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OT: Knee injuries

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Re: OT: Knee injuries 

Post#21 » by emunney » Sun Jan 25, 2009 5:54 am

Todd_Day wrote:I am going through emunney's exact injury, but without good or frequent rehab. No real tears, but massive knee giving out at any point when I've tried light pick up.

I need to get in for surgery, I haven't been in a game since October 2006. It blows. I'm like Bobby Simmons or Danny manning.

I would elect for surgery. It's a quality of life thing.


Discipline, my friend. If you want to ball, you've got to stick with it. Start with all the simple stuff (the quarter squats, the leg lifts, the slow leg extensions and curls, casual slides, eventually light jogging), then move up to all the big movement exercises (for me, that means "pistols", weighted squats, deadlifts), and finally throw in full speed running... and I now do Tabata intervals of split squat jumps and burpees.

Seriously, I suggest just doing 200 deep body weight squats, if your knee is doing well enough to handle it. I did it, and my legs were sore for a week, but my knee felt great. I still do high volume body weight squats once a week. It'll stave off the arthritis for a while, hopefully.

I kind of had to come to terms with the fact that my knee will never be as explosive as it was, but as long as it's sturdy enough to not get hurt every 5th time I step on the court, I'm completely content with it. It just takes consistent work and dedication, and I really think the brace helps.
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Re: OT: Knee injuries 

Post#22 » by drew881 » Sun Jan 25, 2009 9:23 pm

I think the title of this thread should have the OT removed :)
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Re: OT: Knee injuries 

Post#23 » by ReasonablySober » Sun Jan 25, 2009 9:30 pm

Jez2983 wrote:DB - I forgot about this thread and am remembering now!

I have questions:

1) How old are you?

2) What sort of graft are they doing?

3) What activities will you be involved in? (Sport/social activities etc)

If you answer that I can give you some of my thoughts re the surgery. Probably the short answer is that it's best to get it, especially as I think you are under 30. I just had a patient in the other day who was still playing sport without an ACL for around 5 years, but she eventually had to have it done. Having an unstable knee when young would massively increase the need for a knee replacement earlier as the 2 main bones in your leg would bash against each other, especially when doing stupid stuff when drinking!

Please reply, as I have other thoughts also...


1 - 27
2 - Don't know yet. I'm discussing it next week with the doc. I've been told that a cadaver method isn't the best way to go.
3 - I would have liked to play baseball this season, I golf all the time and I swim/workout regularly.

I don't think there's any doubt in me that I'll be having this surgery within the next month and a half.
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Re: OT: Knee injuries 

Post#24 » by Bernman » Sun Jan 25, 2009 9:45 pm

DrugBust wrote::D I've got some people giving me a hookup as it relates to this injury, but it isn't for an instrument ;)


Thus your user name.
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Re: OT: Knee injuries 

Post#25 » by humanrefutation » Sun Jan 25, 2009 10:18 pm

I fell on some ice last week and tore part of my thigh muscle. It's not enough to warrant surgery, so now I'm just resting and icing it, and focusing on physical rehab. I can still kinda walk on it, and the pain has begun to slowly lessen, but I'm now walking funny and am starting to re-train my body to walk normally. It sucks.
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Re: OT: Knee injuries 

Post#26 » by ReasonablySober » Sun Jan 25, 2009 10:29 pm

Bernman wrote:
DrugBust wrote::D I've got some people giving me a hookup as it relates to this injury, but it isn't for an instrument ;)


Thus your user name.


This is true.
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Re: OT: Knee injuries 

Post#27 » by LISTEN2JAZZ » Mon Jan 26, 2009 12:20 am

Call Redd up and see if he wants to try and get a group discount with you.
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Re: OT: Knee injuries 

Post#28 » by teamny1 » Mon Jan 26, 2009 1:07 am

I had ACL reconstruction surgery 4.5 weeks ago from a basketball injury. I used my patella tendon for the graft. Began walking about a week after surgery. Rode a stationary bike after 2 weeks. Now I'm doing lunges and stability exercises. Before surgery I would do exercises to strengthen the hammy and quad. Personally, it wasn't that painful, it was just a pain in the butt to get around the first 4 or 5 days. I started doing the rehab the day of surgery when I got home. I've been busting my butt and I'm being told I'm doing great, so I'd suggest to put 100% effort into the rehab.

They say you can play sports after only 6 months, but presently I've been told that I can ice skate, shoot a basketball. To actually run around and play for fun I can play in about 1.5-2 months. I haven't asked them about competitively since I don't want them to think I'm a psycho, but from knowing my own body it should be about 3 months or so.

I don't mean this in a self-aggrandizing way, but I heal extremely quickly and I have an extremely strong lower body, so that might be why I'm healing ahead of schedule. I say this so there's no false hope. However, I'd say if you work out your lower body hard, safely and as much as you can, until surgery you'll have an easier time with the surgery and rehab afterwards.
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Re: OT: Knee injuries 

Post#29 » by Jez2983 » Mon Jan 26, 2009 2:55 am

1) Definitely have surgery. Chances are increased of arthritis in this knee anyway now due to scale of your injury (sorry about the downer) so walking around with an unstable knee and doing stupid drunk stuff on it like I do (I'm 25) would just increase this degeneration.

