Torn ACL

socalkdg said:
I pray of no injuries for all the kids out there. Sadly it still happens. Big props to all the kids that get hurt and work their way back.

I've heard people talk about the importance of wearing turf cleats when playing on turf. Is this something kids are doing? Are they getting hurt on turf or grass?
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of our now 4 tears, 3 occurred on turf and 1 on grass. There are so many variables and addressing any one is part of the process of risk mitigation (can never have risk elimination, of course). Their Dr has a preference for turf cleats but only “mandates” it during some of the earlier phases before full RTP. I do think they will use them this next time they are cleared but it’s really hard to pin it on that. I think overuse is a bigger risk at large (even if any one player who was injured was fit and not seemingly tired).

It’s all a balance of variables. Control the controllables as much as possible and mitigate the risk to the extent possible.
 
dk_b said:
My twins returned to the pitch in spring and you could see some moments in those spring games. They did not play a ton in summer but they looked fully themselves in the fall club season and first half of HS. Then, and you are not going to believe this, in a span of 2.5 wks BOTH tore their OTHER ACLs (one will be 3 wks post surgery on Mon, the other one week on Tues). The good news: their surgically repaired right knees have been holding up just fine. (And, yes, they are identical)
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So sorry to hear this dk_b. What an emotional rollercoaster this must be for you all. My daughter just tore her ACL in her first semester at college and I just spent the last couple of days making it through this thread. Thank you for sharing your experience and prayers to your family.
 
Colorado Papa said:
So sorry to hear this dk_b. What an emotional rollercoaster this must be for you all. My daughter just tore her ACL in her first semester at college and I just spent the last couple of days making it through this thread. Thank you for sharing your experience and prayers to your family.
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Sorry to hear that your daughter has to go through this. It is incredibly hard when the diagnosis first becomes clear but as many people on this thread can attest to getting started on rehab and then recovery after surgery helps the time pass. The first few days after surgery my son swore he would never play again because he didn’t want to go through this experience again….now 6 months later he is stronger and more motivated than ever. He will never take being healthy and fit for granted again ! When he does return to playing ina. Few months i know he will have done everything possible to prevent another tear but luck (bad luck) is also part of the equation and we will deal with whatever happens. Good luck as you embark on this journey.
 
There is no magic bullet, but my biggest takeaway for prevention is an appropriate strength ratio between the girl’s hamstrings and quads. Soccer players tend to have strong quads and weak hamstrings, which stresses the ACL. Build up the hamstring strength, be as flexible as possible, wear the appropriate cleats for the playing surface. Again, not guarantees, but those steps will minimize risks.
 
Colorado Papa said:
So sorry to hear this dk_b. What an emotional rollercoaster this must be for you all. My daughter just tore her ACL in her first semester at college and I just spent the last couple of days making it through this thread. Thank you for sharing your experience and prayers to your family.
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thank you, @Colorado Papa
Surf Zombie said:
There is no magic bullet, but my biggest takeaway for prevention is an appropriate strength ratio between the girl’s hamstrings and quads. Soccer players tend to have strong quads and weak hamstrings, which stresses the ACL. Build up the hamstring strength, be as flexible as possible, wear the appropriate cleats for the playing surface. Again, not guarantees, but those steps will minimize risks.
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Exactly right. Risk mitigation and probably the single variable most in the player's control is balancing out the quad:hammy strength. 2d most - but still hard - is to try to avoid playing back-to-back games (esp if you are a full 90 min player). No matter how fit a player is, by min 120 or 150, her muscles are going to be tired. It's a reason why we don't see back-to-back games in college or in pro/international tournaments. That said, the social pressure to play is very, very high. And, if they are in a highly-scouted event (say, an ECNL showcase), nobody is going to want to miss being seen. I do wish that CIF would impose a state-wide rule of no back-to-backs after, say, Jan 1 (when the full load is building up). I don't think that is going to happen but that will be part of my girls' protocol next year (one twin was injured in the 3d game in 4 days - Wed, Fri, Sat (Sat was non-league and that's when it happened). She was super fit and playing well and strong but, as we are saying, control the controllables and mitigate the risk.
 
