ACL Injury-Help!

Hell all,

I walked on to the University of Michigan football team this season as a running back. This was my first time playing football. I’m a sprinter. Unfortunately, I was doing a drill in practice where the coach hits you with a bag after running under a gate. After I got hit with the bag, I planted my left foot and my knee buckled, tearing my left ACL. I tore my right ACL about 5 years ago and it took me 1.5 years to get back to my previous level of sprinting and training.

Is there anything that I should do to speed along my recovery? I am a junior and i only have 2 years of eligibility left.

Also, it was mandatory to have our ankles taped every practice. I remember Charlie stating that taping the ankles can translate the force to the knee causing injury. Are there any studies on this? Could this by why I tore my other ACL?

Thank you,
Michael Puhalla

What the hell kind of drill was that? Aside from that, you need an MRI to tell you exactly what has happened and a plan can be made only after the severity is diagnosed. I learned from Al Vermiel that ankle taping increased the incidence and severity of knee injuries back in 1981 when he was S and C coach for the 49ers. Unfortunately, if an athlete is injured in the ankle (though lees severe usually) and the ankle isn’t taped, all hell breaks loose. In the NFL (or at least with the teams i dealt with in recent years, the rule is you can play without ankle tape but if you then get an ankle injury you get fined. I guess that’s about as much acknowledgement of the issue as they will give.

Sorry to hear that man, that sucks. As someone who has torn both ACL’s also, I can feel your pain brother. I agree with Charlie, you need to get an MRI to confirm. Personally I believe my second tear was a direct result of a wonky ankle, i.e. loss of proprioception in that foot. I shouldn’t have been playing at all really.

If it’s a partial tear, prolotherapy can help a lot, but if it’s a complete tear then surgery is your only option for repair.

Good luck
e.

Thanks Charlie and earle. I already had an MRI and it showed complete rupture of the ACL and possible lateral meniscus damage that would require a stitch at the most to close it. Surgery is scheduled on the 23rd of October. When I had my last surgery, my leg atrophied greatly. Would stim help at all? Is there anything else that would help speed along my recovery?

I( think you need to speak to the Docs about stim but you need to be aware that if they pin it the stim can react with the pin to cause bone necrosis. You need good medical advice throughout this ordeal. You can of course use stim elsewhere right away to maintain muscle mass.

Thanks Charlie,

I’ll ask the doc. What is your recommendation for getting my speed and training back to its previous level after I am cleared by the doc (5-6 months post-op)? At 3 months I am allowed to start lifting heavier and do a little bit of running.

http://performanceorthopedics.com/files/ProcProtocols/ACLprotocol.pdf
here’s a link of the doc’s protocol

Sounds pretty good. Only thought is to use the pool for sure, not just as an option once you get clearance for immersion.

On the advice of Al Vermeil, I phoned up Robert Panariello many years ago and discussed ACL rehab progressions for about 90 minutes. One of the best calls I’ve ever made (aside from my weekly calls with Charlie!).

I suggest you get on-line and see some of the material Rob has published on ACL rehab. Here are a few links:

http://www.professionalperformance.net/files/Knee%20ABC’s.pdf

http://www.professionalperformance.net/files/ACL%20Post%20Up.pdf

Also, there has been some research on the use of creatine to maintain muscle mass pre and post surgery. Might be worth while to maintain supplemental creatine use during this period.

As for EMS, there seems to be a greater use of EMS co-contraction therapy (quads and hams at same time) for knee rehab situations. As Charlie mentioned, keep it away from the surgery site if there is any metal used for pinning. I believe Robert Panariello had clients standing when doing the EMS co-contractions.

Charlie knows Rob - so perhaps he could offer some more insight into his methods.

Just as an aside, I was with Al and Rob P at an NFL team when Rob started asking why squats hadn’t been reintroduced yet in an ACL rehab case. The irate trainer said: “How many ACLs have you rehabed?”
Rob replied: “8000”.
That was the end of that conversation!!

