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Caio 02-20-2005 11:43 AM

Knee Surgery
 
I just came back from the doctor after twisting my knee during practice.
My anterior cruciate ligament is rupted and I'll need reconstruction surgery.
The doctor told me that if I want to practice aikido again I'll have to do that otherwise my knee will be unstable and there will be a risk of bigger damage in other parts of it.
Does anyone in this forum had this kind of surgery? And what were the results?

Thanks a lot!

Janet Rosen 02-20-2005 10:58 PM

Re: Knee Surgery
 
Caio, please have a look at my webpage
http://www.zanshinart.com/Aikido/AikiKnee.html
I have just sent a long email to somebody and I'll copy and paste it here in a moment.
Feel free also to contact me anytime before or after surgery at sfcolor@yahoo.com

Janet Rosen 02-20-2005 11:07 PM

Re: Knee Surgery
 
February 2005 knee updating

I had the allograft, so the procedure and healing/rehab are different if you have a graft from your own body
The postop priorities (beyond pain and infection control) are decrease swelling; minimize scar tissue formation; return knee joint to normal range of motion; return to required strength, balance and function. For swelling, elevation ABOVE THE HEART, for some reason is something folks seem to scrimp on. Puttin yer leg up on the couch ain't enough!!! You need to lie on the couch and stack pillows under your leg. Ice of course is a big help, and should be used whenever swelling returns. I found, as did my friend w/ the patellar graft, once we were cleared for stationary bike use, that not only was it the best way to remobilize for range of motion, but it seemed to get the swelling down. Icing before and after is helpful.
For minimizing scar tissue, there are a couple of basic hands-on things your P.T. can teach you. I will NOT tell you what they are because I have no idea whether or not there is a time that is too early to start doing them. But whenever you next see your P.T., if she has not said anything about it, ASK.
For range of motion, it is initially the swelling that is interfering, and as the swelling goes down, the stiffness and weakness. Before you are cleared for the stationary bike, you can just move the leg about in bed, or while standing on crutches. The stationary bike is wonderful to get the process started, and once you are getting some good results, the P.T. can decide if you need additional stretching work using rubber stretch bands to work against.
A proper full rehab program for an active, athletic person should not just focus on strengthening, but on balance and proprioception as well. I felt a little shortchanged at Kaiser, in that I was TAUGHT the rudiments of those things, but had few at home tools adequate to the task, and they would not let me keep coming once they had taught me the requisite scheduled postop knee class.
should have spent the money to join a gym. At the time, I had decided to stop working as a nurse, and was en route to being partly self-employed/partly part time employed, and did not want to spend the money. It was a foolish decision in the long run. Penny wise and pound foolish. The at home regimen without machines and without a clear time limit simply did not do the job. I shortchanged myself and paid for it with a leg that, once I had healed enough to be cleared for return to training, was not as strong and balanced as it could have been, and I've sustained some damage since then. The graft is intact, stretched a bit (though I do tend to laxity in a lot of my ligaments, so hard to say), but there is just enough functional instability that I've redamaged the meniscus to some degree at least a couple of time and I do have some pain along the tibial plateau most days I am active--even taking a good long walk--and standing still for over 1/2 hr makes the knee very stiff and achy. I blame myself for this and hold it up as an object lesson for anybody who asks!
What I'm doing now is seeing a Pilates rehab specialist who is working with me, first correcting all the little imbalances in gait and posture I've developed to live with the painful knee, then on an overall regimen. My goal is to improve the whole body's structure/function in order to keep doing aikido and avoid further arthroscopy until sometime in a remote future.