Curious if anyone’s player has gotten a quad graft with internal brace. The strength of the tendon along with having a seat belt, so to say, is very appealing. Ortho’s doing this seem to be sparse throughout the country….any experience out there?
 
dk_b said:
And, if they are in a highly-scouted event (say, an ECNL showcase), nobody is going to want to miss being seen. I do wish that CIF would impose a state-wide rule of no back-to-backs after, say, Jan 1 (when the full load is building up). I don't think that is going to happen but that will be part of my girls' protocol next year (one twin was injured in the 3d game in 4 days - Wed, Fri, Sat (Sat was non-league and that's when it happened). She was super fit and playing well and strong but, as we are saying, control the controllables and mitigate the risk.
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100%. I had to step in during my dd 11th and 12th grade and say, "no mas" and took heat for it. Back(Fri) to back(Sat) to back(Sun) was the pressure if you want to show these top coaches how amazing you are. The pressure is insane. I tore my left ACL when I was 27 playing basketball. It sucks but with todays technology, you can get a stronger ACL and be stronger player. Just say no if they try and make your kid feel guilty or use fear tactics if they only one to play one game on the weekend. Who makes all the money at the showcases? Who are the one's doing most of the working and not getting paid? One game a week is plenty and maybe a friendly during the week. I just heard from a good pal and his dd tore her acl so this is happening way too much. I wish everyone's dd & ds a speedy recovery.
 
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anita said:
This thread has been quiet for a while…wondering how people are doing. My son is almost 6 months postop and continues to work on strengthening and PT everyday. Like many said it has gone by pretty fast. Other than not playing soccer his life is pretty busy and normal. This last stretch before return to play is going to be challenging! It’s hard to know how cautious to be with him nowadays since he feels so good! Hope everyone else’s kid is doing well. I’m curious how long it took your son or daughter to get back into the groove after returning to play?
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My daughter recovered from her ACL and started playing....7 games in right before Surf cup the other ACL tore. Still only 3 1/2 months post op. Both happened right before major show cases and the coaches (a couple) were coming to see her. Heart breaking but one school is willing to take a chance on her. No money but training and a chance to make the team when she's ready. Hopefully she stays healthy. good luck to all the folks on this forum's player.
 
Colorado Papa said:
Curious if anyone’s player has gotten a quad graft with internal brace. The strength of the tendon along with having a seat belt, so to say, is very appealing. Ortho’s doing this seem to be sparse throughout the country….any experience out there?
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Thing 2 (she was 2d born of my twins and her tears were #2 and #4 of the 4 injuries the two have had) had quad tendon for her right ACL tear (in 2021). I don't recall whether it was with an "internal brace". I will check her chart if I can and message you if I have any insight.

And, Papa, it was lame of me to only say "thank you" w/o commenting about your daughter. Prior to joining this club, I'd have felt bad for her and for you. But the transition from having gone through it, "feeling bad" is now "feeling ill". I'm so sorry.

Red card said:
My daughter recovered from her ACL and started playing....7 games in right before Surf cup the other ACL tore. Still only 3 1/2 months post op. Both happened right before major show cases and the coaches (a couple) were coming to see her. Heart breaking but one school is willing to take a chance on her. No money but training and a chance to make the team when she's ready. Hopefully she stays healthy. good luck to all the folks on this forum's player.
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Damn, Red Card. As a parent, you know exactly what we are going through. And, as kids, your daughter knows what my girls are going through. Your girl is going to make coach happy to have shown patience. I can feel it!
 
