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Author Topic: Kneecaps really should stay in place.  (Read 600 times)

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Offline shincheck

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Kneecaps really should stay in place.
« on: January 25, 2014, 05:32:58 AM »
Hi guys, stumbled across this site trying to learn more about my options and prognosis. I'm sure there have been plenty of posts regarding patella dislocations, although I feel mine has a bit of a spin to it.

I'll do my best to keep it as short as I can, but I feel like no doctors really listen to the story as a whole.

I'm 25. I've been athletic my whole life. I've played basketball, football, ran track and cross country, raced motocross/supercross and have always been active. I've never, ever had any kind of knee problems, barring this last year, and I have zero family history of knee issues. I have an identical twin brother who also has never had any knee issues whatsoever.

A few years ago I took up Brazillian Jiu-jitsu, but felt it wasn't really what I was after, so I transitioned to a MMA gym with a focus on Muay Thai and some karate elements; to simplify, I've been kickboxing heavily the last few years. I eventually got to the point where my coaches were asking me if I wanted to fight, I agreed and managed to win my first.

On August 31 of last year, I had my second fight in front of a huge audience. Thousands of people, including my family, girlfriend, all my friends; they got to come and see my kneecap dislocate. There's a video of my fight depicting the injury showing exactly what happened, but I'll leave that one out. Suffice to say, it seemed like a freak accident from trauma. Regardless, I passed out when it happened, and woke up and looked down and began to feel the worst pain I've ever felt in my entire life. They had to put me on a stretcher, take me to the back and reset it -- reduce it, I think it's appropriately called -- because the doctor said it was "caught." I went to the ER that night, they took some x-rays and said things look fine. They let me go with some crutches, I followed up with a local orthopedic about a week later and he gave me an immobilizing knee brace and had me wear it for 6-7 weeks. He failed to mention my quad would atrophy horribly and didn't suggest any kind of SLR's or anything, so by the time he let me take it off my thigh was jello, whether or not I flexed it. During this time, my left leg had gotten pretty big as it was doing the work for two legs, so the disparity got pretty big as my left quads were jacked and my right were virtually gone. I moved into 2-3 weeks of PT with electrostimulation, but I was having trouble with my insurance and I wasn't able to keep going. The PT understood and gave me exercises to do, and I regained 100% ROM and flexion on my own. 

I've always lifted and ran, so when my knee was ready I was so eager to get back and start lifting. I tempered this eagerness with a healthy respect and concern for not hitting it too hard. I started doing leg presses with only the injured leg, starting at 20 pounds and increasing it over the next few months to where I was putting up 100 pounds 20 times. My right knee -- the injured one -- was coming along, along with my quads. I eventually slipped back into actual mma training, but always taking it easy and not pushing myself too hard. I did a lot of padwork and didn't do any real wrestling or anything that would torque on my knee. Fast forward to January of this year -- 4 months post injury of my right kneecap -- I was getting stronger, quicker and my confidence levels were returning. My knee, although not 100%, was feeling pretty close to normal. I could throw kicks without being afraid it was going to come out even though throwing full force did still hurt; so I just didn't throw my right hard. I was overcoming the mental fears that injuries bring, I was doing a great job of balancing protecting my healing knee while pushing it just enough to strengthen it. I began to think about when I could take my next fight, what was on the horizon. I was working with a pro fighter I know, getting him ready for his fight coming up on the 31st, and we were sparring. I planted my left leg to a 45 degree angle, like I've done literally thousands of times, threw my right leg in a high head kick, he saw it coming and moved forward, effectively "jamming" it, messing up the distance. I see this happening, so I try to recover and as my right leg is coming back down in an arc, I hop back with my left leg -- the plant leg -- to re-establish a distance and reset the engagement. However, as I land my head explodes in pain and I  fall down. I was hearing someone yelling and I realized it was me. I got a sick feeling in my stomach and I looked down to my left knee this time and see the kneecap WAY out of position, down and to the outside. This time it reduces in the ambulance going over some bumps.

This time, I went and saw a new ortho as I wasn't particularly impressed with my previous ortho, apparently all this new ortho focuses on is knees and he was an NFL team trainer for 20+ years. His approach was a lot different: he told me that along with my dislocated patella, he suspected a grade 1 MCL injury. He said I need to begin bending it immediately; he prescribed me some pain medication, and said to take it and continually keep fighting for my range of motion in my now left injured knee even though I didn't take any of the medication -- I really don't like the way pain medication makes me feel, anyway. So, it's been two weeks now, and I am closing in on full range of motion. I am still waiting to get in for an x-ray and an MRI as I'm dealing with insurance and deductible issues, but I should get in this week. The new ortho did mention that the x-rays from the ER on the most recent dislocation shows what looks like to be a bone chip, but he wants another to be sure.

This all leads up to me pondering a few big ideas:

A) I want to fight again, I'm not ready to quit. I want to keep training and keep moving forward and challenging myself. I can't imagine giving up my athletic lifestyle and stopping doing what I've grown to love and have done for years without incident. But, I'm afraid that I have to choose between destroying my knees and qutting. I don't like either choice.

B) I understand the first dislocation to my right knee, as that was seemingly trauma induced. I'm really puzzled as to how the left came out when I was simply doing things I've literally already done thousands of times in my life. I've thrown that kick easily more than a thousand times, I've hopped on one leg before, I've twisted, pivoted and jumped in so many sports and nothing. Could it have been that my left hamstrings were overmatched by my left quads from the long months of my left leg doing all the work? Is the second just a result from the havoc wreaked on my body from the atrophy and resulting disparity in muscle groups?

C) I don't understand how this can be an anatomical problem. As I mentioned, no one in my family has ever had these issues and they're all fairly active. I badly want to believe that this a series of unfortunate events and that I can recover and keep going but everyone else seems to be of the opinion that I need to basically give certain things up for good.

D) How probable is it to expect that, assuming anatomical issues being the underlying cause, that I can expect to be able to turn to surgery to fix the problem? I don't want to go through life being afraid to be the athlete I always have been.

Sorry for the essay. It's difficult to talk to people, however, who haven't also gone through knee problems. They seem to just kind of write you off and expect you to stay down, but that's so hard for me to swallow. Any advice, opinions from anyone else in any kind of remotely similar situation, or general comments are appreciated. Thanks for making it through the wall of text.