Grade 1 MCL sprain rehab

[Ruairi Quinn]

Hi all-

I've lurked on the forums for a while, and would like to ask a question about getting a knee back to normal following a Grade 1 MCL sprain sustained in BJJ practice.

It happened a little over a week ago and an MRI idenified evidence of a Grade 1 MCL sprain having occurred, and also evidence that I might have laterally dislocated my patella (didn't notice at the time, must have moved and then slipped back into place very quickly).

I never required crutches and at the moment I'm walking with a fading limp. The knee is pain-free and I can air squat and break paralell comfortably enough. It feels like there is a little instability there - not so much that it is going to lock up or give out, but like there is a little play or laxity there (which seems to be fading).

I have been training around the injury doing benching, pull-ups, dips, ringwork and whatnot but no BJJ or compound lifts.

Seems like I will be able to go back to BJJ in a matter of a few weeks if I am careful, but I am more concerned about what I need to do prior to going back to heavy squats, deadlifts etc. I also did alot of oly lifts and front squats before I was injured and would like to return to that.

I have been referred to a physio, but would like to ask for thoughts here too.

Would it be safe to progress from doing some sets of careful air squats, with an emphasis on keeping the knees out and shins as vertical as possible, to doing low-bar back squats just with the bar, to then adding weight gradually over the course of a couple of months to build back up to where I was by linear progression?

Or is it the case that I am going to need a more specific approach to rehabilitating the knee (closed kinetic chain movements, kettlebells?) so that the above is safe to do?

[Steven Low]

Would it be safe to progress from doing some sets of careful air squats, with an emphasis on keeping the knees out and shins as vertical as possible, to doing low-bar back squats just with the bar, to then adding weight gradually over the course of a couple of months to build back up to where I was by linear progression?

This is fine. I would actually prefer this approach to the other one -- avoid explosive movements for now.

If you feel any twinges etc. don't feel bad about terminating the workout.

Just keep it moving in proper biomechanical range of motion to keep it loose (air squats are more than fine), and give it a week or two to heal. Then start your linear progression up

[Greg Davis]

I suffered a minor MCL tear from BJJ last year and found squats to not cause any problems (without maxing out on weight though).

Did a lot of cycling instead of BJJ or weights and that seemed to help.

[Ruairi Quinn]

Thanks for the replies, guys. It's good to hear that this is a viable approach, because I would prefer to rehab my knee by keeping with movements which I at least have some familliarity with, maybe that'll help me steer clear of any trouble.

Another couple questions-

- Do I need to work in balance / proprioception exercises- balance board, stuff for lateral stability and if so, what is a good reference for these?

- It's been 10 days since I sustained this injury, and I gather than the tissue healing phase is a couple of weeks longer than this. So as per Stephen's post, if I'm pain-free then I take it it's time to start rehab any time now? I've already been training around it.

[Steven Low]

Sure go for it.

Balance work may help as well if your proprioception sucks.

[Greg Davis]

- Do I need to work in balance / proprioception exercises- balance board, stuff for lateral stability and if so, what is a good reference for these?


Might be something to look at once you are are totally healed up but why rush in to any lateral work until you are symptom free for several weeks?

And I would check out this link (http://blogs.experiencelifemag.com/survival-of-the-fittest/2008/05/eric-cressey-is-unbalanced.html) before placing too much stock in balance work

I don't know what in particular caused your injury but for me I learned to be smarter about the risks of standing over someone's guard, especially de la riva, x-guard, z-guard, etc. and I haven't had any more problems. That being the most important take-away..

[Ruairi Quinn]

Thanks guys. All on track so far.

Greg-

I got my injury rolling with a beginner who was making up for lack of technical knowledge by using alot of force and explosiveness. Thought I was handling him the right way by being fairly relaxed and waiting him out, until he managed to somehow get some weird grapevine / hook on my right leg with his. Before I knew it, he'd exploded it straight out in a kind of kicking motion, and I heard a 'pop'.

If I were going to go back I would probably just remonstrate with myself about rolling with people who are likely to do things like that, I don't know that in this case changing my game would have helped.

I dd see your older thread referencing the de la riva guard and knee injuries - thanks, interesting reading.