Surf Zombie said:
There is no magic bullet, but my biggest takeaway for prevention is an appropriate strength ratio between the girl’s hamstrings and quads. Soccer players tend to have strong quads and weak hamstrings, which stresses the ACL. Build up the hamstring strength, be as flexible as possible, wear the appropriate cleats for the playing surface. Again, not guarantees, but those steps will minimize risks.
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As an aside, it has always been curious to me that so many surgeons recommend the hamstring graft for young females. At least initially, this technique makes the quad/hamstring imbalance problem worse. The gold standard BTB graft does not have this drawback, but has other issues. It seems like if this imbalance were a driving factor, nobody would use the hamstring graft. Unfortunately there are so many factors involved in contralateral tears that I doubt the statistics on injury rate vs graft type allow many conclusions to be drawn.

For those that have current ACL injuries, was the BEAR implant considered?
 
supercell said:
As an aside, it has always been curious to me that so many surgeons recommend the hamstring graft for young females. At least initially, this technique makes the quad/hamstring imbalance problem worse. The gold standard BTB graft does not have this drawback, but has other issues. It seems like if this imbalance were a driving factor, nobody would use the hamstring graft. Unfortunately there are so many factors involved in contralateral tears that I doubt the statistics on injury rate vs graft type allow many conclusions to be drawn.

For those that have current ACL injuries, was the BEAR implant considered?
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We did not discuss the BEAR implant. I have a close relationship with our surgeon so I will ask him.

My girls did the following: Thing 1 - patellar for right, patellar for left; Thing 2 - quad for right, patellar for left. Despite being identical, Thing 2's growth plates were a bit more open (long story as to likely why and not relevant here) and he felt that quad made more sense. This time, they are physiologically identical and their procedures are.

My understanding is that this surgeon does NOT do hamstring grafts for young athletes (perhaps non-athletes) and that the failure is higher and the impact on the athlete is greater. I have a family member who tore her ACL twice and the 2d time had to use hamstring (rather than cadaver (the highest failure rate among young athletes) or quad) b/c of the prior surgery (not the same surgeon for the 2d one for this person).

In looking at the BEAR implant just now, I am confident that while this injury will not go away, treatment will be very different in 5 or 10 years than it is today (just like it is so different compared to what it was when we were kids)
 
dk_b said:
We did not discuss the BEAR implant. I have a close relationship with our surgeon so I will ask him.

My girls did the following: Thing 1 - patellar for right, patellar for left; Thing 2 - quad for right, patellar for left. Despite being identical, Thing 2's growth plates were a bit more open (long story as to likely why and not relevant here) and he felt that quad made more sense. This time, they are physiologically identical and their procedures are.

My understanding is that this surgeon does NOT do hamstring grafts for young athletes (perhaps non-athletes) and that the failure is higher and the impact on the athlete is greater. I have a family member who tore her ACL twice and the 2d time had to use hamstring (rather than cadaver (the highest failure rate among young athletes) or quad) b/c of the prior surgery (not the same surgeon for the 2d one for this person).

In looking at the BEAR implant just now, I am confident that while this injury will not go away, treatment will be very different in 5 or 10 years than it is today (just like it is so different compared to what it was when we were kids)
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Rehab with the BEAR implant follows a pretty similar timeline as an graft-based ACL repair for an injury with no meniscus involvement (and despite what an MRI might say, one does not know whether there is meniscus until the wound is open - bruising is hard to detect on MRI and some bruising will be treated similarly to a tear (that is, no weight bearing for a longer stretch)). I can't see in the BEAR materials any reference to what happens if there is meniscus involvement (I am sure that info is there) but that may be why some surgeons are still not using it.

12914 - MMAN - Miach RevH BEAR Rehab Protocol Packet_V4 JD (miachortho.com)
 
dk_b said:
Thing 2 (she was 2d born of my twins and her tears were #2 and #4 of the 4 injuries the two have had) had quad tendon for her right ACL tear (in 2021). I don't recall whether it was with an "internal brace". I will check her chart if I can and message you if I have any insight.

