Training for the Knife (surgery)

[origami_itto]

So I've gotten a preliminary diagnosis on my ten year old knee injury and will have a prognosis once I get in to the MRI place and have a couple pictures taken.

Looks like it IS, in fact, a torn ACL. Professional treatment for which I so far received nothing but pain pills.

I got myself walking again using Taijiquan fundamental movements, but then didn't explicitly train for about seven years, at which point (about three years ago now) I took up the practice again.

Mostly I've been doing well, but I have re-injured it (well, the surrounding tissue) every three to six months or so since resuming training and push hands and can't put off the surgery any longer unless I want to replace the joint, too.

So the surgery itself involves cutting tendons from the hamstring, drilling holes in the tibia and femur, pulling the hamstring tendons through the holes, and screwing them in place.

Recovery averages from what I can read about is about 3 weeks to put weight on it, 10 weeks before you are past the risk of it rupturing, six months before you're back to light activity, nine before you can go back to full activity and about a year before you're completely back to normal.

Pre-surgery there are western PT recommendations to get the joint fit for the operation, but I thought perhaps the combined esoteric wisdom of the Fist might suggest specific exercises, foods, or nutritional supplements to help bulk that tendon up before and after the procedure.

[Steve James]

It's always hard to decide between having surgery and not. If it's absolutely necessary, get the best diagnostician and surgeon you can afford.

All the best, and hope you have a speedy recovery no matter what you choose.

[H2O]

Had that exact same operation done about 6 years ago. I tore my ACL and meniscus in Judo. The knee is all good, but rehab is going to be a bitch. I’m not sure there’s much you can do now, but the leg is going to atrophy pretty signifigantly after the surgery. My advice is, get the surgery, and take physical therapy seriously. Keep the joint moving as much as you can afterwards so that you minimize the buildup of scar tissue. When you are able to, start doing squats and deadlifts to strengthen the leg again. When you start training martial arts again, go slow and take care not to favor the affected leg.

[Giles]

Finger’s crossed for you there, Origami. Knees have been a theme of mine over the years, including some minor surgery although never anything on the scale you describe. On the basis of both my experience and understanding: the first phase of movement and (re)strengthening the muscles around the knee and your leg in general should be exercises where you are not supporting your body weight. In other words where you can move your knee/leg freely, usually in a lying or sitting position with (mostly) your leg stretched out. And then using a kind of feldenkrais-y or, wait for it, tai chi approach to the exercises. Slow, smooth, ‘gentle’, not forcing it, building up slowly. The most basic exercise is very low-threshold but also surprisingly effective. Can be done quite soon after surgery.

--> Sit or lie on a bed/mattress with your dodgy leg stretched out comfortably, quite relaxed. Then very slowly activate your quads to gently pull your kneecap towards you a little. And simultaneously lift your foot maybe an inch higher off the bed. Which is the same muscle action, just viewed differently. Go to the maximum straightness of knee/leg, at the end ‘tensing’ but not in a jerky manner. Hold for anything from 1 to 5 seconds, depending on your feeling, and then slowly (!) let the foot sink down again and your kneecap return to its original position. As long as this feels more or less OK, repeat as often as you like (100 times if it feels OK) with rest phases in between. Good while watching TV, listening to something etc. Do this several times a day for many days. In this way you not only strengthen the muscles but program into them a ‘healthy track’ for movements of the knee joint. Next phase is to place a rolled-up towel under the knee so that the foot needs lifting a little higher to fully straighten the knee. Next phase: when your leg is held fully straightened, lift your entire leg (not just your lower leg) a few inches from the floor or mattress and hold for a few seconds, or later make small circles in the air before putting down again. But this certainly not in the first few days.

Later again, sit on a sturdy but not excessively thick table or suchlike with the table edge under the hollow of your knee and your lower legs hanging down free. Place a towel under your knee(s) for comfort, start by swinging your feet a little (feels nice, being age 8 again), then use the same slow and smooth manner to lift your foot/lower leg up from vertical hanging to horizontal stretched out. Just one foot, not both! Hold for 1 to 5 seconds, then slowly and smoothly lower your foot again. Repeat as required.

Only when you feel you have built up smoothness and strength in and around your knee through these exercises should you progress to exercises where the knee is bearing any body weight. That’s because these latter exercises involve a greater risk of something going wrong, collapsing etc. Even if it just happens for a moment, this can put you back weeks or worse.

Also do these exercises before surgery. Even if only the first one. Your body will remember them later and find its way easier.

Good luck, keep us posted!

PS. Don't forget to cool the joint regularly in the first 48 hours or so to reduce swelling, but I guess the hospital will give you all this kind of info.

[marvin8]

Pre-surgery there are western PT recommendations to get the joint fit for the operation, but I thought perhaps the combined esoteric wisdom of the Fist might suggest specific exercises, foods, or nutritional supplements to help bulk that tendon up before and after the procedure.

Yes, there are western prehab PT recommendations, exercises, foods and nutritional supplements if you google search.

You might research for reputable Texas NBA and/or NFL teams' orthopedic surgeons. But, there may be a long waiting list. You may get a good surgeon, advice and physical therapy center where professional players rehab.