Wednesday, May 26, 2010

Update 2010: The Fear of Injury - A Question of Trust

The following is a post I wrote in March 2009.

After I was diagnosed with a completely torn ACL, I was given two options…surgery or no surgery. I was told that people live happy, healthy lives without an intact ACL. However, there was one very big problem. The surgeon said four words that filled the room “No ACL….no karate”. My decision to have the surgery was immediate. There was no thought involved because I knew that I needed a healthy, stable knee in order to continue training. There have been people who suggested that I stop training due to my injury.

My ACL tear occurred while working on a two-man bo form. I jumped…my foot planted…my body shifted into position…my knee gave out…I crumbled to the floor… I stood up and finished the bo form. I knew something was wrong as soon as I felt my leg slide out of position. Just writing about that feeling gives me a lump in the pit of my stomach. This was a non-contact injury. My body…my movement…caused this injury.

How did I find my way through the fear of re-injury?

The truth is I did not. It is still with me each time I step on the dojo floor, every racquetball game and each bout of sparring. I try to manage the fear by being proactive. I joined a gym so I could lift weights in order to keep my knee strong. I started Tai Chi in the hopes I will move more fluidly. I play racquetball to see how far I can push my knee.

There was a recent week that I did nothing…no karate, no Tai Chi, no racquetball and no gym. I can tell you with certainty that my knee ached during that week. I kept wondering what I did until I realized it was a direct result of what I was not doing. I know that keeping my knee healthy and strong is a daily pursuit.

I am going to keep moving forward but there is a delicate balance. If I let the fear of injury go completely, I may become reckless in my training. I need just enough fear to keep me cautious and aware.

Update May 2010

I am writing this update as a response to Kicker’s question “How do you learn to trust it (knee) again?” I remember wondering the same thing shortly after my ACL reconstruction. At the time, it was one of my biggest concerns. I walked into the hospital, carrying a knee brace and crutches, with a moderately functioning knee. I left the hospital three hours later wearing a brace and needing to use crutches for six weeks. I barely had the muscle strength to do a straight leg raise. My goal was to return to pre-injury activity. How do you get from point A to point B? How do you learn to trust it again?

For me, I think the answer is simply…Time. It has been three years and I no longer think about my knee or worry about re-injury each time I step on the dojo floor. I still belong to the gym and lift weights to maintain a strong knee. Practicing Tai Chi has improved my balance and I am more aware of the effects of weight distribution on movement. I learned to trust my knee again by being aware of my strengths and limitations. I listen to my body.

When my knee "speaks" to me, I make sure to analyze what I am doing, slow down and be careful. Last week when I was helping with the garage roof, I did not feel comfortable walking on the roof. Due to the angle, I was putting an unnatural torque on my knee. I made an adjustment and was able to continue working.

How did you learn to trust your body again after an injury?

Disclaimer: This blog is my personal weblog regarding my ACL surgery and recovery. Please note that I am not dispensing medical advice rather I am documenting my personal experiences.


Pete said...

I agree -- time is what it takes. I had an ACL repaired in 1995, and I started martial arts a year later. It took a lot of time to feel comfortable. When I started doing jump spinning back hook kicks a couple years after surgery, I was still very nervous about landing and twisting. But I don't think about it now (except when trying to kneel, which is horrifically painful).

Last year's shoulder reconstruction never led to quite the same apprehension as the ACL tear did. Maybe the knee causes more anxiety than other body parts?

Michele said...

Hi Pete, Thanks for commenting! You bring up an interesting point...what is it about the knee? My husband has had shoulder, neck, elbow and knee surgery. I still hear him make the occasional comment about his knee.

nikejo said...

It was good to read this right now. I am just over 4 weeks post op with my ACL surgery and I wonder the same thing. I am feeling so much better than I did in the first dreadful week post op, but I know there is still a long way to go both physically and mentally. I have had a broken foot, and a compression fracture in my back in the past, but this is so different. Much more of a process to work through.

Michele said...

Nikejo: Thank you for commenting. I am glad you liked the post. I have included your site in my ACL Stories blog list. Best wishes on your recovery.

John W. Zimmer said...

Hi Michelle,

I have a friend that went through knee injuries and he had to stop competing. He was a rate fighter on the East coast in the 90's.

Well now he is running a karate club at a local gym and has his daughter helping him.

I have another friend in the 80's that tore his Achilles heel. He took a long time to heal (after the surgery) and then ended up re-tearing it. He had to quit karate.

I've not had to deal with any of that - just the normal aches and pains - injuries that happen as one is getting back into shape. I'm hoping for 1/2 of the shape I was in my teens but will be happy with 25%. :)

Your knee speaking to you is good so long as you listen to it. That is how I've avoided some injuries... I stop running if my knee acts up so there will be another day.

Easy to do for me as a middle aged man with nothing to prove to anyone but myself - karate amounts to kicking the bag (I keep braking my right hand/wrist). :)

Hang in there - you'll keep up to the level of activity you are comfortable with and you body can do.

Kind regards

Kicker said...

Thanks for the post! It helped to read what you have done and continue to do. Good words of advice that I'll hang onto through my recovery and beyond. It's been quite a trip so far and I miss taekwondo so much. In due time...

Michele said...

Thanks for commenting John! You are right..."Your knee speaking to you is good so long as you listen to it". Sometimes I would simply like to ignore it. :)

Kicker: Thanks!