Girls ACL torn

[tjsoccer]

Another decision you could be faced with is the Autograft (own tissue) vs. Allograft (cadaver). For young people, Autografts are more common, but it means a longer recovery. I had mine done with my own Patella tendon and it hasn't given me trouble for 25 years.

Building the hamstring is very important. Dujuan Blair played many years in the NBA for the Spurs, and he didn't have a single ACL in his body. Strength training was credited:

http://www.nytimes.com/2009/11/13/sports/basketball/13dejuan.html?_r=0

 

[charlie murphy]

First, you do not need to rush to have the repair! ( If she was the elite athlete, ie. MRI in the tunnel and helicopter to surgical suite within 48 hours is supported in literature). For the rest of us, the long term outcome is better if you let the trauma to the knee quite. She can and should still bike and do quite low velocity exercise to maintain strength and flexibility. Remember the stronger into the surgery the stronger she will be coming out. Some degree of muscle atrophy will occur, so build ( don't lose) strength so she will have a cushion. Look at your timelines too. Can you fit this into a school break ( thanksgiving or Christmas), to avoid missing school. Do your research on the "best" repair for your daughter. Interview a couple doctors and ask what they feel is the best repair for your daughter and why. The repair for an older person who is less active is different than a repair for an active 13 year old girl. Find a good doctor who does, a lot! (as in this is the primary repair he / she does) of the type of repair you are considering. There are a number of approaches out there, look at the primary literature not the open forums online for guidance. ( I am not going to dispense medical advise on an open forum). The post op rehab is long and can not be rushed , the graft has to take and be strong. Too much too soon stressed the graft . The hard part is that you feel 'better' before the graft or leg is better. From the beginning of the rehab process look for a PT the understands the mechanics of the knee, hip and ankle and the pathomechanics that lead to the weakened knee in the first place. These need to be worked on from the beginning. The comment earlier about being on the ball early , only with a proper ACL brace . These braces are custom fit and you get them from an Orthotist , not off the shelf. I don't see the need for being on the ball early. that muscle memory should remain. I would be more concerned with overall fitness and joint mechanics. Good luck to you and your daughter . These injuries and surgeries are not career ending . The outcomes are very good . The time off may give her a chance to work on other things ( like joint mechanics on the other knee).

 

[sandshark]

We have been through ACL and MCL with my older kids playing in other sports outside soccer. My kid that tore his ACL/MCL is a professional athlete and so time was money but as we found out It is 100% about taking the time to rehab, take it easy on the rehab, do not overdo rehab there is no such thing as doing more rehab to be ready sooner. NO MATTER what anyone tells you it is a minimum of 6 months and 8-months is even better. She will feel like she can play 1-2 month after surgery BUT SHE CANT! In our circle we know of 5 athletes not including my kids that have had a ACL surgery and every single one of them have been in more than once to fix or redo the surgery because they ignored the time needed for a full recovery. I do not know the actual statistics on a future in something like Soccer after a ACL/MCL but im going to guess they are not good no matter what you do for rehab. It has always been my biggest fear in my DD playing. I don't mean to be a Debbie Downer but those are my personal experiences with ACL injuries. Good luck and stay posit, i hope your little girl makes a full recovery.

 

[charlie murphy]

Look at the primarily literature. MED NET . , Journal of Sports Medicine, Journal of orthopedics. etc. Ideas change all the time, a good doctor will move with the times and do what is best for the individual in front of them. you just want to know what your options are and the basics of one approach over another. the reading is dry , jump to the summary . but it is the latest medical information we can get our hands on , unless you are a researcher or medical journal reviewer.

 

[No.Guts.No.Glory]

My daughter also tore her ACL almost two years ago to this date (Sept 27th 2014) playing soccer. She was playing U14 at the time. It was a long recovery , I'd say about 6 to 8 months and since they used part of her own patellar tendon to replace the torn ACL she was left with a huge scar on her knee. With girls, they can be very self conscious about their appearances so the big scar was kind of a bummer for her. I would recommend looking into alternative non-surgical procedures such as stem cell therapies if your health insurance covers that kind of treatment:

http://www.regenexx.com/regenexx-acl-repair-for-torn-anterior-cruciate-ligament/

From what I have researched, the recovery time is faster with far minimal risks of re-injury and future osteoarthritis.

Hope she stays strong and has a prompt recovery!

