Torn ACL
- Thread starter Surf Zombie
- Start date
dk_b
GOLD
There’s a lot of research about ACL tears in girls and women and a number of competing variables that make them more susceptible, especially to non-contact injuries (I did not see one of my twins get injured (it was at a scrimmage at the end of a practice) but have video of the 2d one (injuries 8 weeks apart) and that 2d one was non-contact). Overuse, imbalance between the quads and the hamstrings, the angle created by the ankle/knee/hip (there’s a name for it and I can’t recall it), etc. The PEP training program is designed to teach girls athletic movements that do not sacrifice performance but do protect against ACL tears and if your daughter does only one thing, one ortho surgeon who has published a ton in this area suggests: strengthen those hammies! Soccer players tend to have overdeveloped quads relative to their hamstrings (which may be strong but just out of balance w/the quads). Those large muscles help to stabilize the knee by pulling in opposite directions (my lay description). If the hamstring is tired and less strong, that pull from the quad makes the knee vulnerable - it is why a 4 game set on a weekend may be risky but what really makes it risk is practice on Mon, no true recovery on Tues, practice Wed leading to 2 games on the following weekend. Wash, rinse, repeat. For months on end.
Preventative work does not eliminate the risk but reduces it. Hamstrings. It’s where it’s at.
Preventative work does not eliminate the risk but reduces it. Hamstrings. It’s where it’s at.
Simisoccerfan
PREMIER
Good luck to you all. ACL is not a soccer death sentence and your player can recover and thrive. There is no best way to go with the surgery and every player recovers differently and not in the same timeline. I would love for all players over around 14 to only play one game per week with one practice dedicated to recovery and one dedicated to injury prevention. I know this is a pipe dream due to clubs needing to make money and parent's not understanding what is best for their kids development.
To our recent ACL patients or patient sponsors, my daughter is just over 2 month's post op, but I'm still learning and I want to share info with parents looking for questions to ask and or future parents coming on the board looking for knowledge.
My suggestions:
Breathe, understand for a lot of parents/girls this news is like you've lost a loved one. In a way your daughter will most likely be putting her "soccer life" on hold for a year, this can seem like a small death to some so understand grief and the grieving process as you, your spouse and child deal with it. I know it seems a little over dramatic to look at it this way but everyone deals with it differently. For a parent a year is a year, for a kid a year can seem quite long. Just think about it like dog years, it may be on year to you but it will feel like 7 to your daughter.
With HMOs and PPOs take a look at your choices for ortho surgeons in your area and if they are in your network, you probably wouldn't choose the first repair shop to fix your car you see, why not do a little research on the ortho surgeon you are recommended. See if they have a sports medicine background or training? I will mention it below regarding Rehab but resist the urge to be tempted to fall for the urge to equate Professional sports team affiliation with quality.
Learn about the different surgeries available to your daughter, Bone-platella-bone, Hamstring, Allograft(Cadaver) Hamstring/allo hybrid? Your daughter's leg size and donor sites can affect the surgeons options, know before you go.
Ask about if the surgeon also will use an internal brace in the surgery or if he thinks your daughter/son's current ACL can be repaired in addition to the reconstruction.
Does the surgeon use Platlet rich plasma in his surgery?
I found out there is a surgeon here in the Bay area who is a signatory on a paper using amnion Biological Augmentation (it looks promising)
Post-surgery:
Look into the rehab places around you if your insurance network has choices, use Yelp, google reviews whatever you can find to make sure you are choosing the right Rehab place. Don't be afraid to drop in to see if the place seems like a professional joint or some guys basement rehab in a office park.
See what kind of certifications and degrees the Rehab guy/gal has, don't be lured by Professional sport team internships do a little research on your own.
Find out who else they have working at the Rehab place, your guy isn't always going to be there when your daughter/son goes in, who are his/her backups and partners and their qualifications.
Ask the rehab guy what their return to play timeline can be for your child? How well do they communicate with your ortho surgeon? Don't be fooled or enticed by a hard sell like "I will get your child back on the field by "X month". Every kid is unique and has a best path to recovery it shouldn't be rushed or you can find yourself back in this situation again.
I'm still learning, and will probably add more but I hope this can be helpful to someone
My suggestions:
Breathe, understand for a lot of parents/girls this news is like you've lost a loved one. In a way your daughter will most likely be putting her "soccer life" on hold for a year, this can seem like a small death to some so understand grief and the grieving process as you, your spouse and child deal with it. I know it seems a little over dramatic to look at it this way but everyone deals with it differently. For a parent a year is a year, for a kid a year can seem quite long. Just think about it like dog years, it may be on year to you but it will feel like 7 to your daughter.
With HMOs and PPOs take a look at your choices for ortho surgeons in your area and if they are in your network, you probably wouldn't choose the first repair shop to fix your car you see, why not do a little research on the ortho surgeon you are recommended. See if they have a sports medicine background or training? I will mention it below regarding Rehab but resist the urge to be tempted to fall for the urge to equate Professional sports team affiliation with quality.
Learn about the different surgeries available to your daughter, Bone-platella-bone, Hamstring, Allograft(Cadaver) Hamstring/allo hybrid? Your daughter's leg size and donor sites can affect the surgeons options, know before you go.
Ask about if the surgeon also will use an internal brace in the surgery or if he thinks your daughter/son's current ACL can be repaired in addition to the reconstruction.
Does the surgeon use Platlet rich plasma in his surgery?
I found out there is a surgeon here in the Bay area who is a signatory on a paper using amnion Biological Augmentation (it looks promising)
Post-surgery:
Look into the rehab places around you if your insurance network has choices, use Yelp, google reviews whatever you can find to make sure you are choosing the right Rehab place. Don't be afraid to drop in to see if the place seems like a professional joint or some guys basement rehab in a office park.
