ACL Reconstruction and BJJ

[GS828]

So I just had my ACL reconstructed using a patella tendon graft along with a partial meniscectomy for a bucket handle meniscus on my left knee. I injured it training in a very awkward position. I was defending an armbar and planted my feet in order to turn into the arm bar and begin to stack. The armbar wasn't on tight so I knew I could stack and begin to pass. Out of nowhere I felt my knee buckle as I bridged and heard something in my knee. I immediately grabbed it and was in some serious pain. Once I got home, I got on the couch and RICE immediately. Did this for 24 hours and the pain was gone, however I could not bear any weight on it or straighten out my leg. Went to the dr, got the MRI and was informed of the bad news and given the option of Patella, Hamstring, or Cadaver reconstruction. I opted for the Patella, since I was informed it was the strongest reconstruction and better suited for anyone returning to athletic competition. I am now one week post op and after reading so much literature I thought the best place to seek advice would be from other BJJ/Grapplers. Has anyone here had the patella tendon graft? Any advice on how I can be back on the mat as quick as possible. As all of us grapplers know, rolling is like breathing to me, so any advice is welcomed. I have to admit, when my dr said I would be in pain afterwards I sort of brushed it off. I mean I'm used to all sorts of bumps and bruises and injuring things with rolling, I had no idea what I was in store for, the pain has been unrelenting to say the least, especially on my knee cap (patella). I can barely move my leg from the couch to the floor to use my CPM without wanting to punch something. I am definitely going to need some more of those pain killers they gave me when I left the hospital. So once again, any advice and/or similar stories would be helpful.

 

[Dirty Deeds]

I had my ACL repaired, for the 3rd time, last December. I feel pretty good, overall, but have zero explosiveness on my feet, and get beat in transitions that I used to gain a dominant position in. I am a wrestling based grappler, and am not a very big threat off my back, so I have been working my guard pretty hard, to raise the level of the weakest area of my game, so I should be better overall when I can compete again.

Number 1 and 1a on you agenda are to get your leg straight, and move your kneecap, so it does not bind to the trochlea(sp). I have been fortunate getting back to the gym this time, because I have a great team to train with, and no egos. I have been able to ease back into training.

 

[cian22]

I had ACL surgery using the hamstring about 6 months ago and I just went back rolling last week.The knee feels pretty good at this stage, nice strong but havent got 100% flexibility yet.

When I finished with my physio about 6weeks ago she told me to go for it, get back training and test the knee, but when I went for 6 month check up with the surgeon he was telling me wait another 3 months before goin back.

In the end I felt ok to go back rolling but ill be taking easy for the next few months.
You will probably know yourself when to go back, but I would say at best 5-6 months and at worst 10-12 months.

In saying all that it could be totally different with the pettalla graft.

 

[GS828]

I had my ACL repaired, for the 3rd time, last December. I feel pretty good, overall, but have zero explosiveness on my feet, and get beat in transitions that I used to gain a dominant position in. I am a wrestling based grappler, and am not a very big threat off my back, so I have been working my guard pretty hard, to raise the level of the weakest area of my game, so I should be better overall when I can compete again.

Number 1 and 1a on you agenda are to get your leg straight, and move your kneecap, so it does not bind to the trochlea(sp). I have been fortunate getting back to the gym this time, because I have a great team to train with, and no egos. I have been able to ease back into training.

I can straighten the knee to 0 degrees pretty much with just a little discomfort (no real pain) so that's a good sign I guess. The problem I am having is bearing weight on it. Part of it is fear because I couldn't bear any weight on for a few weeks before the surgery (my meniscus was damaged where it was caught and I couldn't bear weight) and the fact that my knee cap (patella tendon) is missing and it feels awkward, uncomfortable and painful.

 

[Jim J]

Don't try and rush back. Concentrate on rehab and getting as strong as possible. Hopefully your doctor will put you on a long and thorough physical therapy progam.

Getting on the mat is a gambe with 100% healthy joints. Awkward things happen in grappling. You don't want something happening with a knee that is 80% and having to start the whole surgery-rehab process over.

