Knee Injuries

[Bill MacLean]

I am interested in fencing and have a question about knee injuries. First
some background.

I'm left handed but I do not have an ACL (Anterior Cruciate Ligament) in my
left knee. I tore my ACL, MCL (medial collateral ligimant) and medial
meniscus in highh school football. In 1980 (I'm 39) , ACL reconstruction
was still pretty unusual outside of pro and college sports. The doctor
removed the meniscus, stapled the MCL and removed the ACL. A few years
later I had a second surgery, but that was just to remove little bits of
cartiledge that were floating around.

My knee has been pretty stable since then, but I have been pretty sedentary.
Anyway, I've always been interested in fencing, and it seems like it would
be a fun sport plus great exercise.

Does anyone else out there have an unreconstructed ACL? Do you wear a
brace? I would be interested to hear what people have to say. I really
don't want to mess up my knee again. Back in high school I had a lot of time
for physical therapy, etc, but recovery would be a real bummer now.

Is there a lot of pivoting in fencing? From observation, it appears to me
that most of the motion is forward and back, and involves less pivoting
than, say tennis. Is my observation accurate?

Thanks,

Bill

[CLHagenMN]

In article <0dl5a.27722$Hb.560695@news1.west.cox.net>, "Bill MacLean" <l@l.com>
writes:

>From: "Bill MacLean" <l@l.com>
>Date: Fri, 21 Feb 2003 08:13:48 GMT
>
>I am interested in fencing and have a question about knee injuries. First
>some background.

>I'm left handed but I do not have an ACL (Anterior Cruciate Ligament) in my
>left knee. I tore my ACL, MCL (medial collateral ligimant) and medial
>meniscus in highh school football. In 1980 (I'm 39) , ACL reconstruction
>was still pretty unusual outside of pro and college sports. The doctor
>removed the meniscus, stapled the MCL and removed the ACL. A few years
>later I had a second surgery, but that was just to remove little bits of
>cartiledge that were floating around.

First of all, we really should make a point of finding otrthopedists who fence,
and get their opinion on this sort of thing;

Secondly, is there any chance that you will pursue a reconstructive procedure?
(yeah, you kind of missed the window by a couple years...)

>My knee has been pretty stable since then, but I have been pretty sedentary.
>Anyway, I've always been interested in fencing, and it seems like it would
>be a fun sport plus great exercise.

Well, does 'sedentary' mean you are significantly overweight? (no offense...)
Fencing IS fun, even if you don't pursue competion, serious, or otherwise
(though that IS half the fun for me...).
It CAN be good exercise, but, I must confess, that it shouldn't be considered a
complete exercise regimen.

>Is there a lot of pivoting in fencing? From observation, it appears to me
>that most of the motion is forward and back, and involves less pivoting
>than, say tennis. Is my observation accurate?

This is more a question of personal style; by the nature of the game, it's not
necessarily expected that pivoting is demanded, as is more important in
wrestling, rugby, soccer, football, or even ulimate frisbee (a fairly athletic
friend of mine tore her ACL doing that), BUT you will find people (myself
included) that do quite a bit of pivoting in their actions. Of course, it's
not like there's somebody falling on top of you. (or rather there's not
supposed to be - despite what some of the ill-informed posters will say in
this forum.)

People DO fence with braces on, but (having suffered a serious ankle injury, I
can say) there's no subtitute for continuing habilitation therapy/strength
training.

You can probably start out easy, and see how you like it; if you think you want
to go farther, you should probably seek direct consult with an sports-oriented
orthopedic, and don't be afraid to ask them how much they know about fencing
first.

Good luck.

[Bill MacLean]

Lots of great posts, and I really appreciate all this great info.

Here's a little update. I went to the orthopedic surgeon today, and had a
very good appointment. His first remark was "I'm not so sure that fencing
is the sport for you, because of all that footwork, but let me take some
x-rays and then we'll talk more." Once the x-rays were back (by the way,
that is very cool, the x-rays are instantly displayed on a monitor, no more
waiting for the film, etc), things became more positive. The Dr. said my
knee looked surprisingly good considering the injury I had. He manipulated
the knee and then said that he thought I could try fencing. He suggested I
just start slow and really watch my form.

All this is great news. My second lesson will be Wed night. I am going to
ease into it, and see how my knee responds. I'm really looking forward to
learning, but also have to keep in mind that things may not work, but right
now I'm pretty happy.

I would love to talk with an ortho who fences. I know that Tamir Bloom tore
his ACL (trailing leg), and I thought he became an orthopedic surgeon, but I
cannot find an email address for him anywhere.


Thanks,

Bill

[Carol]

Perhaps contact Doc DeFabio through the NJ division.

