Problems with A-C-L lead to problems with S-E-X

Dear Alice,

I'm a woman and recently tore up my MCL [medial collateral ligament] and ACL [anterior cruciate ligament]. So I can't bend my right knee. I'm having difficulties finding a comfortable position to make love with my boyfriend. Before my knee problem, we had great sex. But now it's just real hard to orgasm. I loved riding him on top, but now I just can't do it. So now what?

Dear Reader,

Condolences on your bum knee and difficulty orgasming. To quote another famous Al (Einstein, that is), "In the middle of difficulty lies opportunity." Try not to think of your torn ligaments as a setback, but as a chance to add a whole heap of new positions to your sexual repertoire. Sure, riding your boyfriend on top was Old Faithful, but sometimes Old Faithful prevents couples from experimenting with the huge range of other options.

To narrow down the many paths for your new sexcapades, focus on what you enjoyed about being on top, and find more comfortable positions that can capture some of those positive elements:

  • Multi-tasking — For some women, the real advantage of being on top lies in the freedom of their partner's hands to stimulate their clitoris while they handle the penetration. This added maneuverability also makes it easier for the clitoris to rub against the partner's pubic bone. Many positions (outside of the missionary) will still allow for these perks, so you two can explore, discover, and enjoy configurations that won't leave the other player out of the game.
  • The Talented Mr. Grafenberg — Or maybe the notorious G-spot was your goal when you took to the high ground. Fortunately, your quest has more to do with the angle of penetration than with the positioning of the remainder of your limbs. Having your partner on top with your legs tucked against your chest or placing a pillow under your hips might do the trick to recreate the sensation, and a little manual labor couldn't hurt either.
  • The Driver's Seat — For some, it's calling the shots that holds top priority. And in many ways it makes sense that since you're the one looking for the pleasing, you be in control of the rocking and rolling. Fortunately, this can still be achieved through a little artful positioning, so don't fret having to give this up.
  • Face Time — Perhaps one of the more important elements for you was being able to hold eye contact with your boyfriend as you made love. Many standard (and non-standard) positions will accomplish this, so you've got a bevy of choices if this is a non-negotiable during sex.

Once you've prioritized your pleasure list, it's time for the break down:

  Knee-friendly Multi-tasking Talented Mr. G Driver's Seat Face Time
Missionary :)       :)
Missionary with legs against stomach :)   :)   :)
Reverse missionary (laying down but on top) :) :)   :) :)
Spooning :) :) :) :)  
Scissors (on your backs, your head at your partner's feet and vice versa) :)   :) :)  
Standing ?       :)
Sitting on edge of a table/desk :) :) :)   :)
Custom Design: Right leg on floor, left leg kneeling on bed, and partner underneath ? :) :) :) :)
And so on, until... :) :) :) :) :)

Mixing it up with a little oral pleasuring by your partner or solo sex could help make the time off your injured knee pass by more quickly. And if you haven't experimented with one already, don't forget about the new levels of pleasure a vibrator can add. If you find that alternate positions are still uncomfortable, a little extra vibration might prove an enjoyable substitute for the perfect pose.

But if your defunct knee has still got you down, remember that casts do come off and pain may soon subside, putting you back in the saddle again. In the meantime, keep practicing and wear protection. And if you're concerned about sexually transmitted infections (STIs) or pregnancy, a condom, too.

Last updated Apr 28, 2015
Originally published Feb 20, 2004

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