Returning from ACL tear as much mental as physical

Detour Coffee proprietor Valerie Spence gets into the stroke during the Smoky Mountain Rowing Center’s “Learn to Row Day” recently on Louisville Lake. The rowing event marked Spence’s return to athletic activity after knee surgery over the winter.

Photo by Brandon Shinn

Detour Coffee proprietor Valerie Spence gets into the stroke during the Smoky Mountain Rowing Center’s “Learn to Row Day” recently on Louisville Lake. The rowing event marked Spence’s return to athletic activity after knee surgery over the winter.

Spence pushes for another repetition on the weight machines at Cherokee Athletic Center.

Photo by Leslie Karnowski

Spence pushes for another repetition on the weight machines at Cherokee Athletic Center.

Local entrepreneur and Roller Derby athlete Valerie “Val Yumm” Spence is on the long and arduous road back from an ACL tear.

Local entrepreneur and Roller Derby athlete Valerie “Val Yumm” Spence is on the long and arduous road back from an ACL tear.

If you are around sports much at all, you’ve probably seen an athlete go down with an injury.

When we see that, we hold our breath and hope that it is something minor. If it is a knee injury, we all wait to see if it is the feared diagnoses of an anterior cruciate ligament (ACL) tear.

Unfortunately, ACL injuries are all too common in sports. If the ligament is torn, surgery is almost always the best option. We then await the day when that athlete can return to the court or field and resume playing.

But what happens in the time in-between these two events?

Unless you have been unfortunate enough to go through this injury or are in the profession of getting athletes back to competition, you probably haven’t thought much about it. I have the unique perspective of both having been the athlete trying to return and one of the professionals trying to get the athlete back.

I see the athletes go through the daily drudgery of rehabilitation because often I am the one putting them through it, but I have also been on that side of the fence.

At any given time in the clinic, we will have at least a half-dozen patients who have had an ACL reconstruction. I try not to brag, but we are quite good at rehabbing these patients and getting them back to the activities they love, be it hiking, playing competitive sports, or just getting back to work.

Roller Derby athlete Valerie “Val Yumm” Spence is currently one of the people in the middle of the whole process. Val, owner and proprietor of Detour Coffee in Maryville, knew she was hurt and would have surgery, but was not prepared for the complete loss of function of her leg. Unless you have been through it before or are warned about it, the disability, even though temporary, can be very disconcerting.

Val shared that the hardest thing for her after the injury and surgery was the complete stop in physical activity of any kind. If you have ever seen flat track roller derby, you know what kind of shape these ladies are in. Roller derby is a very physical sport, and they train very hard for it.

The injured athlete goes through a wide spectrum of emotions from injury to return to sport. Initially, they will go thorough denial that they are injured, or that it is as serious as they have been told. They will also go through anger, at pretty much everyone and everything. With an active person, they may also experience depression, especially as the months of rehabilitation drag on.

Unfortunately for these folks, the process cannot be rushed a whole lot. There are precautions for each phase of the recovery, so that no re-injury occurs. The hard part of the ACL rehabilitation process is when the athlete begins to feel pretty good and wants to increase their activity, but is not able to because of the restrictions that are put into place to protect the surgically repaired knee until it can completely heal.

The typical time frame for return to play after an ACL tear is about 20 weeks, or five months. Some athletes have made it back in as few as 12 weeks, but that is rare. For most of those many months, the athlete will attend physical therapy three times a week.

In the first few weeks, the focus is on regaining range of motion in the repaired knee. As the knee continues to heal, proprioception (balance) and strengthening exercises are started. These are gentle at first, and progress in intensity and difficulty as the athlete gets better.

The goal is to return the athlete to pre-injury levels of strength and performance, so that they can safely return to competition if the want to. While Val has not decided if she will return to roller derby, she will be healthy and strong enough if she chooses to and at the very least can return to her active lifestyle.

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