#77: Warning-Don’t Follow my PT Protocol if You Had Meniscus Repair. My PT Put Me at Risk
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- Опубліковано 28 сер 2024
- On November 8th 2023, I had ACL reconstruction and meniscus repair. My PT had me running 10 weeks post surgery and my surgeon was NOT HAPPY about it. I was also doing deep squats and forced flexion. You cannot do any of those things until at least 4 months post meniscus repair. My PT was pushing my foot to my hamstring within weeks of my surgery. My surgeon told me to stop going to physical therapy and to do my own PT from home (I have a gym).
I only found out that my protocol was wrong because I started reading. I was on crutches for 6 weeks and was already running 4 weeks later, doing heavy leg press, and ass to the grass squats. This is apparently like the worst thing you can do after meniscus repair. In the words of my surgeon, just because you can do doesn’t mean you should. In fact you most certainly shouldn’t.
I am beyond pissed about this. If my meniscus is torn, I will be raising hell. People will need to move to another zip code
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damn man, I had meniscus repair and acl reconstruction last December. The recovery process was long and slow, with many ups and downs. Having a good quality PT is so crucial. Those positions you showed at 10 weeks makes my knee hurt just watching you. Sorry you had to go through that.
Yeah man, it will be 16 weeks tomorrow. Making really good progress doing basic lifts at home (carefully) per doctor’s orders. Nothing crazy. Just squats without weight at first and then on the balance board, now with balance board holding (not swinging) a kettle bell at my chest. Leg extension and leg curl. Quad is almost the same as my other leg, but the hamstring is really slow. Not only did they take the hamstring tendons to make an ACL, but he had to retract my lateral hamstring tendon to work on my meniscus. So oddly, the muscles where he harvested the tendons (gracilis and semitendonosis) are less atrophied than the muscle on the lateral side that was just retracted. But it was retracted for hours supposedly.
@breza-grappling9459 ya I had the quad graft. One thing my PT used a lot were backward sled pulls (for quad strength) because of the amount you can load up and the lack of eccentric and low ROM. I walked into his clinic at exactly 16 weeks and he got me started right away doing that. Then at some point I started doing pushes (don't remember when). Bulgarian single leg quarter squats felt good too. It's been over a year and I'm still like 95-98% size on grafted quad (its less defined). The grafts do a number on all the muscle and nerves. We did the bosu kettlebell hold at some point too (don't remember the time frame). I couldn't imagine trying to navigate this without a PT. Especially before 6 months. Good luck man!
The research about rehab protocol for meniscus repair with or without acl reconstruction are very poor, and the majority of studies about rehab post surgery encourage fast loading with pain monitoring, as long as i know there is no study showing that doing running at 10 week or doing a deep squat can have long term risk
Im a french pt and i always do the protocol given by the surgeon even if i think maybe we can do quicker and even if i think there's no real good study behind the surgeon's protocol just to not be treating like your pt today
But i can understand that there's pt who want to do quicker to have better result with their patient
If someone have some studies about any detrimential effect of doing pain free early runs and deep squat after a meniscus repair i will appreciate it a lot
Yeah my surgeon is cautious. I was non weight bearing for 6 weeks. And apparently it isn’t standard practice to sew a meniscus together at my age (44), so he wants to make sure he doesn’t have to do it again
If you had pain (not light pain) on some exercises and your knee was swelling after, maybe the exercises needed to be changed.
Good luck for your rehab, the journey is difficult with all the professionals arround you but it'll get better !
@H3XSlever thanks man! Early on I definitely had swelling after PT, but not afterwards
100% agree on the need to educate oneself. I see it like this: There are three parties involved: The surgeon, the PT and the ourselves. We can probably make the most of it if we listen to everyone, while also educating ourselves and then make our best educated guess (leaning either towards conservatism or risk, depending on our unique life situation).
The situation could (and may) just as well be flipped, with the PT giving better advice than the surgeon. It's really not easy to judge, if we don't have insight into the joint mechanics ourselves. I'm in a similar spot and it's a constant struggle to decide whether I should/"could" push harder or if it may already be too much/risky etc.
Thanks for sharing, I wish you all the best!
Thanks man! Yes I had to use my judgment.
I've was injured by my PT after my meniscus tear. I feel ya. Had to do my own research and find out what worked for me. Side note: when I was up for it, the single best thing was Firas Zahabi's Strong and Stable Knees 4 Life. His stability progression was amazing.
Thanks man. I will take a look!
