dislocated knee first day of MT

[verynicehowmuch]

I've been studying Tang Soo Do for about 3 years and I'm looking for something to study alongside it. About a week ago I tried a class at a Muay Thai gym. There was a conditioning class and a sparring class and I accidentally showed up for the sparring one, but I just went with it. About 15 minutes into sparring (I was fighting using what I know from TSD), I took a kick to the knee and it got dislocated.
It caused a small fracture and also a lot of swelling. I can't bend it and I'm in a leg brace but I can walk fine.
Is it wise for me to return to Muay Thai or is the risk of re-dislocation too high? Can I even return to TSD? Am I pretty much out of commission now? What can I do to prevent this from happening again?

 

[skribs]

Here's my advice:

• Your doctor will give better advice than random people on the internet
• If you're not sure, safety is more important than martial arts training

 

[drop bear]

Happened to me because I tended to pivot like a boxer and got caught. So basically my knee turned inwards which is a bad position to take kicks.

The prevention is just better structure.

 

[jobo]

I've been studying Tang Soo Do for about 3 years and I'm looking for something to study alongside it. About a week ago I tried a class at a Muay Thai gym. There was a conditioning class and a sparring class and I accidentally showed up for the sparring one, but I just went with it. About 15 minutes into sparring (I was fighting using what I know from TSD), I took a kick to the knee and it got dislocated.
It caused a small fracture and also a lot of swelling. I can't bend it and I'm in a leg brace but I can walk fine.
Is it wise for me to return to Muay Thai or is the risk of re-dislocation too high? Can I even return to TSD? Am I pretty much out of commission now? What can I do to prevent this from happening again?

Have you really dislocated it, I doubt you would be walking with out sticks if You had, Over extended it perhaps, mt, carries a high risk of injury as it's real,

 

[JR 137]

Dislocated knee cap (patella), or the knee itself? Two very, very different things with different recovery and rehab timeframes.

Regardless of which one you did, follow your physician’s advice. If all you saw was an ER doctor, you need to follow up with an orthopedist. And a physical therapist afterwards.

When I was working as an athletic trainer (sports medicine, not personal trainer) I saw many dislocated patellas. It’s a several week recovery and rehab thing, but not a career ending injury. I guess it could be under certain extreme circumstances, but it’s typically a strengthening program to keep it from reoccurring if it’s a first time thing.

An actual knee dislocation is pretty rare. When that happens, there’s usually stuff that’s torn that requires surgery to repair, either meniscus or sometimes ligaments such as the ACL or PCL. Oftentimes the articular cartilage is torn/damaged. That typically can’t be repaired. I’ve only personally seen one knee dislocation in my 18 years or so experience. He did return (soccer), but it was only for one season; he was a college junior and played his senior year. If he had a few more years left, I doubt he would’ve played them all as he had some problems all season long.

Follow up with an orthopedist and physical therapist before deciding to return or end your training.

 

[hoshin1600]

An actual knee dislocation is pretty rare. When that happens, there’s usually stuff that’s torn that requires surgery to repair, either meniscus or sometimes ligaments such as the ACL or PCL.

i tore my LCL doing BJJ with a guy who was trying to get mount and decided to grab my leg and twist it like tearing off a Turkey thigh on Thanksgiving.

 

[hoshin1600]

15 minutes into sparring (I was fighting using what I know from TSD), I took a kick to the knee and it got dislocated.

the bigger question is ..did you learn anything about your TSD training and how MT is a very different experience?
maybe not throwing kicks out there like a point fighter, hanging the leg out there in space for two long, if the kick isnt going to connect solid dont throw it. my guess is the MT guy saw the opening and took it, just like he always does but in this instance your from another style so your prior action or reaction put you in a bad spot for that kick.

then again it just could have been bad luck.

 

[Gerry Seymour]

See JR's post above. I assume, based on your description, it's a patellar dislocation, but you need to be certain you know what it is, so you can make good decisions. Once you have the "all clear" from an orthopedist and PT (I'd wait for both to clear), you should be good to go back to both TSD and MT (assuming doc and PT don't see a reason not to - they'll know things we cannot). Drop bear makes an excellent point, so use this for learning. Even if you're not going to go back and train MT, go back and talk to the instructor or some experienced MT guys and find out why this doesn't happen to them. Learn the structure that protects that knee from re-injury.