 

[Not_that_Serious]

research. research and read EVERYTHING. take it slow build strength. id also find an Active Release Technique (one with years of experience dealing with professional athletes - not someone who just certified to bill people) to help with mobility or breaking down scar tissue after.

 

[charlie murphy]

research. research and read EVERYTHING. take it slow build strength. id also find an Active Release Technique (one with years of experience dealing with professional athletes - not someone who just certified to bill people) to help with mobility or breaking down scar tissue after.

Find a real Physical Therapist! Your orthopedist will send you the right direction . The rehab is protocol driven, the orthopedist does not want HIS/HER surgery messed up, they will put you in good hands. I would not let a massage therapist touch a patient post op unless directed specifically by a PT or the orthopedist. There is physiological balance that needs to be realized between scar tissue formation that is beneficial and scar tissue that is inhibiting. Save your cash , unless you are directed to go to a massage therapist and invest in sports specific training/ agility training once clear to progress past the acute phases of rehab.

 

[Not_that_Serious]

Find a real Physical Therapist! Your orthopedist will send you the right direction . The rehab is protocol driven, the orthopedist does not want HIS/HER surgery messed up, they will put you in good hands. I would not let a massage therapist touch a patient post op unless directed specifically by a PT or the orthopedist. There is physiological balance that needs to be realized between scar tissue formation that is beneficial and scar tissue that is inhibiting. Save your cash , unless you are directed to go to a massage therapist and invest in sports specific training/ agility training once clear to progress past the acute phases of rehab.

I didnt say not to go to rehab. you must rehab with a PT postop. also not all orthos are made the same. many people have the word "Dr" as a title but are not the brightest bulbs - especially those you are forced to use that part of a network. i dont know if you have had ART performed on you but ART certified folks are mainly Chiros and PHYSICAL THERAPISTS. I did not trust ANY chiro until I found the place I go to - thought they where all bone cracking quacks. I used them two post acromioclavicular decompressions (one done at Kerlan Jobe by a Mighty Duck surgeon), back issues and feet issue - saved me from having surgery on the left arm & keeps slip disk issue at bay when it flares. The place I go to work on Professional Athletes. People like the Mighty Duck players and Mr Olympia bodybuilders - hyper picky people who do not let "not real" professionals work on them. Hey they even work on average Joes like me and my kid. You know they even look at your MRIs and reports before even touching you (if they even decide to touch you) - who knew they would be able to do that?

If one keeps a closed mind and doesnt ask questions about what else might be out there - you will just be steered in the pen with the other sheep. Remember, surgeons get paid to cut you up. Trust the one that will do everything they can to NOT cut you - when at all possible. Also keep in mind not all PTs are at the same level of being able to treat a person - some dont know how to treat an athlete. This is very evident if you are ever sent to hospital-based rehab centers - where you get different people treating you every time you come in and/or kids just out of school or obnoxious PT who has worked at dozens of rehab centers. They treat you to function, but quality of life or getting back to being the "best" might not be the priority. One of my best friends (UCLA/CHapman grad) is a PT, very smart, but always tells me about her limitations with rehabbing athletes (doesnt have the experience) and most PTs limit a lot of various manipulation/treatment in order to minimize legal liability. I have been in and out of rehab centers since I was 12 - and had manual manipulation performed less then a handful of times. Almost in each case I had manipulation the Physical Therapist or Chiro stopped working on me and asked I see 2nd or 3rd opinions - which you have a right to. Other times, fixed ROM issues and broke up scarring in order to get the ROM I had lost. Point is, dont drink the Kool Aid. Do everything and anything for your child or yourself and dont blindly listen to people - people might have other agendas. You are your kid's advocate since they dont get a real voice.

Sorry for the rant, but hopefully people are not steered away from looking at other avenues because they have some preconceived notion about something or think what they know something because that is what they where fed by friend, spouse, therapist, doctor - people who have there own opinions based off what they where told in school or someone who knows someone who had something done to their cousin.

 

[charlie murphy]

I didnt say not to go to rehab. you must rehab with a PT postop. also not all orthos are made the same. many people have the word "Dr" as a title but are not the brightest bulbs - especially those you are forced to use that part of a network. i dont know if you have had ART performed on you but ART certified folks are mainly Chiros and PHYSICAL THERAPISTS. I did not trust ANY chiro until I found the place I go to - thought they where all bone cracking quacks. I used them two post acromioclavicular decompressions (one done at by a Mighty Duck surgeon), back issues and feet issue - saved me from having surgery on the left arm & keeps slip disk issue at bay when it flares. The place I go to work on Professional Athletes. People like the Mighty Duck players and Mr Olympia bodybuilders - hyper picky people who do not let "not real" professionals work on them. Hey they even work on average Joes like me and my kid. You know they even look at your MRIs and reports before even touching you (if they even decide to touch you) - who knew they would be able to do that?