2) In Aus, we do autografts (from your own body) and generally hamstring grafts. Patella grafts are generally thought to be stronger but generally more painful post op (I think Ayt had one???). If you have a patella graft, you get patella tendinitis, with a hams. graft, you strain a hamstring. I personally think the hamstring is better as you have 3 hamstrings and only use say 1/2 of one, so you have 5/6 hamstrings intact, so to speak, whereas you take a 1/3 of the patella tendon. I wouldn't have a allograft (from a cadaver) if it was me.

3) The last 3 you could do with no ACL (except like deep squats in the gym or single leg stuff), so having an ACL is obviously a plus. For baseball you'd need an ACL unless you just hit home runs every time and don't field :)

Generally the post-op period seems fairly painless. You work on Range of Movement 1st, then strength, then proprioception or position sense, which is the most important and most overlooked aspect of rehab.

*****THIS IS ALSO DIRECTED ATteamny1****

The graft is really strong for the 1st 2 days post-op, while there is still a blood supply to the ACL, so technically you could play sport then, but the knee is swollen and bloody sore from the op, so playing sport is impossible. It takes 10 weeks for the blood supply to grow back, so you can't do any resisted knee extension, like kicking a ball or the knee extension machine at the gym, until 10 weeks post op (there's debate about this still, but I wouldn't want to risk it). Generally, you wait till the surgeon tells you to return to sport, coz they kinda know what they're doing. I would not consider any 'fun' sport till 4 months, and contact 6 at the earliest. You just need to let the graft/tissues/muscles regain as much of their previous function as possible.

DrugBust - talk to others on injury forums or people you know about their surgery. I'd make sure you get a really good surgeon but you have to find out from others how good they are - of course all surgeons will say they're great!!!
ALSO - when's the op for (roughly) In Aus, we wait till the MCL heals by itself (6 weeks) then recon the ACL/clean out the meniscus at the same time. Operations of MCL's generally have the same outcome of it fixing itself.
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Re: OT: Knee injuries 

Post#30 » by ReasonablySober » Mon Jan 26, 2009 3:23 am

I pitch and plant on my injured knee. I plan on being one of those old dudes you have to drag off the mound so I'm thinking I'll need a good one. :) Thanks for the the thoughtful post Jez.
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Re: OT: Knee injuries 

Post#31 » by Jez2983 » Mon Jan 26, 2009 3:27 am

No probs - free advice is what I'm all about! One other thing, which isn't very nice and surgeons don't ever tell you is that there is a small percentage of grafts that just fail by themselves, so do exactly as your told, but sometimes grafts just don't take.

And also, clearly Sessions>>>>Amare. Haven't you seen his all-star level play?
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Re: OT: Knee injuries 

Post#32 » by teamny1 » Mon Jan 26, 2009 3:38 am

Thanks Jez for the advice, I'm definitely not going to go out and just do competitive trials based on my own, dumb opinion lol, no worries there. Good luck to you drugbust and since I forgot to mention it before, I'd definitely recommend surgery. Better to do it now as opposed to later when our bodies are older.
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Re: OT: Knee injuries 

Post#33 » by TDcraz5 » Mon Jan 26, 2009 5:18 am

suck!
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Re: OT: Knee injuries 

Post#34 » by James1980 » Mon Jan 26, 2009 3:57 pm

This thread jinxed Redd's knee.
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Re: OT: Knee injuries 

Post#35 » by GrandAdmiralDan » Tue Jan 27, 2009 12:39 am

This seems like the appropriate thread to talk about what other athletes have dealt with Redd's specific injury. Redd tore BOTH his ACL and MCL.

That looks to be somewhat uncommon.
I think we should work on a list of athletes with that injury and figure out how long it took them to recover, as well as note if they ever made a full recovery, etc.

I think this is a good google search to use:
http://www.google.com/search?hl=en&lr=& ... tnG=Search

That will filter out all of the Redd links, Tom Brady (he is seemingly the most relevant comparison to Redd as far as this injury goes) links as well as anyone like Livingston who also tore the PCL. If anyone can improve that search string, please do.

Apparently, when you tear the MCL too you wait for the MCL to heal before you can have the surgery to repair the ACL, which is going to add more time to the recovery period from this injury than just tearing the ACL by itself.

Here is a Boston Globe article on the Brady injury:
http://www.boston.com/sports/football/p ... mcl_tears/
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Re: OT: Knee injuries 

Post#36 » by Jez2983 » Tue Jan 27, 2009 9:28 am

Right. Awesome - after I spent 15 minutes writing a massive post, my stupid browser craps itself - BOOOO!

James1980 wrote:This thread jinxed Redd's knee.