 

[FriedRice]

I've been studying Tang Soo Do for about 3 years and I'm looking for something to study alongside it. About a week ago I tried a class at a Muay Thai gym. There was a conditioning class and a sparring class and I accidentally showed up for the sparring one, but I just went with it. About 15 minutes into sparring (I was fighting using what I know from TSD), I took a kick to the knee and it got dislocated.
It caused a small fracture and also a lot of swelling. I can't bend it and I'm in a leg brace but I can walk fine.
Is it wise for me to return to Muay Thai or is the risk of re-dislocation too high? Can I even return to TSD? Am I pretty much out of commission now? What can I do to prevent this from happening again?

X-Ray won't show ligament damage, you'd need an MRI. They won't authorize an MRI yet, unless you're screaming in pain, as it costs $2-3k. You can probably walk straight, even jog but it's going sideways or pivoting that you prob. can't do and will fall straight to the floor. You're screwed for a while and it would be nuts to train anytime soon, other than rehab training. Wear thick, grappling knee pads made for MMA, now dur. rehab. and when training 3-6 months later. These are known to save ACL's from snapping off to a certain point.

So did you kick a bunch of MT dudes in sparring class, landing weird & fast kicks that they're not used too...albeit, not landing hard, but a lot?

 

[FriedRice]

the bigger question is ..did you learn anything about your TSD training and how MT is a very different experience?
maybe not throwing kicks out there like a point fighter, hanging the leg out there in space for two long, if the kick isnt going to connect solid dont throw it. my guess is the MT guy saw the opening and took it, just like he always does but in this instance your from another style so your prior action or reaction put you in a bad spot for that kick.

then again it just could have been bad luck.

I bet the MT tried to sweep the standing leg while he threw a side kick and/or chambering his kicking leg too long. Like in points fighting, it's illegal to kick the leg so they just stand on 1 leg and keep spamming sidekicks. You can just cover up, charge in to take/jam the sidekicks and kick out the leg, and sometimes the sweep/kick lands right on the knee = snap.

 

[Gerry Seymour]

X-Ray won't show ligament damage, you'd need an MRI. They won't authorize an MRI yet, unless you're screaming in pain, as it costs $2-3k. You can probably walk straight, even jog but it's going sideways or pivoting that you prob. can't do and will fall straight to the floor. You're screwed for a while and it would be nuts to train anytime soon, other than rehab training. Wear thick, grappling knee pads made for MMA, now dur. rehab. and when training 3-6 months later. These are known to save ACL's from snapping off to a certain point.

So did you kick a bunch of MT dudes in sparring class, landing weird & fast kicks that they're not used too...albeit, not landing hard, but a lot?

It doesn't usually take screaming pain to get an MRI, if the doc recommends it as a next diagnostic step. If a doctor doesn't recommend it, he probably doesn't think there's any real benefit to be had at this point (and no real risk in not doing it yet).

 

[JR 137]

X-Ray won't show ligament damage, you'd need an MRI. They won't authorize an MRI yet, unless you're screaming in pain, as it costs $2-3k. You can probably walk straight, even jog but it's going sideways or pivoting that you prob. can't do and will fall straight to the floor. You're screwed for a while and it would be nuts to train anytime soon, other than rehab training. Wear thick, grappling knee pads made for MMA, now dur. rehab. and when training 3-6 months later. These are known to save ACL's from snapping off to a certain point.

So did you kick a bunch of MT dudes in sparring class, landing weird & fast kicks that they're not used too...albeit, not landing hard, but a lot?

There’s several hands-on ways to tell if there’s ligament and/or meniscus damage. An orthopedist will move the joint in specif ways (special tests) such as a Lachmann test, anterior and posterior drawer test, varus and Valois stress test, McMurray’s, etc. There’s rarely anything an MRI finds that an orthopedist doesn’t already know, especially within the knee. An MRI will pretty much confirm his/her findings and justify surgery when necessary. I’ve had several orthopedists (good ones at least) who said most MRIs are a waste of time and money. Especially in the knee as they already know (let’s say) the ACL is completely torn and needs reconstruction. Combine that with they’ve got the tools to fix anything else in there, and I get their argument. My counter is “even if we both know 100% certainty that I need my ACL repaired, I’d at least like to know that you’re probably going to have to do something else in there too.”

The overwhelming number of MRIs are for patient comfort/piece of mind. Certain things like how much damage a meniscus has and where, how severe something like a shoulder labrum is torn, etc. and if it’s worth operating on are another thing. A lot of stuff is pretty cut and dry. The knee is pretty simple compared to a shoulder.

 

[verynicehowmuch]

the bigger question is ..did you learn anything about your TSD training and how MT is a very different experience?
maybe not throwing kicks out there like a point fighter, hanging the leg out there in space for two long, if the kick isnt going to connect solid dont throw it. my guess is the MT guy saw the opening and took it, just like he always does but in this instance your from another style so your prior action or reaction put you in a bad spot for that kick.

then again it just could have been bad luck.

Actually, yes, I did learn how different MT feels compared to TSD. At first I instinctively made no contact (which is sadly what I'm used to but trying to change) but after a few minutes I got used to both taking and receiving hard kicks to the body/legs. And honestly I was getting my *** handed to me but I loved the thrill of actually taking a hit, which is why I wanted to try MT in the first place. That and I wanted to learn to stop over-telegraphing and throwing too many kicks.
What eventually caused the "dislocation" though was my stance being too wide and too much weight on the back leg, which was due to the fact that I was extremely fatigued from sparring. I think the biggest mistake I made was not taking the conditioning class first, i.e. learning how to spar before actually sparring.

tl;dr - I showed up for MT, accidentally showed up for a more advanced class, am a total novice, my style was incompatible with their kind of sparring, my leg got screwed up, and now I want to learn MT even more to prevent it from happening again (and to be a better fighter of course ).

 

[FriedRice]

There’s several hands-on ways to tell if there’s ligament and/or meniscus damage. An orthopedist will move the joint in specif ways (special tests) such as a Lachmann test, anterior and posterior drawer test, varus and Valois stress test, McMurray’s, etc. There’s rarely anything an MRI finds that an orthopedist doesn’t already know, especially within the knee. An MRI will pretty much confirm his/her findings and justify surgery when necessary. I’ve had several orthopedists (good ones at least) who said most MRIs are a waste of time and money. Especially in the knee as they already know (let’s say) the ACL is completely torn and needs reconstruction. Combine that with they’ve got the tools to fix anything else in there, and I get their argument. My counter is “even if we both know 100% certainty that I need my ACL repaired, I’d at least like to know that you’re probably going to have to do something else in there too.”

The overwhelming number of MRIs are for patient comfort/piece of mind. Certain things like how much damage a meniscus has and where, how severe something like a shoulder labrum is torn, etc. and if it’s worth operating on are another thing. A lot of stuff is pretty cut and dry. The knee is pretty simple compared to a shoulder.

Good info, although I can't agree with it. I certainly would not get ACL surgery w/o it as there are degrees of tears. My case was not where I was screaming in pain and cried all the way to the hospital in the ambulance while waiting for surgery the next day, like some of my friends at the gym. That's a clear cut case of needing surgery, but not for me. The primary provider Doc couldn't tell from her physical tests/examination + x-rays, although she held out for 1 more follow-up appointment before allowing the MRI. So she sent me to get an MRI and then to the Ortho surgeon, who looked at the MRI before even seeing me. When he came in, he told me that there was no need for surgery as it wouldn't help. I can't remember if he even did any tests with my knee and sent me to get an appointment with the rehab Doc. I prob. only saw him for 2 minutes, because I asked some questions.

My knee is still only working at 70% at best, after 2 years.

 

[Ironbear24]

Take a bath in tub of four leaf clovers and other various good luck charms. That is some serious bad luck you got there.

 

[verynicehowmuch]

Take a bath in tub of four leaf clovers and other various good luck charms. That is some serious bad luck you got there.

as long as the injury doesnt last forever im fine with it :/

 

[JR 137]

Good info, although I can't agree with it. I certainly would not get ACL surgery w/o it as there are degrees of tears. My case was not where I was screaming in pain and cried all the way to the hospital in the ambulance while waiting for surgery the next day, like some of my friends at the gym. That's a clear cut case of needing surgery, but not for me. The primary provider Doc couldn't tell from her physical tests/examination + x-rays, although she held out for 1 more follow-up appointment before allowing the MRI. So she sent me to get an MRI and then to the Ortho surgeon, who looked at the MRI before even seeing me. When he came, he told me that there was no need for surgery as it wouldn't help. I can't remember if he even did any tests with my knee and sent me to get an appointment with the rehab Doc. I prob. only saw him for 2 minutes, because I asked some questions.

My knee is still only working at 70% at best, after 2 years.

They don’t operate on incomplete ACL tears under most circumstances. Truth be told after everyone I’ve seen with a partial ACL tear, you’re better off tearing it completely and getting surgery. I’ve never seen an athlete rehab a partial tear and fully recover. Ever. And I’ve seen more than a few.

Maybe I was being too general in my statement. A complete ACL tear is pretty easy to diagnose without an MRI. You pull on the knee at a certain angle (Lachman’s test and anterior drawer test), and the knee keeps going when it should stop. You get a gray area when it’s not completely ruptured, as there’s generally more slack than the opposite knee, but there’s still what’s call and end feel.

As a clinician, I say an MRI isn’t necessary when you’ve got a positive Lachman and anterior drawer test. If I was a patient, there’s no way anyone’s opening me up without an MRI One of the surgeons I was talking about this with does about 10 ACL reconstructions a week. I’d say he knows when it’s torn and when it’s not without an MRI. But if I did mine, I still wouldn’t go into the OR without it.

Last point...
Level of pain has absolutely nothing to do with this injury. Most people I’ve seen stay down for a few minutes then get up and walk around just fine a few minutes later. I’ve heard “I’m pretty sure I’m OK” several times. I’ve had 3 people not even fall. For reference, I saw about 2 or 3 a year for about 16 years.

The one that stands out the most for me was a men’s basketball player. He comes back the first day of school and we do his pre-season physical. He says he twisted his knee playing pickup basketball over the summer. He walked it off, and it swelled a little overnight. He iced it the next day and didn’t have any more problems. He played 3-4 times a week the entire summer afterwards without any issues. I do a Lachman test (its always the first test I do) and he’s got no ACL. Anterior drawer and pivot shift test were also positive. We were all pretty shocked; he was even more shocked.

 

[FriedRice]

They don’t operate on incomplete ACL tears under most circumstances. Truth be told after everyone I’ve seen with a partial ACL tear, you’re better off tearing it completely and getting surgery. I’ve never seen an athlete rehab a partial tear and fully recover. Ever. And I’ve seen more than a few.

Maybe I was being too general in my statement. A complete ACL tear is pretty easy to diagnose without an MRI. You pull on the knee at a certain angle (Lachman’s test and anterior drawer test), and the knee keeps going when it should stop. You get a gray area when it’s not completely ruptured, as there’s generally more slack than the opposite knee, but there’s still what’s call and end feel.

As a clinician, I say an MRI isn’t necessary when you’ve got a positive Lachman and anterior drawer test. If I was a patient, there’s no way anyone’s opening me up without an MRI One of the surgeons I was talking about this with does about 10 ACL reconstructions a week. I’d say he knows when it’s torn and when it’s not without an MRI. But if I did mine, I still wouldn’t go into the OR without it.

Last point...
Level of pain has absolutely nothing to do with this injury. Most people I’ve seen stay down for a few minutes then get up and walk around just fine a few minutes later. I’ve heard “I’m pretty sure I’m OK” several times. I’ve had 3 people not even fall. For reference, I saw about 2 or 3 a year for about 16 years.

The one that stands out the most for me was a men’s basketball player. He comes back the first day of school and we do his pre-season physical. He says he twisted his knee playing pickup basketball over the summer. He walked it off, and it swelled a little overnight. He iced it the next day and didn’t have any more problems. He played 3-4 times a week the entire summer afterwards without any issues. I do a Lachman test (its always the first test I do) and he’s got no ACL. Anterior drawer and pivot shift test were also positive. We were all pretty shocked; he was even more shocked.

Maybe you can help me, I'd appreciate it a lot.

I was sparring and threw a kick that was blocked, and my student tried to kick out my standing 1 leg (around the ankle).....before my kicking leg could come back to the ground. My defense against this would be to hop on this 1, standing leg to clear the sweeping kick. I went too early or the student was too slow and I hopped up and landed, and got kicked around the knee with my full weight on 1 leg.

I heard a loud "BAP" and so did others nearby, and this was with the music pretty loud...as the top and bottom half of my leg, went in opposite directions at the knee. What saved me, I totally believe this, was the heavy duty grappling kneepads that was I wearing so I can throw hard knees w/o causing injuries.

1. It didn't hurt right away, until later.
2. I can walk straight, but can only turn slowly. Pivoting or turning normally, I would crash to the ground like my knee locked up.
3. I couldn't squat, especially fully down into a sitting squat.
4. It took 1 year before I could squat.
5. I still feel it when I exercise too hard....like a rubber band is wedged/stuck in the knee.
6. I bought 10 pairs of these knee pads and religiously wear them for all activities/sports....but had to wear them for normal walking in the first 4+ months or so for support.
7. Still can't kick the heavy bag hard w/o feeling my knee wanting to give, so I get scared and stop... and especially not too many kicks even at medium, like 30 kicks at most.
8. When I cup my knee firmly with my hand, put my ear near it and move my leg back & forth, it sounds like there's gravel inside, rustling around....I can feel it grinding. The good knee...nothing. Like night vs. day difference.

The Ortho Surgeon said an edema to the ACL. But can it also be my meniscus? Personally, I thought that Surgeon didn't give a rat's butt what it was b/c I have stinky insurance. Thanks for any advice.

 

[Monkey Turned Wolf]

Actually, yes, I did learn how different MT feels compared to TSD. At first I instinctively made no contact (which is sadly what I'm used to but trying to change) but after a few minutes I got used to both taking and receiving hard kicks to the body/legs. And honestly I was getting my *** handed to me but I loved the thrill of actually taking a hit, which is why I wanted to try MT in the first place. That and I wanted to learn to stop over-telegraphing and throwing too many kicks.
What eventually caused the "dislocation" though was my stance being too wide and too much weight on the back leg, which was due to the fact that I was extremely fatigued from sparring. I think the biggest mistake I made was not taking the conditioning class first, i.e. learning how to spar before actually sparring.

tl;dr - I showed up for MT, accidentally showed up for a more advanced class, am a total novice, my style was incompatible with their kind of sparring, my leg got screwed up, and now I want to learn MT even more to prevent it from happening again (and to be a better fighter of course ).

I would disagree with your underatanding of what happened. Conditioning, from what i can tell, isnt the issue. Conditioning could help prevent bruising or even fractures, but what youre describing sounds like it would happen regardless of conditioning. Unfortunately, and this is not your fault, you don't know how to kick/defend properly against a kick with contact. You dont know the angle to have your leg, and thus your knee, or how to distribute your weight, so when a kick came, your leg was at a bad position and your knee dislocated. The solution to this is not conditioning (although you absolutely will need that if the MT class is full/hard contact), but learning how to properly theow a kick, when to defend, and how to properly avoid or check a kick. Even then you can still seriously hurt yourself (check out anderson silva ufc 168 for an example), but for the most part you should be okay.

 

[JR 137]

Don’t put too much stock into the surgeon didn’t care due to insurance. They’re going to get paid, and most have no idea what your insurance is; their office people handle that stuff. I’d chalk it up to the guy just being a douche bag. There’s certainly no shortage of them around. I’ve got quite a few stories of their ways, including a guy I told my father NOT to see, but he did anyway.

There’s no way anyone would miss a complete ACL rupture on an MRI. When it completely tears, it doesn’t get cut in half and flop around, so to speak; it explodes. When it ruptures, there’s nothing left but a small stump, kind of like the stump left on a clam shell after you’ve pulled the clam out. On an MRI, you’d see no trace of an ACL, hence making missing it impossible.

I’ve never heard of an “ACL edema.” That’s a new one to me. If you had/have ACL damage, you either partially tore it, or what is quite rare in my experience (not sure how truly rare it actually is) is you may have an avulsion if the ACL, which is basically the ACL pulling itself partially off the bone, either taking a layer of bone with it or not. I’ve only seen one of those.

As far as I know, the ACL doesn’t repair itself very well, if at all. Hence why I said everyone I saw with a partial tear would’ve been better off with a full rupture. I’ve rehabbed them, and quite honestly it was a waste of everyone’s time. It’s ok for an office type person who plays bar league softball a few Sundays a year, but that’s about it IMO.

There’s really no way for me to tell what’s going on in your knee without putting my hands on it and watching you walk around. What you described as far as how it happened could lead to anything - ACL, MCL, LCL, meniscus, articular cartilage, etc. The MCL and LCL repair themselves, the ACL, PCL, meniscus and articular cartilage typically don’t.

“Locking” of your knee puts up a meniscus red flag, as does instability somewhat. The instability, especially when pivoting/turning red flags ACL damage and subsequent muscle atrophy. But that’s all just spitballing to be honest.

See an orthopedist. Ask him questions. Don’t let him yeah yeah yeah you. They typically think you know what they mean or that you won’t underst if they get technical. Tell them what you do for a living (teach MA?) and it’s hindering you. Tell him it feels like it’s getting to the point where you can’t work anymore. Ask for a referral to a physical therapist. If he says you don’t need one, ask why.

It’s hard describing how these guys’ brains work. I’ve been around a lot of them, so it’s easier for me to weed through and see the nonsense. It’s also easier for me to communicate with them than most people off the street.

Edit: Last thought - primary care doctors suck at this stuff, no matter how well intentioned they are. If you need a referral from your primary doc, don’t take no for an answer. You’ve been dealing with it for long enough.