If one keeps a closed mind and doesnt ask questions about what else might be out there - you will just be steered in the pen with the other sheep. Remember, surgeons get paid to cut you up. Trust the one that will do everything they can to NOT cut you - when at all possible. Also keep in mind not all PTs are at the same level of being able to treat a person - some dont know how to treat an athlete. This is very evident if you are ever sent to hospital-based rehab centers - where you get different people treating you every time you come in and/or kids just out of school or obnoxious PT who has worked at dozens of rehab centers. They treat you to function, but quality of life or getting back to being the "best" might not be the priority. One of my best friends (UCLA/CHapman grad) is a PT, very smart, but always tells me about her limitations with rehabbing athletes (doesnt have the experience) and most PTs limit a lot of various manipulation/treatment in order to minimize legal liability. I have been in and out of rehab centers since I was 12 - and had manual manipulation performed less then a handful of times. Almost in each case I had manipulation the Physical Therapist or Chiro stopped working on me and asked I see 2nd or 3rd opinions - which you have a right to. Other times, fixed ROM issues and broke up scarring in order to get the ROM I had lost. Point is, dont drink the Kool Aid. Do everything and anything for your child or yourself and dont blindly listen to people - people might have other agendas. You are your kid's advocate since they dont get a real voice.

Sorry for the rant, but hopefully people are not steered away from looking at other avenues because they have some preconceived notion about something or think what they know something because that is what they where fed by friend, spouse, therapist, doctor - people who have there own opinions based off what they where told in school or someone who knows someone who had something done to their cousin.

So just to clarify: you don't want 'people' "fed by friend, spouse, therapist, doctor - people who have there own opinions based off what they where told in school or someone who knows someone who had something done to their cousin ( or themselves) ."
Got it! We should listen to a person on a forum who no one knows, over our trusted friend, or your loving spouse, and the trained medical professional who are just out to make a buck off our ailment. Would you not fall into your last classification : "opinions based off what they where told in school or someone who knows someone who had something done to their cousin" . That is completely contradictory.
So you realize that the sub acromion decompression was done on your shoulder , and your back and your feet are not your knee. You also used you body worker / massage therapist for maintenance after the surgeries. Not acute rehab. I don't think a doctor is just going to cut you if they see an acl tear. You could live without an acl , if you chose. You would just be very limited. I do not think that PT and medical professionals that are based in a hospitals are lesser then others as you describe. May be you need a different insurance plan so you can access better care. There are some great hospitals in Southern California. Chiropractors are chiropractors and some are certified in specific soft tissue technique that they may have learned over the some one weekend course as the massage therapist. You also realize that Tom Brady had his ACL done at Kerlan and Jobe ! You do what is best for you. It seems to have worked out really well. Just a little hypocritical to say "don't blindly listen to people" on an open forum. actually that is hilarious , that's really funny! I owe you an apology. thanks.

 

[Not_that_Serious]

So just to clarify: you don't want 'people' "fed by friend, spouse, therapist, doctor - people who have there own opinions based off what they where told in school or someone who knows someone who had something done to their cousin ( or themselves) ."
Got it! We should listen to a person on a forum who no one knows, over our trusted friend, or your loving spouse, and the trained medical professional who are just out to make a buck off our ailment. Would you not fall into your last classification : "opinions based off what they where told in school or someone who knows someone who had something done to their cousin" . That is completely contradictory.
So you realize that the sub acromion decompression was done on your shoulder , and your back and your feet are not your knee. You also used you body worker / massage therapist for maintenance after the surgeries. Not acute rehab. I don't think a doctor is just going to cut you if they see an acl tear. You could live without an acl , if you chose. You would just be very limited. I do not think that PT and medical professionals that are based in a hospitals are lesser then others as you describe. May be you need a different insurance plan so you can access better care. There are some great hospitals in Southern California. Chiropractors are chiropractors and some are certified in specific soft tissue technique that they may have learned over the some one weekend course as the massage therapist. You also realize that Tom Brady had his ACL done at Kerlan and Jobe ! You do what is best for you. It seems to have worked out really well. Just a little hypocritical to say "don't blindly listen to people" on an open forum. actually that is hilarious , that's really funny! I owe you an apology. thanks.