Lol that pt about to get double legged
He was about to get headlocked because he spent all his time being catty about people with the women in the clinic. You know when you have a friend and he can talk shit to you but when someone else tries that it’s awkward? Yeah like all the time. I had to check him twice and decided to just not come back so that nobody gets hurt 😂
Coach I hope you will recover soon. Man your work is great. I profit from the instructional till today.
I just have a difficulty with inside position. Especially inside thigh position from underhook. It doesn't quite work for now when I try it. Because when I put my thigh on the inside, my partner who is extremely strong (way heavier then me) uses his leg from the outside to still do stuff. I don't know. Like push with his hips in having a strong base and I kind of don't habe that much control. Generally when he pushes with his hips, or does like outside trip or footsweep (even though I keep head position, but we move), its very hard.
Also he often does the double underhooks the way that is wrong, where you said that I can go for head and arm or inside trip, but I can't. He pulls so tight and pushes his hips in immediately and I lose a strong base, feel a bit lifted even, can't turn to do head and ar. because he pulls tight and can't inside trip because his strong base and him pulling up.
That position is not meant for control over long periods of time. It gives you a momentary advantage. Changes are you standing too upright. If you were leaning forward a bit then that will help prevent the back trip. Using ko uchi gari from there, far side knee tap, or far side ankle pick would make it impossible to pull you back. It’s happening because you aren’t putting weight on his far leg. I push from in there, before then the weight is moving away from his back tripping leg. He would have to stop his weight and my own weight from moving in that direction. And because I have inside control, he can’t clear his leg to uchi mata or hari goshi off my push. Again, these are moments of control to have an advantage over the kuzushi
Also, size matters. My old coach had 125lbs on me. It’s not like I was disappointed that I couldn’t move him well. I was just maintaining position and surviving the round. Weight classes exist for a reason
I hope you the best in your recovery.
I had a similar situation trying to get a correct diagnosis and correct treatment for BPD.
Thanks man. Yeah I am gonna do my best to get better and stay safe at the same time
unrelated: I see so many videos of people emphasizing the underhook as the most important grip in grappling styles overall(bjj, wrestling, sambo, etc) because of its supposed versatility in escapes, takedowns, guard passes, sweeps, control, and limb isolation. Do you agree, or do you think the underhook is overrated and overemphasized and it’s simply just another grip like collar tie, 2 on 1, head control, sleeve grip, overhook, etc? I see people, specially beginners like myself, get tunnel vision because they’re told to always “fight for the underhook.”
The underhook is great because you can run a system of attacks while maintaining inside control. Unfortunately a lot of people don’t know how to do it properly and teach it poorly with shitty head position. Watch my video on the underhook system and russian defense and you can see the connections
Another thing I would love you to explain more is, when I do a trip, the opponents leg is always in a way of doing a trip as well (when I do an insinde trip, his leg looks like it would when he does an outside trip, or vice versa, or when doing osoto gari it's identical).
What exactly are the key things that make me throw him and prevent him from throwing? Head and shoulders bend forward? It doesn't quite always work how I plan. Would love some tipps.
I wish you a speedy recovery
This is what makes grappling tough. At some point we all know the same techniques. What makes them work is the set up through kuzushi. Without a system of push pull and connecting various techniques in a sequence, you won’t get very far. This is by far the part that takes the longest to master. I have been doing this all my life and still learn. I had my mind blown by my judo sensei last night. His knowledge of systems for trapping people is unbelievable.
In terms of what you are trying to explain with regard to his legs being in the wrong place, you probably haven’t mastered the basics of the technique and I would recommend spending a lot of time on one technique and get very good at it before you try anything else
@@josephbreza-grappling9459 I didn't mean his leg being on the wrong place. I mean his leg is also in a throwing place and it's mainly other things that decide to throw (who unbalances who-kazushi) and meant what are the main things to look out for.
My favorite trip is ouchi gari/ouchi gake. Inside trip. I like it alot and the fact that I can transition from it very well. I can go to uchi mata or sumi gaeshi from there.
What are the things you coach told you last night?
@BMO4ever well yeah for a lot of throws my throw is also his throw. Like osoto gari, he has the same move-sort of like the arm drag. But it just depends on spinal alignment which is a big one. My coach is a master of getting you “stuck.” And he and I were going through some osotogari to sasae and osotogari to seoi otoshi combos. His understanding of the game is so next level it’s hard to comprehend or explain. It just reminded he how many levels there is to this shit
Oh shit that sucks jeez
Not related at all with subject of the video: I am curious to know about your perspective as a former d1 athlete, trainer and neuroscientist (a person who hava a deep insight on human skill aquisition and retention) on what John Danaher says about "drills" at Lex Friedmann's podcast.