Charlie,
I’ll definitely be using the pool. After my first ACL surgery I did not have access to a pool during my therapy and had sub-par therapy. My leg was only 50% the strength of the non-injured one. The doc released my to run after 6 months since the graft was healed completely. I ran the whole summer junior olympic season running a full second slower than what I should have been running in the 100m. Looking back at the film, it looks like I am galloping. Long story short, I went back to therapy and started pool use 3x a week. I believe it help a lot. What kinds of exercises would you suggest in the pool? The had me aqua-belt run against a current in deep water and backpedal and high knee in chest deep water.

On your trainer note, some of those trainers think they know it all, but don’t have a clue. At UM they would not let my lift my upper body b/c it would harm my knee. I laughed.

Number 2,
Thanks for those links. I’ll look at more of Rob’s material. I never thought to post the leg up to even out the bar when squatting. I had that same trouble squatting for about 2 months when I was able to start. I’m using creatine at the moment to help maintain and was planning on using it throughout therapy as well. The co-contraction EMS seems interesting. I will look into that.

go with the pool work you did before but much earlier on. Look at the Rob P stuff closely

Good to see your heads in the right place. An injury like this can be as bad mentally as physically. I had an operation last year and I found that really concentrating on rehab keeps you sane… you’ll be fit agin before you know it!

Thanks Cheetah. I plan on hitting it hard and try to be at or better than 100% mid-summer.

Thanks guys, I will keep you all posted on my progress. Surgery is in 1.5 weeks.

surgery went well. I’m up and walking with little pain.
I’ll keep you guys posted on the recovery.

How’s the knee coming along?

its coming along good. 8 month mark was yesterday. strength is about 80%. running is still awkward due to the strength deficit. I’ve been using the jump rope and the pool for tempo work and have been doing 2 heavy and one bodyweight leg sessions per week.

As a former acl patient I certainly can empathise on your rehab and agony. I healed too quickly cause I was running 3 months after my surgery but i didnt have full extention so I had to go back and get it scoped again. Thankfully I was able to run again but it took me forever to get my speed back (literally like a year after the 2nd surgery).
Secondly Im glad that you were able to make the team at u of m, unfortunately you have a idiot strength and conditioning coach in barwis so if I were you I would definately follow the advice of the administrators on this site. Also if your in that area, email ESTI or SPEEDCOACH, they both have extensive knowledge in that area, trust me I talk to them about once a week. Again I was blessed to have a excellent doc at michigan state (he does usa gymnastics on the side).

ACL’s take a minimum 6 months to graft. What graft did you get? Appears most doc’s recommend patellar for male athletes s and hamstring double bundles for female athletes (at least in my area).

I have seen it in every instance rehab does not address force absorption at all. Everything is force production.

I use a screen that I have not had an ACL case pass right out of therapy. It took several weeks of work to get into acceptable ranges.

Also, at your recovery so far, I would think you could start to work it harder on the strength side of things. Hard to say everything I have done in the past. I just had NFL guy coming off knee issues, and was babied for 7 months in therapy. Doing squats with bands for 2 x 20 reps isn’t going to help this guy get back to taking a pounding on Sundays.

I am often amazed at how many doctors, pt’s, trainers are so conservative with athletes that they truly hold back the athlete’s rehab. all the while the athlete loses further conditioning and additional, likely unnecessary atrophy. Certainly, as in any field there are good ones too.

I know of one PT who would not allow the athlete with the ACL injury to squat but did require the athlete to bound-no joke.

I understand in the rehab process that there, at times, might be discomfort even crossing over into a somewhat painful zone (for lack of a better term) but when the athlete told the pt repeatedly that this “rehab bounding” was really hurting her knee the PT kept insisting on this “protocol.”

If some method is causing a reaction from someone, in this case, with a fairly high tolerance for pain-a few previous injuries-one would think the PT would find another exercise or method to rehab.

Yes, been my experience with PTs as well. I feel you need to hold them back early and then increase things as time goes on while still keeping an eye on them. What appears to happen is they are babied the entire process and then let loose to do what they want. The result is usually another injury ala down in Charlotte. Not sure what doc would cleared that guy so fast.