AM

Re: Torn Medial Meniscus
 
As a Physical Therapist of over 20 years experience I totally agree with Janet. I also suffered a torn medial meniscus in Aikido.

Important points:

Keep the thigh muscle strong through non weight-bearing exercises such as cycling or swimming.
DO NOT hyperflex or rotate the knee so no Seiza or Shikko.
Consult an orthopaedic surgeon as it may need to be removed (mine had to be)

Take time for it to heal. At your age tissue is still growing BUT cartilage takes 3 - 6 MONTHS to heal.

Finally be patient.

Don 03-03-2005 04:00 PM

Re: Torn Medial Meniscus
 
Three to six months to heal....

I have a tear on my lateral meniscus (outside) and I'm supposed to get the torn part taken out on Monday. Now, the doc says its on the very outside (you must really have to know what you are looking for in those MRI's) and shouldn't be a problem. He stated I should be completely back to normal (sans a piece of meniscus) in 3 weeks to a month. I regularly swim, do starimaster and do weights at the Y and feel my quads and hamstrings are okay. Your statement about cartilidge taking three to six months was for a meniscal REPAIR I hope, and not removing a torn piece. Otherwise I have a lot of rethinking to do about this.

philipsmith 03-04-2005 04:11 AM

Re: Torn Medial Meniscus
 
Don,

Don't panic. Medial menisci are larger and take more pressure than laterals. Also the outer margins of menisci heal much more quickly than the central portions. 3 - 6 months should allow natural healing i.e. without surgical intervention which is (in my opinion) preferable for a teenager as if the tissue is removed at that age it can often induce early arthritis of the joint.

For us more elderly types (once we've finished growing) surgical removal is often the best option because it heals more quickly.

The Molinjir 03-05-2005 05:32 PM

Re: Torn Medial Meniscus
 
Update for my knee:

I apparently have some rare condition, so that the meniscus is not attached properly or something...

Anyway, I am doomed to surgery now... and I was told I may not be able to do Aikido again..

aikidoc 03-05-2005 09:39 PM

Re: Torn Medial Meniscus
 
Have torn the medial meniscus in both knees. One I had surgery on 11 years ago and am still doing aikido on it-it does real good. The other is still torn and stiffens and sometimes hurts if I do too much knee work. I'm hanging on it as long as I can (lose the cartilage = knee replacement later). I had a hyalgan injection and that helped a lot. The general mechanism for injury of the medial meniscus is hyperflexion with external rotation of the foot. That's how I did the first one-tumbing handspring when I was a kid. Aikido aggravated it so I had it snipped. I also had a plicae which is what you may be referring to-not sure. Anyway, I just try to avoid a lot of knee work-sometimes I have good days and sometimes it gives me trouble.

Nikopol 03-06-2005 09:00 AM

Re: Torn Medial Meniscus
 
I had part of my meniscus removed two years ago. It actually let go during Aikido but the cartilage in my case had been damaged previously according to the doc. The meniscectomy is an arthroscopic surgery done through two little holes, they pump air in to make room and go in and suture the cartilage if there is blood supply to both pieces. In my case there wasn't so I had the torn bit removed and the remainder smoothed off. I lost half of the medial, so a quarter of the knee's support. This surgery was done in Tokyo by a good sports doctor and didn't cost much with national health insurance.

I was concerned mostly about being able to play soccer again. Well, since the tear I had been using a cane, and I used that for about a month after the operation. The doctor was sure I would play soccer again, and he was very helpful. First of all, he wanted me to start walking the day after the operation, with the cane at first. It is important to keep flexibility. If you don't move it through it's full range you could lose range of movement permanently. First, heat is very important for flexibility. I took many hot baths and slowly worked back to seiza in the bath and whirlpool (not seizaho!; use your arms to slowly lower yourself down as far as it is comfortable. The water will support your weight. Not all at once! Rome wasn't built in a day.) . Little by little the pain subsided, it took about a year before I could really do seiza. I went back to football with a supporter. Get a supporter for the interim.

See Aaron's post - stretch, massaging as you go. And Phillip is spot on about cycling... which I also did to strengthen the muscles without impact on the knees. (Use low gears, take it slow.)

Nutritionally, it may surprise you or not, but to rebuild cartilage, the doctor recommended eating... cartilage,,, nankotsu to be exact which is chicken cartilage often eaten fried here with mayonnaise, and quite tasty. The other thing is jello.. gelatin which is actually made of the same stuff. As a supplement you want to take glucosamine and Chondroitin daily. These are made to promote blood flow in the joints and rebuild cartilage.

Aikido , especially suwariwaza (what did me!) is very strenuous on the knees, but once you have that treated and recuperate (could be a year), you can go back to Aikido

BUT when you DO:

Always warm-up and stretch! Neglect neither. Keep at the hot baths, especially on cold days if you feel stiffness. ... do seiza in the tub... , always get to the mat a half hour before your practice so you can stretch out slowly. Do your own stretches... your needs are different and you know that best, don't just do the standard warm up. Don't train when fatigued; If you go in without proper muscular support you will be at a risk for injury. Be careful with ukemi. Practice ukemi SLOWLY and ALONE; getting up after an Ukemi is as bad as suwariwaza, be sure you are ready and when you are sure, be mindful: take it slow and carefully. If your knee gives you trouble.. any pops, clicks, or pain, STOP. You have to concentrate, and respect your knees and your temporary limitations. Bow out of suwariwaza and explain to your sensei for a while. If your partner is using too much force, it is best here as well to stop and mention it to him.

Eat well, rest well, stretch. I am now playing soccer on a team, coaching and refereeing (I reffed a game this morning) and going to Aikido three times a week, I stopped using the knee supporters a few months ago. Remember to strengthen, rebuild and respect, and Aikido can keep this from happening again.

And you're young so you will heal quickly. Accept the 'ban' for now, but keep working on mobility (gently) and strength (slowly) with an eye towards full recovery and return to Aikido.

Nikopol 03-06-2005 10:34 AM

Re: Torn Medial Meniscus
 
Quote:

John Riggs wrote:
The other is still torn and stiffens and sometimes hurts if I do too much knee work. I'm hanging on it as long as I can (lose the cartilage = knee replacement later).

Sorry my posts are so long. John - a knee replacement is not neccessary after partial removal of the meniscus. It can regenerate to some extent, proper support through good muscle condition will help minimize arthritis.

As I said it's often possible to suture. If a piece of torn meniscus gets pressed in the joint you will have lots of pain and greater damage.
The doctor is going to smooth the rough bits to prevent that.

If you are going to get it done, do it sooner. It is like driving on a flat tire. Take your doctor's advice.

aikidoc 03-06-2005 09:35 PM

Re: Torn Medial Meniscus
 
I did not detail the severity of mine. I did not just crack the edge. I split the medial in half and part of the lateral. If they snip this one it is half the cartilage, plus part of the lateral.

Nikopol 03-07-2005 01:57 AM

Re: Torn Medial Meniscus
 
if it's split in half you should have the best chance of having blood vessels on each side. it's the edges that tend to get snipped. what I said before still applies, an improperly seated piece of meniscus can find it's way between the bones where it will get mashed beyond repair.

Didn't your doctor suggest you have it sutured and then trim the lateral? Of course they don't know what they can do until they go in but a good sports physician wouldn't be telling you to work out on severed cartilage. Maybe you need to get a second opinion.


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