Did you not read the entire post? Must have glanced over the part where i said get 2nd and 3rd opinions. Also where I said keep options open. You also make a lot of assumptions. Obviously is you have a significant tear, no amount of manual therapy or strengthening is going to fix the issue. My reply was to your find a "real" therapist. The problem is not all doctors and therapists are equally qualified to care for a patient. The point is you are telling people to get seen by "real" professionals as if whom I suggested where not "real" help . Not all tools made the same and always good to stock your tool chest with the best you can find/afford. Not everyone has a Kerlan Jobe Doctor doing their surgery - you also assume you and Tom Brady get the same treatment plan. My Kerlan Jobe doctor even said my treatment wasnt the same as treatment provided to Mighty Duck players. After two year of still having right arm issues post surgery - he agreed he was going to do "alternative treatment". You think we get the same treament Scott Niedermayer did to get him playing six weeks after tearing his pectoral muscle? My ART specialist (who by the way works with Kerlan Jobe ) came in after that, helped strengthen the arm and get rid of the pain - also stopped me from having surgery on the other arm. Same ART person stopped me from getting my wrist cut up by a surgeon who said I had carpal tunnel, and after one of the best PT arm specialists in the country had diagnosed me with pigmented villonodular synovitis - it was neither. Chiro found it was pronator teres syndrome from overly squeezing barbells - he diagnosed it in 5 mins after suffering for 7 years with it. Also figured out my sartorious tear with patella dislocation - 3 years multiple MRIs seen by many doctors and couldnt find anything. Havent seen the inside of rehab facility for anything but my shoulder. Not all doctors have the same work ethic, not all doctors try to keep learning the most advanced type of treatment - many are content to get their info from reps or be content with what they learned in school. A doctor's scope of knowledge is often limited and many times come with egos. Treatment can often depend on what is best for those paying the bills - ever go through a workman's comp doctor?

Point of all this? Help people. Many doctors, therapists and the likes are closed minded. If you find a good doctor, answers your questions and seems not to be CLOSED MINDED, trust him. if not get another opinion and get more resources to help you. Not here to argue about what I know vs what you know or who has a better opinion. People are smart,can read and ask appropriate questions with their provider - hopefully after some research.

 

[soccercrazy]

so unfortunately my 13 year old daughter just completely tore her ACL. From anyone's perspective out there what can we expect before returning? Like how long ? What can we do to make it be more successful? Extra training when further along in rehab? The doctor is saying 8 months post op before she will be able to play? Is this realistic? Can she return as strong as before assuming she puts the work in? Any advice is appreciated. Thanks

I am sorry about your daughter, I feel your pain. We experienced this a year ago, and like you, asked many questions to as many people we could talk to, but this made it very overwhelming. The bottom line for us was that we found a specialized doctor, Pediatric, Orthopedic Surgeon who specialized in sports medicine and who had a record number of successful surgeries. Her injury occurred in August last year, her surgery happened in early October (he used her Patellar tendon vs. cadaver, as he said the success rate was much higher using own body parts), and she resumed playing in late April with specialized brace (which she loathes). It's important to do your due diligence with doctors. I am not familiar with Kaiser; however, I do know others with Kaiser, who took their MRI's to other surgeons and paid for second opinions to make sure all doctors were on the same page. From a mental health perspective, bear in mind your daughter may experience a sense of loss-- loss of practices, loss of teammates, loss of a team who she's spent years with. And while teammates may "text" throughout the duration, it lessens as time goes on, games are stilled played, practices still happen, and she may experience the disconnect and sadness can happen. Try to keep the connections going so she doesn't feel lost. Also note that when she returns, "she" will feel physically good and will believe she's 100%, but that may not be the case. Even if she runs, she has not trained with her team, and she'll be a bit off kilter. It will take time, maybe a month, or two, at the most, but if she gets frustrated, you can ensure her that she will come back, and come back even stronger than ever before. Finally, PT will be a struggle - not because it's hard, but because it's "boring and monotonous". It will be the most important part of her recovery, so commiserate with her, but make sure she does what the doctor orders, I can't emphasize how important this will be. Hope this helps and best wishes for a speedy recovery!