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Injuries Chronic & Acute

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Old 08-16-2004, 05:08 AM   #1
Chris Williams
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What I really want to know is: are there exercises I should be doing in order to really build up the knee, especially the stabilizing muscles to help hold the knee in place during a hard landing (my injuries come from falling off mountain bikes). I was thinking box jumps, that sort of thing, as well as the more usual squats.

Also, any exercises to avoid...sprinting/ stair climbing etc?

I'm a newbie and v. excited about Crossfit training, but worried about my knee because I had ACL surgery 18 months ago (that went v. well), and 2 months ago stretched the interior ligament and lightly torn the meniscus. The knee is getting better now, and I'm able to cycle and do air squats, but I want to prevent this injury from recurring (and giving up mountain biking isn't an option!)



Thanks in advance for the feedback
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Old 08-17-2004, 12:49 PM   #2
Rick Worthington
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I've had 2 ACL reconstructions on my right knee and one on my left along with numerous scopes on both to remove bits of my meniscus. By 18 months post-op I was a full go for all activities - including wrestling which cost me all those ACLs in the first place.
I've found that since following CF for the past year, my knees feel better and better each week. I still need a pretty decent warm up for any WOD that involves running.
Keep the weight light until you master the form and don't shy away from exercises like overhead squats which I think have contributed to my knee recovery. I think biking is actually one of the best exercises for ACL rehab - although moutain biking poses a slightly different threat.
Of course, I'm not a doctor and can only speak from my own experience. I know there are some very bright gals and guys on this forum who may take a different angle to this.
Good luck on your recovery and welcome to Crossfit.
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Old 08-17-2004, 03:25 PM   #3
Ryan Atkins
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Hi Christophe,

Welcome to Crossfit.

Like Rick, I'm not a doctor and am speaking solely from my own experience.

I've had tremendous success using the stable of exercises from Crossfit to enhance my recovery (had an ACL allograft and meniscotomy(sp.?) in February of this year).

The progression I've used went something like this:

1. nonballistic, nonweight bearing movements/stretching. Usually the stretches/holds presented in rehab, emphasizing, initially, partial range air squats. I waited until I had decent range of motion before going on to the exercises in step 2.

2. nonballistic, weight bearing movement, working towards full range of motion. Front and back squats, deadlifts, overhead squats, etc. Starting out with just the bar and low reps. Making small increments in weight and reps as time progresses and depending upon feedback from the knee.

3. Ballistic, weight bearing movement, limited range of motion. Power cleans, push presses, dumbbell swings w/ moderate knee bend, limited jump roping etc. Phases 2 and 3, in my case occurred at the same time.

4. Ballistic, weight bearing movement, full range of motion. Clean & jerk, snatch and variations of both. I guess box jumps would fit into this category, although I'm not sure when I reintroduced them exactly.

I've had good success using this progression. Within the past couple of weeks I've reintroduced freestyle fighting practices (stand up and ground, but I've avoided, for now, working takedowns and takedown defense - IMO the area where a reinjury is most likely to occur). Also I've added light weight Olympic lifting sessions for two of the three days in a WOD cycle. The only times I've had soreness in the knee is from running (too far, too soon) and from some pistol work a few weeks back (I've since stopped practicing the movement - figure I'll reintroduce it in a couple of months).

I'm not sure of the injury rate (particularly knee injuries) for mountain bikers, but you may want to review your priorities. You may have to accept the high probablility of another knee injury (and associated time off) as part of the territory for your chosen sport, especially if you're overly aggressive. The nature of some sports (i.e. NHB fighting) combined with a hell bent attitude doesn't exactly lead to a long life of athletic vitality, IMO.

Hope this helps,

Ryan
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Old 08-18-2004, 03:00 AM   #4
Chris Williams
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Thanks Rick & Ryan for the feedback. I'm keen to get info from athletes who have lived through similar experiences, rather than the "text book" answers from doctors.

It sounds like sensible weight training, combined with WOD, is the way to go. Running doesn't sound too good though.

I was wondering if anyone has used bands (or something similar) to strengthen the knee on rotation type movements?

Also, can someone pls explain exactly what the difference is between "ballistic" and non?

Finally Ryan, you seem to have made v. rapid progress since Feb. I was more like Rick, taking nearly 18m to be really confident on the knee (that's when i blew it the 2nd time!). You are also right, I am reappraising priorities...less aggressive mountain biking, and less Muay Thai, as this also puts a lot of (twisting, in particular) pressure on the knees. Less is more in the long term....!
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Old 08-19-2004, 10:07 AM   #5
Ryan Atkins
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Christophe,

I used bands in the early stages of recovery, but have since stopped using them. I liked using them for air squats or thrusters. They provided little/no resistance near the full squat position, but gave some resistance when the knee was near full extension allowing someone to work on full range of motion while still providing for a decent workout. I was never shown exercises that involved rotation of the knee while utilizing bands, however.

With regards to ballistic and nonballistic movements - From what I understand, ballistic movements will involve the use of explosive power in order to generate momentum to aid in moving the weight and/or body. Nonballistic movements involve no such use of momentum (at least not at therapeutic loads performed in a slow, controlled manner). If I were to yell, "Stop!" to someone performing a nonballistic movement, chances are they will be able to comply relatively quickly and halt in any position of the lift. The same can't be said for someone who was just beginning the thrust upwards on a push press or the dive under the bar in a squat clean. The same applies to someone midair in a box jump.

Hope this helps and I hope you recover well.

Ryan
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