University of Chicago
Type of paper: Thesis/Dissertation Chapter
Any Given Friday
On any given Friday night any athlete could be injured. It is not wished upon any athlete but accidents happen. On a particular Friday our 17 year old athlete suffered an anterior cruciate ligament or ACL tear while playing football for his high school. The athlete was trying to make a quick cut and when he planted his left knee the ACL popped. The athlete himself was able to hear the pop it was so loud. Immediately the athlete went to the ground grabbing his knee. He was not able to put weight on left leg. There was a noticeable amount of swelling while he was being carried off the field.
The athlete made the trip from the football field to the local sports clinic for an MRI and to consult with the orthopedic surgeon about options and severity. While the athlete was waiting on the MRI results in a couple of days he was told to perform what is known as RICE, or Rest Ice Compression and Elevation. (webmd.com) These combinations can help with inflammation and pain. Once the doctor got the MRI back, he was able to tell that there was a complete tear of the ACL.
The doctor was now telling the athlete and his parents their options of surgery or no surgery and probably not playing again and having more issues down the road. Obviously they chose surgery to repair the torn ligament. Once the athlete was complete with surgery the rehabilitation process begins. Most doctors recommend a seven month rehabilitation progression. Each week must be completed before moving on to the next step of rehabilitation. It is really up to the athlete and how serious and how hard he pushes himself, all while trying not to overdo it at the same time. Here is an example of the seven month long rehabilitation progression:
Range of motion exercises can begin immediately after surgery. The initial focus is to regain full extension (the ability to fully straighten) of the knee. In general, flexion (ability to bend) is much easier to regain than extension. Patients will work with physical therapists to work on gait training (walking), gentle strengthening, and aerobic work. I like to get patients on a stationary bicycle as soon as possible after surgery as this improves strength, motion and aerobic activity.
Work is continued with physical therapy. As motion increases, emphasis is shifted to strengthening. Specifically balance and proprioceptive exercises. Once normal motion has been achieved, some sport-specific activities can be started. Before beginning these activities, motion must be near normal and the swelling in the knee gone.
Early sports activities can be started and patients can often begin light jogging, cycling outdoors, and pool workouts. Side-to-side, pivoting sports — such as basketball, soccer and football — must be avoided. Toward the end of this phase, some athletes can begin shuttle runs, lateral shuttles and jumping rope.
Continued progression with sports specific activities. This phase of rehabilitation is often the most difficult, because patients may have a knee that “feels” normal, but is not ready for the stresses of some sport activities. Emphasis of rehabilitation should be on sport simulating activities. These will include figure-of-eight drills and plyometric, and over time will include sport drills. For example, a tennis player may start light hitting, a soccer player some controlled dribbling, etc.” (about.com) After completing all of these steps the athlete will be closer to getting back on the football field. There are a few other issues that need to be considered before he can be released to participate in full contact football. Making sure that the left knee is fully functional without any give or “play” in the knee. The surgeon will also have to give the ok and will probably fit the athlete for a special brace made just for him. Once the release is given by the surgeon, the athlete can then start to participate in full contact football.
Cluett, Jonathan. “Rehabilitation After ACL Surgery.” About.com Orthopedics. Medical Review Board, 4
Oct. 2010. Web. 27 Sept. 2012. http://orthopedics.about.com/od/aclinjury/p/rehab.htm. Healthwise. “ACL Injuries-Topic Overview.” WebMD. WebMD, 4 April 2011. Web. 27 Sept. 2012. http://www.webmd.com/a-to-z-guides/anterior-cruciate-ligament-acl-injuries-to