Nup - coz he would have hurt it when it was originally started :wink:

GrandAdmiralDan wrote:That looks to be somewhat uncommon.


Not uncommon - 'unhappy triad' - crap name, crap injury. You wait 4-6 weeks for the MCL to heal and give a stable knee. Therefore it's essentially just an ACL recon.

GrandAdmiralDan wrote:That will filter out all of the Redd links, Tom Brady (he is seemingly the most relevant comparison to Redd as far as this injury goes) links as well as anyone like Livingston who also tore the PCL. If anyone can improve that search string, please do.


ACL's are very successful. The orientation of the ACL means good bony anchors are possible. Good bony anchors = good stability. By contrast the PCL has crap bony anchors and therefore is a very unsuccessful recon with poor stability in the long term.

A basic rehab plan (off top of my head)

- crutches 2-3 days
- Range of movement recovery 1st 2 weeks
- start pool work as soon as scars closed (get infections in open wounds from pool)
- I do closed chain knee strength ASAP - 2-3 weeks usually. Squats and lunges, etc.
- Exercise bike 4-6 weeks (surgeon-dependent)
- Gym 6 weeks - NO knee Extension until 10 weeks as graft not strong enough
- Jogging 3 months
- Proprioception (position sense) exercises right through until 6 months. Start off standing on one leg then things like hopping, jumping/landing then starting/stopping running, changing direction. Most important yet most overlooked aspect of rehab.
- 6-12 months return to full sport (depends on surgeon)

GrandAdmiralDan wrote:Apparently, when you tear the MCL too you wait for the MCL to heal before you can have the surgery to repair the ACL, which is going to add more time to the recovery period from this injury than just tearing the ACL by itself.


They found they got as good an outcome by waiting for the MCL to heal itself as they did by repairing it surgically. And then the ACL is performed on a laterally stable knee and there's less 'cutting and grinding'. Therefore 7 1/2 to 13 1/2 months rehab.

With Redd he could be ready by the start of next season but I'd say they'd go conservative and wouldn't be surprised if he missed a month of next year. Technically he could be ready by the pre-season league games.

With all ACL's there's a risk of failure, regardless of what rehab is done. Obviously crap rehab = higher failure rate. With a good surgeon/rehab, spontaneous failure is the only risk with Redd's knee, and it's an unpreventable risk.
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Re: OT: Knee injuries 

Post#37 » by Jez2983 » Tue Jan 27, 2009 9:41 am

There isn't any recent info on ACL failure rates, but I found this

http://www.ncbi.nlm.nih.gov/pubmed/1962708?ordinalpos=19&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

If 95% didn't fail and there wasn't an increased failure rate in ACL's that were reconstructed, those numbers should have got better over the last 17 years.

Anecdotally I've never seen a failure, probably coz most people stop contact/high-level sport post op. It would also be almost impossible to determine what a spontaneous fail would be, as all people remember *something* in their histories that could have caused the re-rupture!!!

In AFL, there are quite a few re-ruptures but its a different and more physical sport.

I'd suggest Redd's knee would have less than 1% chance of spontaneous rupture, but would have an increased risk of re-rupture on return to basketball. We'll see him again in some form on an NBA court.

Also he has arthritis in this knee to look forward to in old age!
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Re: OT: Knee injuries 

Post#38 » by ReasonablySober » Tue Jan 27, 2009 2:46 pm

Jez, you have been an absolute superstar in this thread. Depressing as hell, not gonna lie, because you're telling me essentially what my doc just did, but a superstar none the less.
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Re: OT: Knee injuries 

Post#39 » by GrandAdmiralDan » Tue Jan 27, 2009 3:08 pm

DrugBust wrote:Jez, you have been an absolute superstar in this thread. Depressing as hell, not gonna lie, because you're telling me essentially what my doc just did, but a superstar none the less.


Yes, I agree. Even if I don't have the kind of personal stake in it that DB has, speaking for the rest of us who are primarily interested in this as it relates to Redd, thanks for this info. No offense to DB there either, I'm just not going to lie and pretend that I care more about your knee than Redd's knee :lol:
But, I obviously still care about my RealGM buddy DB's knee, since I have followed this thread since he posted it, before Redd did the same thing.
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Re: OT: Knee injuries 

Post#40 » by ReasonablySober » Tue Jan 27, 2009 3:09 pm

GrandAdmiralDan wrote:
DrugBust wrote:Jez, you have been an absolute superstar in this thread. Depressing as hell, not gonna lie, because you're telling me essentially what my doc just did, but a superstar none the less.


Yes, I agree. Even if I don't have the kind of personal stake in it that DB has, speaking for the rest of us who are primarily interested in this as it relates to Redd, thanks for this info. No offense to DB there either, I'm just not going to lie and pretend that I care more about your knee than Redd's knee :lol:
But, I obviously still care about my RealGM buddy DB's knee, since I have followed this thread since he posted it, before Redd did the same thing.


No worries :D

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