When you do get back on the mat, start with drilling but no live rolling. When you do start rolling, only roll with very experienced grapplers and let them no about your injury. You will eventually be able to start rolling hard again, but if you aren't fighting for a living, don't try and rush back.

 

[curb1850]

Ahh man good luck. I'd make sure to do a really solid, long, rehab and wait for them to give you the green light.

 

[SMillard]

since you are going to have a few months on your hands, do a search on the subject. I listed my experience (although it was a cadavor graft) and many others have listed their experiences. In short though, it sucks, it's a pain in the ass but it is something you can recover from.

 

[Dirty Deeds]

I can straighten the knee to 0 degrees pretty much with just a little discomfort (no real pain) so that's a good sign I guess. The problem I am having is bearing weight on it. Part of it is fear because I couldn't bear any weight on for a few weeks before the surgery (my meniscus was damaged where it was caught and I couldn't bear weight) and the fact that my knee cap (patella tendon) is missing and it feels awkward, uncomfortable and painful.

As Jim J said, don't rush back. Hopefully you get matched up with a good PT, because they will lead you through the process of trusting the joint again. It will not feel "right" for a long time, but don't get discouraged. The graft is stronger than most realize, even immediately post op. The range of motion is crucial, but you need to move your kneecap around with your hands also, as you will have excees scar tissue forming on/around the patella/tendon.

Good luck.

 

[Big Eck]

Although it depends on a lot of different variables, take it super easy for the first few months. I tore mine just doing normal hip throws, had surgery this past June. Had a hamstring graft, and at about 6 months, my hamstring is giving me more problems than my knee itself. But generally I'm in decent shape. Just babying the hell out of it so I don't have problems with it later down the road and can train like I did before tearing it.

You can push it and try to get back early and be missing training time and icing your knee for the rest of your life, or you can take the appropriate amount of time to recover and get 100% back to where you were prior. Again, this depends on a lot of variables... Graft, surgeon, PT, etc. But it's wise to give it plenty of time to recover rather than to try and rush back.

Give 100% in PT and don't skip sessions. I made sure I did everything that my PT instructed of me, and I let him know whenever I was having any sort of pain or swelling whatsoever.

My personal advice would be to not even consider going back to live free sparring until after 6 months. Even at this point, I'm only working technique and going very slow with trusted training partners. Hit the gym and lift or swim and use the elliptical if you're itching to work out.

Also, check out this link:

ACL injuries in BJJ, submission grappling and MMA

 

[Big Eck]

As Jim J said, don't rush back. Hopefully you get matched up with a good PT, because they will lead you through the process of trusting the joint again. It will not feel "right" for a long time, but don't get discouraged. The graft is stronger than most realize, even immediately post op. The range of motion is crucial, but you need to move your kneecap around with your hands also, as you will have excees scar tissue forming on/around the patella/tendon.

Good luck.

Totally agree. It takes almost a year for the nerves to come back. It felt weird as hell drilling triangles last week with the lingering numbness from the surgery.

 

[Ninjamurf]

Okay, so here's my experience. I had almost exactly the same thing done about 10 years ago that you're describing (soccer injury.) Not sure if my meniscus repair was "bucket handle" but I don't think it much matters. I think the meniscus will be well and healed LONG before the ACL. Interesting things I learned along the way...

(Disclaimer-I am NOT a doctor!!! This is all stuff I'm pulling from my addled brain from over a decade ago.)

Allograft (cadaver) takes longer to heal because it's "outside" material that your body has to get used to. But the rest of your body parts stays intact. (i.e. you're not cutting your patellar tendon or hammy.)

Hamstring replacement is usually recommended for "lighter" people (and the ladies for the most part.) But it tends to be weaker than the patellar graft...thusly, if you are heavier, as I am/was, it's not recommended.

Patellar tendon graft is what most "athletes" get. I don't have the numbers but I would be surprised if the number of NFL players having this type of surgery vs. the other two wasn't close to 100%. Supposed to be the strongest and have one of the shortest recovery periods.