See what kind of certifications and degrees the Rehab guy/gal has, don't be lured by Professional sport team internships do a little research on your own.
Find out who else they have working at the Rehab place, your guy isn't always going to be there when your daughter/son goes in, who are his/her backups and partners and their qualifications.
Ask the rehab guy what their return to play timeline can be for your child? How well do they communicate with your ortho surgeon? Don't be fooled or enticed by a hard sell like "I will get your child back on the field by "X month". Every kid is unique and has a best path to recovery it shouldn't be rushed or you can find yourself back in this situation again.
I'm still learning, and will probably add more but I hope this can be helpful to someone
dk_b
GOLD
I agree with this completely. Far more important to me: is the surgeon a specialist in pediatric orthopedic surgery and does she/he work with athletes? The approach (hamstring, patellar, quad, cadaver) may vary depending on the athlete and docs have different views of which is "best". However, failure rates are obtainable and not "opinion" so you may want to find those out, especially for an athlete.
The healing timing is also interesting - it is not just about getting leg strong but having the grafted tissue actually "turn into" an ACL. That takes time.
VegasParent
SILVER ELITE
Great info. My DD crossed the 2 month mark yesterday. When the Dr. told my kid she would be out a minimum of 6 to 9 months, I thought that's not too bad but in my kids mind it felt like he said 6 to 9 years.
Surf Zombie
GOLD
How often are you having your DD attend practices/scrimmages/games while injured? Once a week, every event?
dk_b
GOLD
As much as they want but it has not been that frequent - very few practices once school started and some games. Given that their priority is rehab, they are opting to go to a local gym where they can do PT/Dr-approved exercises on non-PT days.
VegasParent
SILVER ELITE
She goes to practice once a week. The other days conflict with PT right now but that should be changing with high school soccer ending. She's been to every local game. She's going to the ECNL showcase this weekend (she was a discovery player before getting injured) and the GA showcase next month. She want's to go to the Florida showcase in March but not sure about that one yet.
As you move through the process and come out on the other side, make sure your daughters engage in injury prevention exercises prior to do anything soccer related. Band work that helps load the hams, quads, Glutes will help to protect the tendons as they begin to train/play. My DD religiously does it before anything she does. It really does reduce these injuries. I wish she had been doing it long prior to her tear.
dk_b
GOLD
As I drove one of my daughters home from her 6-month appt, she made a similar comment - she said she knew that there were things she could have been doing prior to her injury but will REALLY do them now. Tough way to learn but my hope is that all these girls can spread this gospel to their friends and teammates. As I noted above, you can’t eliminate all risk but you can address certain of the controllable variables and reduce that risk.
No doubt. I wish clubs would to more to "enforce" this stuff, but they don't and never will in my estimation.
We haven't told her "No" but her club team practices about a 45 drive away, rehab twice a week at PT and doing the PT homework multiple days a week is priority. HS soccer is just starting here in NORCAL so she is part of her Varsity Team but more in a equipment manager/motivator for her teammates. She has attended a couple of her club team games but sometimes that's a little hard on the psyche so she has stayed away.
Regarding preventive exercises, my daughter was actually one of the few girls at her club that was pretty religious about that and post game. Being on the skinnier side my wife was super concerned and worked hard with her building quad and balance. Unfortunately, she just suffered an unfortunate contact injury. Not dirty just unlucky.
dk_b
GOLD
They won't. And, yet, many will say they do. And very few (likely close to none) will actually reflect on their own injury rates and consider whether they are doing enough. This is a Californiacentric bulletin board and whether one is in NorCal or SoCal, we are all pretty close to some of the best medical resources in the country/world, some of the top researchers and practitioners in the area of pediatric orthopedics. Why don't more clubs/high schools tap into those resources and provide hands-on, daily, injury prevention programming? We know coaches never want to give up the precious additional 20 to 30 mins that can save kids from many months of rehab - even the clubs that do something, might have a weekly session that is not taken all that seriously when, as we know, this is a daily thing that needs to happen. (when I coached travel baseball, I'd bring out people from Children's in Oakland to work with my kids on dynamic warm-ups, elbow and shoulder injury prevention, etc. It was worth it to do a pre-season throwing program to help prevent injuries rather than a return-to-play program following Tommy John surgery (which, like ACL for girl soccer players, is epidemic among boys in throwing sports).
Deep breath . . .
I know of one coach who was religious of dynamics prior to every training. Even if you arrived late to training, you still had to do the dynamics routine. He would always boast that he never had a player tear an ACL. When we moved on to other clubs, it was inconsistent and it always worried me this was not implemented. When I could, We would arrive early and do dynamics before training start time. I didn’t understand, 15 mins isn’t going impact training - a good coach will manage time well.
I'm 100% with you. It's truly an epidemic and the clubs are in the best position to help curb it. If you leave this stuff up to the girls, they'll never do unless of course they've torn their ACL. I almost feel like clubs are negligant in this.. It takes 15 mins to complete the muscle loading. SMH.
Roostah
BRONZE
Keep in mind that the NFL has some of the strongest, best trained athletes and 46 players have suffered ACL tears so far this season (most of them non contact). This may point to injury prevention may not be as simple as strengthening or dynamic warm ups.
dk_b
GOLD
none of it is injury prevention, just risk mitigation. There will always be some risk - my intention was not to suggest otherwise (apologies for any confusion my comments may have caused (sincerely))
Sorry to hear about the club membership
I had my ACL surgery 25 years ago next month. I can say I got an a appreciation and hunger in hoops when I got off IR that I never had before. I actually played smarter and better after my ACL.