To Cut or Not To Cut: Part 3

By: Joe Boffi

The new ACL in my knee has passed the 6-month mark of its existence.  If you just read that sentence and don’t know the story of my ACL, you can Click Here to start from the beginning.  But to give everyone a short recap, the story begins around 4 years ago when a traumatic sports injury caused my ACL to tear.  I lived with it torn for many years while kickboxing, doing jiujitsu, weightlifting, and any other activity I wanted.  During that time, I did extensive movement therapy on my knee to avoid surgery.  Finally, at the end of 2017 I was experiencing constant arthritis, a nagging softball sized baker’s cyst, and periodic bouts of instability.  I had finally had enough and decided to get cut. I received a new ACL February 9th.

After 6 months of physical therapy, acupuncture, strength training, and a low-to-moderate return to sport I’d like to report how my knee has held up (to learn more about the previous 5 months and what I did for physical therapy click here). At this stage I like to say I am 90-95% back to normal (normal being surgery left knee compared to non-surgery right knee).  There are two physical movements and one physiological trait that I am judging this percentage on.  The first physical movement is the ability to completely sit back into the position known as seiza. See the picture below for a demonstration of seiza.

Within the last month I have gained the ability to sit into seiza without pain.  I was experiencing some pain on the lateral and medial parts of my calf when reaching the end range of this position.  It still doesn’t feel “normal” and I do bias my other leg a little with my body weight. 

The second physical movement is a combination of strength, stability, and mobility.  I would like to be able to do an unassisted pistol squat on both legs equally.  Here is an example of myself performing a pistol squat.

The ability of my left leg to do a pistol squat is still not on par with my right leg.  To complete this movement, I need to use a very slight assistance from a Trx, or some other suspension trainer. While on my right leg I can complete around 15 unassisted quality reps.  When I can do the same number of pistols squat on my left and right leg I will say my leg strength has returned to normal.     

The final factor I’m considering is having no fluid accumulation, or calf compensation causing hypertonicity in some of the stringy muscles behind the knee. When they get inflamed they protrude a little and make full knee extension a little difficult. I’ve been told the fluid accumulation is just the bodies response to protect the knee from new and strenuous activity post-surgery. This seems to be true because the swelling goes down quick and doesn’t always return the next time I do the same activity. 

At this point I’m extremely happy with my outcome. I’ve noticed in my day to day life that the arthritis around the inside aspect of my patella has disappeared 99.9% of the time.  The only time it flares up is occasionally while I am performing a movement slightly incorrectly and loading my knee too much, or when reintroducing a new activity that I haven’t done for a while.  While bouncing around on my toes for boxing or jiujitsu I feel very stable.  There is no longer any clicking when moving around on the ground and grappling.  The next step in my recover is more time.  After 9 months I am going to start training jiujitsu and mma at a more competitive level.  Be sure to check back in a few months to see how a full return to competitive sport training goes.  

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