And, Papa, it was lame of me to only say "thank you" w/o commenting about your daughter. Prior to joining this club, I'd have felt bad for her and for you. But the transition from having gone through it, "feeling bad" is now "feeling ill". I'm so sorry.



Damn, Red Card. As a parent, you know exactly what we are going through. And, as kids, your daughter knows what my girls are going through. Your girl is going to make coach happy to have shown patience. I can feel it!
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Dk_b I didn’t sense any lack of compassion in your reply:) Besides the cumulative pain we know you are going through would excuse you from all!
The last week has been a rollercoaster for us. My daughter is in her first semester at college and was a month and a half into training. She was pretty fit going in but the week prior to her injury she had mentioned to me that she felt like an old lady. She had come from a pretty intense training environment but I guess 7AM training sessions plus the weight room and 20000 steps a day walking to class might have been too much. My daughter was not the only one who tore her ACL in non-contact this week either so my opinion is that there was some overtraining going on.
Anyway, the team ortho is offering only a patellar graft and after my crash course on outcomes and benefits/risks I am convinced that the quad is the best option these days. My research led me to Dr Mackay who has a clinic in Scotland and does the knees on most pro futballers in Europe many times uses an internal brace to repair instead of reconstruction. Some are back
On the field 6 months later. These tears appear to have to be directly off the femur which does not seem to be the case with many young player tears and my daughters ruptured in the middle. His team was very responsive and they put me in touch with a surgeon in New York, Dr Defilice ,who has made a name for himself in the area of repairs but also with reconstruction using the IB as a seat belt to the graft which alows PT to get more aggressive earlier and shorten recovery times.
We have also been intrigued with the BEAR implant but once again this is only available for proximal tears which usually happen to older players.
I want to say thank you to everyone who has contributed here. It has been helpful and therapeutic as we try to turn our grieving into a plan of action. I hope to add to this resource as our family goes through this journey.
 
Question for those who are further down the recovery road, at what point post surgery did your DD feel like she was back to 100%? Mine is 15 months post surgery and feels as though she is 85-90% of the way back, but still has some catching up to do with her teammates who didn’t miss a year of soccer.
 
Surf Zombie said:
Question for those who are further down the recovery road, at what point post surgery did your DD feel like she was back to 100%? Mine is 15 months post surgery and feels as though she is 85-90% of the way back, but still has some catching up to do with her teammates who didn’t miss a year of soccer.
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I think it’s pretty hard to compare recovery schedules because of all the variables. My DD told us she felt “back” at about a year post op. She had the benefit of playing a good bit of soccer to get there though. She had a relatively uncomplicated tear with no meniscal damage.
 
Surf Zombie said:
Question for those who are further down the recovery road, at what point post surgery did your DD feel like she was back to 100%? Mine is 15 months post surgery and feels as though she is 85-90% of the way back, but still has some catching up to do with her teammates who didn’t miss a year of soccer.
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First ACL tears (right knees) occurred in spring 2021 (March and May, respectively). Not sure what they'd say but I think they were "back" in fall of 2022 but spring of 2022 (when they were cleared) and last summer had unusually light schedules so they did not log that many in-game mins until the fall. Perhaps with a normal game schedule, they'd have seemed fully back a bit earlier. That's what we are hoping this go round.
 
supercell said:
I think it’s pretty hard to compare recovery schedules because of all the variables. My DD told us she felt “back” at about a year post op. She had the benefit of playing a good bit of soccer to get there though. She had a relatively uncomplicated tear with no meniscal damage.
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Very true about the variables. Mine tore her meniscus as well and then about a month into her return to play the knee blew up and they had to drain it. Scar tissue build up was causing inflammation, so she needed a scar revision procedure, which shut her down for a bit. Stop start, stop start.
 
So my daughter is exactly one week Post-surgery. The pain and lack of mobility was real, especially the first two days when there were two settings , 10/10 pain or an Oxy comma.
by day three were able to wean away from the heavy meds. PT starts tomorrow…gotta get that quad to wake up.
 
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