ACL-R: The Race to the Finish

[Guest Prosoft Admin]

Is that what it really is?  A race?

 

You know, many patients and parents and coaches can easily fall into the trap of looking at the ACL Reconstruction process as a 100m dash.  Whoever finishes the quickest wins.  The fastest is the best.

 

Is that really true? Is it that simple?

 

Athletes with an ACL injury needing to undergo a Reconstruction are often confused by the whole process of choosing their surgeon and where to get their Physical Therapy. Both are key decisions in the recovery process. But is it just like a 100m race where whoever offers the fastest return must be the most advanced and "best" choice?

 

Remember that biologic healing is a critical component of a successful outcome.  While sometimes it's a sign of "advanced" techniques or rehab approaches to get great results earliest, that is absolutely not always the case.  You cannot look at the recovery process from a surgery like this, or any procedure, as merely a contest of time.  First one to the finish line is not necessarily the winner here.

 

I gave the example of a college lacrosse player who was up at the school turf over the summer doing his reactive agility drills with a friend who was also on the tail end of her ACL-Reconstruction rehab and was preparing to go back to playing.  She was close to being released and had gone through the "protocols" of running and agility drills.  But it was clear to my patient that his friend, Mary,  couldn't decelerate on that leg and wasn't doing any work dealing with rotational or side to side control demanding only that leg prove itself.  Everything was allowing the other leg to compensate.  And she had no idea what the reactive drills he was doing were all about.  She wasn't asked to do any unexpected reactive work...just increase the agility drills to fast paces and then back to trying practice.

Maybe in the crystal ball of things Mary will do just fine and the "roll of the dice" that was taken by never forcing her to handle single-leg multi-directional deceleration tasks or do unexpected reactive agility work will end up ok. 

BUT I WOULDN'T WANT TO TAKE THAT CHANCE.  Would you? 

 

And I can tell you that when my patient considered what he was working on, how Mary looked like she couldn't really stop well on her reconstructed knee/leg, and she hadn't done any reactive work yet, that he was happy to take the extra few weeks of prep to feel more competent and more confident in his knee. 

 

 

He knew his ACL recovery wasn't just a simple race of who finished first. It was about who was going to go back looking and being the best, so that when he went back he would STAY BACK and not have to worry about getting hurt again.

 

If you have questions about the ACL recovery process or any other post op rehab process feel free to give us a call at 218-0240.

Mike Napierala, PT, SCS, CSCS, FAFS