June 2014 Issue – ACL Recovery Time is a topic heavily discussed between players. Unfortunately, with the high rate of ACL injuries in soccer players, the conversation is all too common. Although the diagnosis for many is the same (ACL tear), recovery time for each athlete is individualized and different.
The general time frame given for complete rehabilitation is between 6-9 months. That large 3-month window is given because not each athlete will be ready at 6 months. Not all athletes will need 9. And coming back at 6 months doesn’t mean you’re better than someone needing 8, 9, or 11 months.
Goals of ACL rehab:
0-6 weeks: Control swelling. Restore ROM (range of motion) and limit pain. Begin to initiate muscle contraction and proper gait mechanics.
6-12 weeks: Continue to maintain full ROM and gain muscle mass and muscle endurance. Pain free unassisted walking. Physicians look to clear an athlete to begin a progression back into jogging around the 12 week mark.
3-5 months: Continue muscle gains and initiate muscular strength and power exercises when cleared by a physician. May begin sports specific activities.
5+ months: Continue sport specific activity. Progress into full activity as tolerated.
*This timeline is very general a vague and will differ from athlete to athlete. Progression in protocol is determined by your physician. No athlete should attempt to conduct his or her own rehabilitation.
Some factors contributing to recovery time:
Graft choice. The three most common choices for a graft are the patella tendon, hamstring tendon, or cadaver tendon. Each one slightly alters the recovery time.
Diagnosis. What injury has occurred? Is it an isolated ACL tear with no other structures injured? Was there meniscal damage that needs to be repaired or an MCL that needs to heal?
Athlete compliance. This is the biggest deterrent to recovery. I often tell athletes, “Surgery is the easy part, and rehab is the hard part”. Athlete’s cannot be in rehab 20 hours /day. It is imperative that athlete’s “do their homework” outside of scheduled rehab time. Especially in the early stages of rehab, compliance with your HEP (home exercise program) is essential because there is so much you can do at home. You may do 30 quad sets at rehab but asked to do 100 more at home.
Scroll down to the December issue for a video of Ali Krieger going through a series of exercises to recover from her ACL injury.
April 2014 Issue – Player Preseason: Getting Fit and Staying Healthy — As the Spirit’s preseason wraps up, all eyes are on April 13th. The 4 weeks of preseason will be leading up to this day. The entire team, staff, and Washington Spirit community are excited to kick off the season against the Western New York Flash. Our goal, as the sports medicine staff, is to have everybody healthy and available to play.
Preseason presents a unique situation and wonderful opportunity. Everyone is finally coming together for the first time. There is a myriad of tasks to accomplish, from tactics to fitness to technical work, however every player is coming off a different “off season.” Some have trained on their own, some are coming from school, some have played an entire season internationally, and some are coming back from injury and rehab. Their bodies are in different states, and juggling the workload and injury rate is always tricky.
Preseason is very demanding. We do not have a match for 4 weeks. We have double training sessions every day. Some days we are on the field for 2 sessions, other days we are on the field in the morning and in the weight room in the afternoon. Throw in 4 exhibition matches and if you don’t plan properly, you can be in for a nightmare. Even healthy players need rest. If you have been out to our exhibition matches so far, you will notice few players going the distance and playing 90 minutes. Again, we are preparing for April 13th, not March. Preseason not only allows coach the opportunity to try out different formations and player combinations, it gives players a bit of rest they might not get during the regular season.
Preseason also allows us the most time to treat and recover from injuries. We have 4 weeks to get everybody healthy for April 13th. During the season, we may have 5 or 6 days to get ready for the next match. During the season, exhibition matches don’t count on our record and are intended to help gel players together and iron out team details. While we want everybody to be able to play, we know that these games aren’t the time to push through injury. Preseason allows us the time to be most conservative. Everyone is excited and eager to play and it’s hard to tell them they are going to sit, or get limited minutes. Players want to mesh together and prove themselves but we constantly tell them, “We need you April 13th, we don’t need you March 29th.”
Crystal Dunn, Spirit and NWSL 2014 first draft selection, found out first hand what preseason is all about. “It was tough because I wanted to play and be out there with my new teammates but I understand the importance of not rushing my recovery so that I’m healthy when the season starts.
The regular season is a fast paced, whirlwind of a time. We have games every 5-6 days, travel across the country, and are constantly on the go and getting ready for matches. Preseason gives us 4 weeks at home to prepare the athletes for the demands of the regular season and get everyone healthy. While most athletes dread the word preseason, it is truly a unique time of the season and one the staff is very grateful for.
March 2014 Issue – The thigh bone’s connected to the knee bone. The knee bone’s connected to the leg bone. We’ve all heard the song before, but it rings all too true when dealing with pain. We are all connected, from head to toe, and a lot of times, we hurt in one place because another place isn’t working properly.
As an athletic trainer working with female athletes of all levels, one of the most common complaints I encounter is knee pain. And most often than not, the problem spot is not in their knee. Download the following article on exercises that players can do on their own at home.
February 2014 Issue – The physical demands of soccer often lead to tight and even pulled muscles that limit or prevent players of all ages from performing. To keep different muscle areas such as hamstrings or calves loose, foam rolling is becoming a more common practice. Never heard of foam rolling before? Then take a few minutes and download the article from Emily Fortunato, head athletic trainer of the Washington Spirit from M.O.S.T. Emily provides diagrams on different foam rolling exercises for different muscles.
M.O.S.T.:Spirit on Foam Rolling
January 2014 Issue – