Issue link: https://www.massageandbodyworkdigital.com/i/1505456
L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 33 TECHNIQUE I'm puzzling together an approach that they seem to love. My knee-work is more delicate, precise, and informed. I put a knee "master class" on my teaching schedule this fall as a kind of deadline for having something useful to share, and I'll be ready. But for now, there's still plenty to learn about how to help. And my knee-journal entries are less and less frequent. This one was written at 11,000 feet as I backpacked in the Rockies, blissing out on wildf lowers and blue skies. I'm aware I'd be telling a very different story if my recovery hadn't gone so well, and I owe a lot of that to luck—and to having so many options, including the option to have surgery. I'm feeling grateful both for my body and for the learning it affords me, so that I can better help others less fortunate than I've been. Author's note: Everyone's decision about having surgery (or not) is their own to make, and everyone's injury, pain, function, circumstances, and options are different. This is a log of my personal decision- making about my knee injury. It is not a recommendation to make the same decision. And as practitioners, we can best serve our clients by supporting their decisions. Notes 1. a) Though completely ruptured ACLs are not conventionally thought to be able to repair themselves, these two papers discuss spontaneous ACL reformation. The conditions under which this might happen, including age factors, etc., aren't well established. Hidetoshi Ihara and Tsutomu Kawano, "Infl uence of Age on Healing Capacity of Acute Tears of the Anterior Cruciate Ligament Based on Magnetic Resonance Imaging Assessment," Journal of Computer Assisted Tomography 41, no. 2 (March/April 2017): 206 –11, https:// doi.org/10.1097/RCT.0000000000000515; Matias Costa-Paz et al., "Spontaneous Healing in Complete ACL Ruptures: A Clinical and MRI Study," Clinical Orthopaedics & Related Research 470, no. 4 (April 2012): 979–85, https://doi.org/10.1007/s11999-011-1933-8. b) The outer parts of the meniscus are more highly vascularized than the inner parts, and tears here are known to heal on their own. 2. M. E. Eastlack, M. J. Axe, and L. Snyder-Mackler, "Laxity, Instability, and Functional Outcome After ACL Injury: Copers Versus Noncopers," Medicine & Science in Sports & Exercise 31, no. 2 (February 1999): 210–5, https://pubmed.ncbi.nlm.nih.gov/10063808/. 3. Louise M. Thoma et al., "Coper Classifi cation Early After Anterior Cruciate Ligament Rupture Changes with Progressive Neuromuscular and Strength Training and Is Associated with 2-Year Success: The Delaware-Oslo ACL Cohort Study," The American Journal of Sports Medicine 47, no. 4 (March 2019): 807–14, www.ncbi.nlm.nih.gov/pmc/articles/PMC6546284. 4. Thoma et al., "Coper Classifi cation Early After Anterior Cruciate Ligament Rupture Changes with Progressive Neuromuscular and Strength Training and Is Associated with 2-Year Success: The Delaware-Oslo ACL Cohort Study." 5. Eastlack et al., "Laxity, Instability, and Functional Outcome After ACL Injury: Copers Versus Noncopers." 6. Newcastle Sports Medicine, "The Knee Meniscus: Torn Between Rehab or Surgery?" (January 15, 2018), https:// newcastlesportsmedicine.com.au/knee/meniscus-injuries/. 7. Raine Sihvonen et al., "Arthroscopic Partial Meniscectomy Versus Placebo Surgery for a Degenerative Meniscus Tear: A 2-Year Follow-Up of the Randomised Controlled Trial," Annals of the Rheumatic Diseases 77, no. 2 (May 18, 2017): 188–95, https://doi.org/10.1136/annrheumdis-2017-211172. 8. Robert J. Ward et al., "Meniscal Degeneration Is Prognostic of Destabilzing Meniscal Tear and Accelerated Knee Osteoarthritis: Data from the Osteoarthritis Initiative," Journal of Orthopaedic Research (April 2023), https://doi.org/10.1002/jor.25575; Edward C. Cheung et al., "Osteoarthritis and ACL Reconstruction—Myths and Risks," Current Reviews in Musculoskeletal Medicine 13, no. 1 (January 2020): 115–22, https://doi.org/10.1007/s12178-019-09596-w. Til Luchau is the author of Advanced Myofascial Techniques (Handspring Publishing), a Certifi ed Advanced Rolfer, and a member of the Advanced-Trainings.com faculty, which offers online learning and in-person seminars throughout the US and abroad. He and Whitney Lowe cohost the ABMP-sponsored Thinking Practitioner podcast. He invites questions or comments via info@advanced- trainings.com and Advanced-Trainings' Facebook page. WATCH: "KNEE PART 2" 1. Open your camera 2. Scan the code 3. Tap on notifi cation L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 33