Tearing a cruciate ligament is a very common injury that occurs majorly in sports (judo, BJJ, football, ski, tennis…) after a wrong sudden change of direction, shock rotating the knee, landing incorrectly from a jump, having a collision or a crossed leg lock (which was the cause of my injury in August)
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The cruciate ligaments :
There are two cruciate ligaments: the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL).
Placed behind the kneecap, the two ligaments link tibia to femur and hold them together during a rotation. In other words, these ligaments ensure the rotational stability of the knee.
The ACL prevents you from a displacement of the tibia going forward in relation to the femur. The PCL prevents you from a displacement of the tibia going backward in relation to the femur.
After tearing a cruciate ligament, it is up to the doctor to decide whether it is necessary or not for you to get an operation, depending to age, sport activity and other criteria concerning the patient. After tearing a cruciate ligament, it is up to the doctor to decide whether it is necessary or not for you to get an operation, depending to age, sport activity and other criteria concerning the patient.
There are different techniques to reconstruct a cruciate ligament that have all in common the removal of a portion of a tendon to transplant it at the place of the cruciate ligament, considered that the suture of the same ligament is impossible. Personally, I received a surgery with the "McIntosh" technique, which involves taking a 15cm strip of fascia lata (lateral tendon outer thigh) to build the new ligament. The transplant takes time to adapt. From the first day until the 3rd month, the vitality of the transplant decreases gradually. During the 3rd month , blood vessels begin to form and make the transplant alive and strong again ( there is a risk of about 1% chance that the blood vessels do not form themselves and the transplant fails)
From the day after the operation, you need to follow a protocol of re-education lasting 6 months. After the operation, the protocol may differ, here it is a little summary of mine: 1st month: rehabilitation of the articular amplitude and rebuilding the leg’s muscles. It’s the most painful moth, during two weeks a rigid support is worn together with crunches for 3 weeks. The leg feels heavy and the cicatrisation is ongoing. Every day, the physio asks you to flex the leg a little bit more. The objective is to be able to flex it to 90° to the 15th day after the operation. It’s preferable to continue the muscular training at least for the upper body and the healthy leg. A big hematoma will appear during the first weeks.
3 weeks after the operation: start of the reabsorption of the hematoma thanks to the k-taping
2nd - 3rd month: follow the same exercises, start indoor cycling as much as possible. You can easily be able to reach 1 hour of cycling and train again your cardio, but again you should ask the medical advice to your physio/doctor. 3rd month: complete recovery of articular amplitude. Quadriceps exercises with distal progressive resistance in open chain. Plyometrics exercises, lateral jumping rope, cycling, swimming without fins. 4th month: straight running with alternation of cycling/swimming. Possible return (or start) to progressive yoga. 5th month: intensification of muscular reinforcement. Specific training close to the movements of your usual sport. 6th month: return to rotation sports (BJJ drills, technique, light rolling and intensify little by little) 8th month: return to rotation/contact sports (judo, rugby…) and after return to competitions
How to reduce the risk of tearing a Cruciate Ligament? Avoid the techniques forbidden in competition such as crossed leg locks. If they are forbidden there must be a good reason why! They are often dangerous. Reinforce your knees. There are plenty of techniques to reinforce the knees under the name of proprioception, and here they are some examples:
-Balancing on an instable object: on a inflatable balance pillow, keep your balance on one foot, when the balance is stabilised, pass a 5 kg kettlebell around the hips of the elevated leg
-On one foot, leaning forward and touching the floor
-On one foot, with a partner who throws a ball to you in different angles (up, down, right, left)
- The chair with a gym ball between your back and the wall, with series of not more than one minute.
These are the 4 examples of exercises that my physio gave me after my surgery. He also suggested to practice them everyday and for ever to reinforce the knees and avoid a new injury. Of course if you feel any discomfort and pain, you shouldn’t force the movements and you should instead consult a doctor. Take care of yourself!