Oh you mean how he says they are unnecessary once you have built the skill?
@@josephbreza-grappling9459yes
@@josephbreza-grappling9459Exactly
Exactly
I don’t agree with it in the way others are perceiving it…let me explain
Watch the best wrestlers and judokas in the world and they drill drill drill. There’s a reason why the level of wrestling is where it is currently is in Jiu Jitsu-they don’t drill sequences. You don’t just drill moves in isolation. You are supposed to have a partner giving you like 50% resistance so you can drill your set ups, level changes, and sequences off of attacks.
There are zero sequences right now in BJJ from the standing position. It’s like low level highschool. Take a shot without a set up, get stuffed, and then look over at your coach and be like “see, doesn’t work.” Because wrestling isn’t moves. Judo isn’t moves. Good stand up grappling and ground grappling are sequences.
Now, I think what John is referring to is that drilling slowly against opponents giving zero resistance is useless. That I agree with in terms of time spent. In wrestling, you start off that way and ramp it up. Your partner ramps up their resistance and helps you by stopping your first, second, or third chain in the sequence. I think this is what John also means by rolling with lesser skilled people helps you. This is because it is sort of like drilling against 50% resistance if they suck.
So, I doubt that he really means drilling is useless-I just think he was putting Lex in his place by being like drilling a move 1,000x isn’t an efficient method to improve. Judokas and wrestlers drill hard, and the results are undeniable. The competition at the highest levels of judo or wrestling are so many levels above Jiu Jitsu that it’s impossible to quantify. Is this because of drilling? Meh probably not, it’s probably the pools of competitors are larger. At the Olympic wrestling training center, these guys are banging each other’s heads in wrestling hard rounds all day every day. Quite the opposite. They are drilling sequences hard as fuck so that they are automatic
Bruh. I thought you were just advancing so quickly because you have maintained athleticism as an old MF 😂.
I work with people who have experienced medical trauma/abuse, emotional and physical DAILY in my practice. I encourage EVERY SINGLE PERSON who needs to be in the hospital to have an advocate, and, how to self advocate when there are questions. I know you have no issues there, but it upsets me for the guy who doesn't know how to communicate that for whatever reason.
How dare you trust the advice of the professional in charge of your physical healing to use the correct protocol? 😂
When YOU tell me you've done your research, I know that is not the same as most people who make that statement. Because, science-I send YOU articles to say "ok. Why is this a valid or invalid study?"
I'm glad you pressed for some answers before additional damage occurred.
Yeah I asked several times and he just said “well that’s what I have.” I think it’s partly my surgeon’s office. They should have told him that, but then again he is the professional who is supposed to make the call. He knew what my surgical repairs were, and I actually talked to him about it. But I left mostly because he was a douche who was virtue signaling and trying to mack the women in the place. Lol
@@josephbreza-grappling9459 you KNOW how much I hate "that guy." Me hurting feelings by telling dudes like that what I thought of that behavior...in a honest, appropriate for the situation, and direct manner (but serving the same level of respect lol) could have been your favorite pastime in grad school 😂
@@LittleBreza just so you know, at some point I will make a video of my major injury from highschool…seizure, life flight, and all. I know you don’t like seeing it, but it’s something that needs to be shown at some point. Coming back from that to the senior All Stars was the only opportunity I had left to make a statement for my HS wrestling career. And, I lost most of my collegiate scholarships, because nobody wanted a guy with a broken neck. I can only find one of the articles, but there was the one where the reporter falsely reported I broke my neck and severed nerves. He totally made that up and it cost me. But I have some of the other articles talking about how I signed to wrestle D1.
The only reason I want to post it is because so many people feel like they have to hang it up after an injury. If had, I wouldn’t have developed a large part of who I am. It’s not what happens to you, it’s how you respond to it
@josephbreza-grappling9459 I think that would be great. Big things come from hard situations, just like manure helps beautiful flowers grow.
I kinda wish there was video of me losing my 💩 on adults who tried to exaggerate the long term effect the injury would have for secondary gain. 😂 Trying to throw hands at whole ass adults in my sisterly rage. And having coaches and refs applaud.
Then again...I'm really happy that people didn't have 24/7 access to pocket sized recording devices at that time. 😂 That could have been viral. 😂
@LittleBreza hahahaha!!!