Now, the pain in your knee is to be expected to be a bit more than the other types of graphs for a reason. They basically cut out the middle third of your patellar tendon. But they ALSO took out a chunk of bone on each end where it connected to your patella and the tibia. Then they drilled a couple of holes on the interior of your knee and actually jammed those bone pieces in to connect your "new" ACL. This is actually one of the reasons that it is so strong. Those bone chunks from the transplant actually grow "into" the bone inside your knee connecting everything all nice and tight like. BUT it also left some holes in the bones that your body is trying to refill. This will ache like a summbich. Take your painkillers when needed.

Another nifty thing I remember hearing is that tendon material and ligament material are different. So your body will actually take the next couple of month and CHANGE that tendon into a ligament. (I'll be honest, I'm not sure about the mechanism behind this but I remember being blown away when I heard it. Lead to gold.)

As for numbness I actually STILL have a little dead spot on the front of my knee. Doesn't bother me at all. Just feels weird when I scratch the scar. The dead spot WAS huge, however, and now it's just a little portion. I've heard that sometimes it all comes back, sometimes less so. Least of your worries though.

All in all I think the advice given here is spot on. Do your PT. Do your PT. Do your PT. You should be back in 6 months or so. Another thing. Not sure if it will be the same with BJJ but I remember being real tentative when I stepped back onto the soccer field. I wanted to be careful. Gingered it. I had buddies that had the surgery tell me, "you just have to do it. Trust me." It wasn't until the first time I really got stuck in and...*BANG*..."hey, that didn't hurt at all?" After that I was fine. In fact, it's now my STRONG knee! If I hop down from climbing a fence or something I hop down onto my reconstructed one. It's like, "well this knee is only 10 years old. My other one is 40+."

 

[stifler2]

i just started training again after a year off for rehabbing my acl reconstruction.

im relearning how to shoot, wrestle and grapple and im scared shitless because i had surgery on my left knee, and thats my 'shoot' leg..so my knee swells up and is brusied all the time..thats normal right? i have my knee wrapped/brace on of course but still..thats not enough for me mentally..im concerned about popping it again ..any tips?

 

[thesaadishsnake]

Heh, I've been doing BJJ for 6 months with a torn ACL. Maybe I'll get surgery, maybe not -- definitely not at this stage since I'm still a white belt. I only hurt it once in BJJ, but after that incident it's been fine. I know what will make my knee buckle, so i'm extra careful if I'm in someone's half-guard or someone is trying to grapevine my legs.

In terms of explosiveness and physical ability -- I don't feel any different actually. I've actually had to the torn ACL for years w/o realizing it, so I guess my body got used to it? I've also played basketball and football without any problems.

The only thing is that I haven't competed yet cause I'm worried about a single-leg messing it up. I want to see how those would feel in a controlled setting before going into a tournament.

 

[Ninjamurf]

Heh, I've been doing BJJ for 6 months with a torn ACL. Maybe I'll get surgery, maybe not -- definitely not at this stage since I'm still a white belt. I only hurt it once in BJJ, but after that incident it's been fine. I know what will make my knee buckle, so i'm extra careful if I'm in someone's half-guard or someone is trying to grapevine my legs.

In terms of explosiveness and physical ability -- I don't feel any different actually. I've actually had to the torn ACL for years w/o realizing it, so I guess my body got used to it? I've also played basketball and football without any problems.

The only thing is that I haven't competed yet cause I'm worried about a single-leg messing it up. I want to see how those would feel in a controlled setting before going into a tournament.

You can survive without the ACL just fine actually. All the ACL is there to do is stabilize the knee when the muscles don't support it. So a lateral movement that happens "out of the ordinary" or "before you're ready for it" may cause it to pop. When you walk or run or whatever your body usually says, "I'm putting this leg on the ground, time to tighten up the muscles." In those cases the ACL has very little to do. It's the sharp cuts, or someone causing you to stumble, that get the body saying, "oh crap! Quick, tighten the muscles around knee! Arggh, too late! Hope the ACL holds up!" So you can do almost anything without an ACL. But the more you train and the more intense the level of training? The more chances of having a problem.