Bill MacLean wrote:

> I would love to talk with an ortho who fences. I know that Tamir Bloom tore
> his ACL (trailing leg), and I thought he became an orthopedic surgeon, but I
> cannot find an email address for him anywhere.

[Bill MacLean]

Being brand new to fencing, I am not familiar with the different
organizations. What is the New Jersey Division? I would love to get ahold
of this guy.

Thanks,

Bill

P.S. Good news so far. The ortho said he liked the look of my knee . Had
my second lesson Wed and no knee pain!

"Carol" <ca.donohue@verizon.net> wrote in message
news:3E5EE38E.4B0F0FEF@verizon.net...
> Perhaps contact Doc DeFabio through the NJ division.
>
> Bill MacLean wrote:
>
> > I would love to talk with an ortho who fences. I know that Tamir Bloom
tore
> > his ACL (trailing leg), and I thought he became an orthopedic surgeon,
but I
> > cannot find an email address for him anywhere.
>

[Jacq-]

I just had the surgery in September and am now back to fencing!! However, if
your knee is stable enough to play say, basketball, you are probably stable
enough to fence. The best way to tell is go to a physical therapist or a
good sport med Doc. They will be able to tell you if you are sound enough to
fence.

I had to have my ACL and meniscus repaired. As a new procedure they
automatically replace the LCL which was a blessing in disguise. I had
injured my knee doing a lunge about 3 years ago (actually due to a fallen
arch). Although surgery was no cake walk, I am almost fully back into the
swing of things. I plan on attending Nationals this year in Women's Epee.

Jacquie
Anchorage, AK
"Bill MacLean" <l@l.com> wrote in message
news:0dl5a.27722$Hb.560695@news1.west.cox.net...
> I am interested in fencing and have a question about knee injuries. First
> some background.
>
> I'm left handed but I do not have an ACL (Anterior Cruciate Ligament) in
my
> left knee. I tore my ACL, MCL (medial collateral ligimant) and medial
> meniscus in highh school football. In 1980 (I'm 39) , ACL reconstruction
> was still pretty unusual outside of pro and college sports. The doctor
> removed the meniscus, stapled the MCL and removed the ACL. A few years
> later I had a second surgery, but that was just to remove little bits of
> cartiledge that were floating around.
>
> My knee has been pretty stable since then, but I have been pretty
sedentary.
> Anyway, I've always been interested in fencing, and it seems like it would
> be a fun sport plus great exercise.
>
> Does anyone else out there have an unreconstructed ACL? Do you wear a
> brace? I would be interested to hear what people have to say. I really
> don't want to mess up my knee again. Back in high school I had a lot of
time
> for physical therapy, etc, but recovery would be a real bummer now.
>
> Is there a lot of pivoting in fencing? From observation, it appears to me
> that most of the motion is forward and back, and involves less pivoting
> than, say tennis. Is my observation accurate?
>
> Thanks,
>
> Bill
>
>

[Jacq-]

The ACL is very important especially for those occasions when doing a lunge
quickly is not done properly.

