Posted On: 09/12/20 9:14 AM
Submitted to Prep Dig By Dan Van Veen
Our family has learned a few things about ACL tears over the last 18 months. My daughter suffered an ACL avulsion (ACL detached from the bone) and then nine months later, had an ACL tear in the other knee. It has been a journey filled with a lot of hard experiences, but also maturing and learning has resulted. The following insights will hopefully help others who are on this difficult path or who one day, unfortunately, will be.
TIP 1: To the athlete, you CAN come through this better than ever — and those aren’t just words. You can. You’ll gain an understanding of how important conditioning is and if you embrace it, you can come out of this stronger than before your injury took place. It isn’t going to be easy, but the more effort you put into the recovery, the better you’ll come out of it. You will face mental hurdles, but you can make it. You’ll also hopefully come through with a deeper appreciation for health, exercise, nutrition, and the sport you love, not to mention empathy for others with injuries.
TIP 2: Parents, be prepared for some wild mood swings . . . pain and frustration and the “unfairness” of an injury of this nature requires patience and understanding as the emotions your child will experience can have them saying things they don’t really mean, but say because they’re releasing a level of anger and frustration that they may have never experienced before. Breathe and realize sometimes you don’t need to respond, as just getting the words out, such as: I’m going to quit, you don’t understand, I hate (insert topic) . . . is sometimes just an athlete’s “release” of frustrations that exercise used to handle.
TIP 3: After an MRI-confirms a tear or detachment, choose your surgeon carefully — even if that means waiting to get the best. The wrong surgeon can end or reduce your child’s career, despite his/her best recovery efforts. Don’t know who the best is? Contact a local college or minor league team – who do they use? Be sure the surgeon is very experienced in repairing ACLs for athletes. It is also very important where the new ACL is harvested — the patellar tendon is, if it’s thick enough, the first/best choice.
TIP 4: The right physical therapy (PT) program is also a must. The wrong PT can slow recovery, cause a permanent (or painful-to-correct) loss of flexibility/range of motion, resulting in a loss of ability. Be sure you enter a proven program that regularly gets athletes back playing at a level equal to or better than they were prior to the injury.
TIP 5: Some PT programs promote PT twice a week; others three. A “real” moment? Your insurance will likely cover only a limited number of PT appointments (such as 20 per year). If money isn’t an issue, push for three times a week (the accountability factor and outside encouragement is very helpful); if paying upwards of $250 to $400 per hour for PT is going to hurt, then go twice a week (to extend your weeks of insurance coverage). Get a list of exercises your child can do safely on their own from your PT specialist. If you don’t have insurance, the other option is an occupational therapist (who probably doesn’t know much about return-to-play athletics). Key things are: Flexibility, strength, and rubbing out the scars (scars reduce flexibility . . . they are as big under the skin as on top of the skin).
TIP 6: Injured athletes need to surround themselves with positive people. Pessimists, complainers, whiners, etc. are “energy suckers” — it’s going to be hard enough to fight through an ACL injury with its many physical and mental challenges as the pain, depression, and self-doubts are real. Injured athletes need people who speak encouragement and believe in them; and some days those people have to believe in them more than the athlete believes in himself/herself.
TIP 7: Watch what you eat. It’s not just how much, but what you eat. You want to eat foods that help your muscles repair, but you also need to watch calories as you’re not exercising nearly as much and don’t want to come out of this 20 or 30 pounds overweight (and risk a weight-induced injury). So, reduce portions, no soda (diet or regular), avoid late-night eating, and no “mindless” snacking.
TIP 8: It’s not uncommon for an athlete to tear a second ACL within a year. Why? Possibly it’s because not enough attention is paid to strengthening the supporting muscles of both legs (quads and hamstrings, in particular) and then rushing the comeback — playing too much, too soon. Also, the injured leg is typically favored, requiring the “good” leg to carry more of the load, therefore the reason to focus on strengthening both legs.
TIP 9: Keep your coach informed. Some coaches have a lot of experience with ACL injuries; others do not. Coaches need to hear from you on your progress and what your PT person is saying about your recovery. When PT ends, continue to inform your coach, as progress varies.
TIP 10: Keep your school’s principal and child’s school counselor informed. If the injury initially takes place during the school year, it will be vital to communicate to these two key people to make sure your child gets the understanding and help he/she needs to catch up on school work, make it to classes (i.e. crutches or walking slowly), and instructors can be properly informed.
TIP 11: Now what? Between the end of PT and taking the court once again is a time of insecurity and not knowing what to do. PT says you’re ready to ease back into playing ball, but what does that mean? We found (after the second go around) that what really benefited our daughter was putting her into an athletic “development” program for 6-8 weeks. The program (called Redline Athletics here) focused on enhancing speed, quickness, strength, and vertical jump. Basically, it’s where the athlete pushes to not just perform, but excel. This increases the overall strength and fitness and helps increase confidence in the injured knee.
TIP 12: If possible, get in a few private volleyball lessons prior to taking the court. Having the benefit of lessons where raw rustiness and apprehensions won’t be on display to teammates or coaches is a mental plus and there’s no risk of colliding with others.
TIP 13: When you’re back on the court, it’s common to have a hesitancy to dive, reach, jump when close to others, etc. The secret to overcoming those fears? Repetition. Staying after or coming in early to have someone set to you and/or hit balls at you helps with reflexes, but practicing with others on the court is what is going to get you there. The key is getting to the point where you’re focusing on the game, not on your knee . . . and with every ball, you’re that much closer.
Finally, there will be other athletes in your school who will experience an ACL tear — take time to be an encouragement to them. Doing so will be good for the person with the injury and be good for you as it will remind you of . . . what a gift it is to play the sport you love!