Janet Rosen 02-20-2005 11:12 PM

Re: Knee Surgery
 
I will add that there are professional soccer players out there who continue to play having blown out their acl's. They are highly conditioned athletes, with more muscle strength and dynamic coordination than most aikidoka, so that even though they don't have actual acl's, they are functionally stable.
It is not unheard of for people who dance or do aikido to be able to achieve this stability without surgery. I have trained with one such person.
So if a person really is opposed to surgery, is functionally stable enough to do sedentary "activities of daily living" for a while, and is really motivated, it is theoretically an option to defer surgery and give all-out athletic training aimed at acheiving a functional knee a chance to work. I would NOT recommend going this route without the solid ongoing support of a properly trained and certified rehab person/athletic trainer.

mouse7000 02-21-2005 12:41 AM

Re: Knee Surgery
 
Hi Caio,
Sorry to hear about your injury. I tore my ACL in June, but didn't have the replacement surgery until December. I had a patellar autograft done which I am very happy with. My knee feels more stable and I am able to bend it without being in pain more so 2 months post surgery than I was able to 5 months after my injury but before surgery. My Surgeon said that I shouldn't return to Aikido for at least a year, which I am ok with.

However, as Janet said, there are people out there who are training without acl's who haven't had problems. I would guess the reason he suggested you have replacement surgery is because you are at a higher risk for meniscus damage/tears which can be very painful and cause instability. You are also at a higher risk for arthritis. Whether you have surgery or not you will still need to keep those knee muscles strong.



Just a few things to add to Janets post- If you do decide to have surgery make sure your doctor does ACL's and has a good record for success. make sure you feel comfortable asking him questions and that he takes the time to answer them. Ask him about pre surgery physical therapy. It might be frustrating to work hard to build your knee strength up only to have surgery and have to start all over again, but it will make your recovery smoother and hopefully quicker.

Follow thier instructions- allow your body time to heal, don't push yourself faster than what they say because it may result in problems down the road, however if you do have surgery you are in for a long rehab process so stick with it. It will pay off.

If you have any questions feel free to email me at mouse7000@msn.com. You can also check out my weekly acl diary at http://home.comcast.net/~mouse7000 It might give you a general idea about recovery times. I have learned to appreciate the small "baby" steps. Obviously I havent returned to Aikido yet, but i plan on it and am working towards it. Right now I am able to hold a few of the stances, lunges etc for 30 seconds-1 minute but no twisting or turning yet.
Good Luck!

Michelle

Caio 02-21-2005 08:12 AM

Re: Knee Surgery
 
Thanks a lot guys! I only went to one knee specialist and I want to see at least 2 before doing anything. The way I feel, it's going to be hard for me to get back to practice with athletic training only, although I'm really ok for the daily routine. I walk, drive, go up and down the stairs and even run small distances without much pain. I cannot sit in seiza though. I'm afraid to go back to aikido and get a bigger injury.
I'm not afraid of the surgery, I just want to feel confident to get back on the mat. I'm 34 by the way.

Thanks again, I'll keep you posted!

Janet Rosen 02-21-2005 10:41 AM

Re: Knee Surgery
 
You should definitely NOT go into seiza as you will only rip your meniscus to threads.
I frankly have doubts whether anybody who has had a serious knee injury should ever go back into seiza, but have no research to back me up. Orthopedists, rehab RNs, and PTs and pysical trainers I've talked with have tended to agree however....

Stone 02-21-2005 12:54 PM

Re: Knee Surgery
 
I had surgery last summer to remove a torn meniscus in my left knee. My knee is nearly 100% now however, I was able to sit in seiza prior to the knee surgery (although somewhat painfully) and now it seems physically impossible to sit in seiza. There is something in there still pinching. That is the only thing I cannot do right now and I'm wondering if I ever will again.

Janet Rosen 02-21-2005 04:12 PM

Re: Knee Surgery
 
Why would you want to sit in seiza, when it is a position known to have the potential to shear off peices of the meniscus?

Caio 02-21-2005 05:48 PM

Re: Knee Surgery
 
Probably I'll just seat with my legs crossed.

But what about shikko and suwari waza??

Janet Rosen 02-21-2005 06:17 PM

Re: Knee Surgery
 
You should follow your own doctor and PT recommendations on this.
Personally, I don't do any seated technique anymore, period. My ability to train for the rest of my life is more important to me than my ability to do any particular form or technique.
And I've seen too many folks with decades more yrs in the art than I have repeatedly do the same thing over and over and go back for more and more surgery. Better to learn from others than to do it to ourselves, I think.


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