JP
"Bill MacLean" <l@l.com> wrote in message
news:98B5a.36462$Hb.790179@news1.west.cox.net...
> Hi Peter,
>
> Thanks for the good reply. I have an appointment with an orthepedic
surgeon
> on Monday, and he will evaluate me. I think that it will probably be
okay.
>
> I forgot to mention that I visited a club Wed night and did some footwork.
> I actually did some lunges (slowly) on Wed while the coach was watching,
and
> my knee is not bothering me. It seems to me that in the lunge, most of
the
> inertia is from the upper thigh, so the ACL isn't as important as the PCL.
> I may be all wrong about this, so I look forward to speaking with the
> doctor.
>
>
> Two points:
>
> 1. If anyone out there fences without an ACL or even with a reconstructed
> ACL in the lead knee, I'd be really interested to hear about.
>
> 2. What is the incidence of ACL injuries among fencers? If a lot of
people
> with good knees end up with an ACL injury, this may not be the best sport
> choice for me.
>
>
> Thanks,
>
> Bill
>
>
>
>
> "Peter Harrison" <pbharriso@hotmail.com> wrote in message
> news:b35kpr$qt9$1@ngspool-d02.news.aol.com...
> > You are right that there is not much pivoting, but one of the main
> functions
> > of the ACL is to prevent movement where the tibial plateau slides
forward
> > under the femoral condyles (that is one of the basic tests to identidy
an
> > ACL tear - grab hold of the top of the lower leg just below the knee,
with
> > the knee bent at 90 degrees, and try to pull it forward. If it moves,
> then
> > the ACL is torn.)
> >
> > A brace will help, but no brace can hold your joint as well as nature
does
> > with intact ligaments.
> >
> > 2 years ago I tore my LCL and lateral meniscus. I could fence ok, but
> would
> > have to stop in the middle of a lesson or a footwork session to flex the
> > knee. I just had surgery to remove the torn part of the meniscus, and
> hope
> > to get back to fencing next month, but it will be interesting to see if
it
> > is better or worse. One (older, in his 60s) guy I spoke to at the gym
> > yesterday said it took him 3 years before he could run without pain
after
> > meniscus surgery.
> >
> > Hopefully, someone in the group with an ACL injury will post something.
I
> > will be interested to hear the story.
> >
> > I used to work at the US Military Academy hospital, where our
orthopaedic
> > surgeons were doing 2 ACL repairs a week. This sounds like an
incredibly
> > high number, until you consider that they were looking after 2,000 kids
> > playing football. The injuries were seldom on the Varsity team, but on
> the
> > others that were not as fit.
> >
> > "Bill MacLean" <l@l.com> wrote in message
> > news:0dl5a.27722$Hb.560695@news1.west.cox.net...
> > > I am interested in fencing and have a question about knee injuries.
> First
> > > some background.
> > >
> > > I'm left handed but I do not have an ACL (Anterior Cruciate Ligament)
in
> > my
> > > left knee. I tore my ACL, MCL (medial collateral ligimant) and medial
> > > meniscus in highh school football. In 1980 (I'm 39) , ACL
> reconstruction
> > > was still pretty unusual outside of pro and college sports. The doctor
> > > removed the meniscus, stapled the MCL and removed the ACL. A few
years
> > > later I had a second surgery, but that was just to remove little bits
of
> > > cartiledge that were floating around.
> > >
> > > My knee has been pretty stable since then, but I have been pretty
> > sedentary.
> > > Anyway, I've always been interested in fencing, and it seems like it
> would
> > > be a fun sport plus great exercise.
> > >
> > > Does anyone else out there have an unreconstructed ACL? Do you wear a
> > > brace? I would be interested to hear what people have to say. I
really
> > > don't want to mess up my knee again. Back in high school I had a lot
of
> > time
> > > for physical therapy, etc, but recovery would be a real bummer now.
> > >
> > > Is there a lot of pivoting in fencing? From observation, it appears
to
> me
> > > that most of the motion is forward and back, and involves less
pivoting
> > > than, say tennis. Is my observation accurate?
> > >
> > > Thanks,
> > >
> > > Bill
> > >
> > >
> >
> >
>
>

[CLHagenMN]

In article <v663o71asdgc8c@corp.supernews.com>, "Jacq-" <parkertrbl@gci.net>
writes:

>However, if
>your knee is stable enough to play say, basketball, you are probably stable
>enough to fence. The best way to tell is go to a physical therapist or a
>good sport med Doc. They will be able to tell you if you are sound enough to
>fence.

Yes, this soounds like a great 'benchmark' - I imagine many of these doctors
are very comfortable in their knowledge of several sports activities that,
even at routinely active common recreational levels, involve significantly more
torsion of the kneesl; such as basketball and soccer.

[CLHagenMN]

In article <v664736dg1k727@corp.supernews.com>, "Jacq-" <parkertrbl@gci.net>
writes:

>the surgery is done laproscopically now and they can either use your own
>achilies or petelar tendon. I opted for the cadaver, they cryogenically
>freeze the donor tendon to kill all the little buggers on it and I don't
>risk instability in other ligaments/tendons. As I noted in a previous post,
>my surgery was September 17, 2002

I don't mean to scare you, or anyone else, BUT, while the cadaver tissue
approach IS a very safe thing (and, since you have already recovered, I don't
think this applies to you), but we DID have a case, here in Minnesota about 3
years ago, where a patient had this very same procedure, and contracted an
infection from said cadaver tissue. Unfortunately, the doctors didn't quite
understand what they were dealing with, and post-operative choices of
antibiotics were ineffective, and the young adult male patient died.

I don't know quite enough about the medical details of whether they could have
saved him if they had found out the nature and source if the infection sooner,
but the ensuing investigation and forensics indicated that the cadaver tissue,
which (with current technology) cannot be truly sterilized without destroying
the tissue, was the source of the infection of some fairly rare and nasty
bacterial infection, and had actually been the cause of 3 such infections, (I
can't quite remember, but I think someone else died, too.). There was a strong
indication that, through a lack of consistent standards and/or adequate
enforcement, the the cadaver/tissue had not been handled and refrigerated
properly, and was perhaps (IMHO) sat around a little too long before being
frozen.

Freezing really only retards bacterial growth, sometimes quite effectively, but
is NOT a sterilization process.

Again, I don't mean to overstate any risk, there are thousands of these
proceduresd done every year, you are probably more likely to get killed in a
car accident than have this happen to you, but I am just saying that it's still
not a %100 proposition.

Gaad to hear it's working out for you!
:-)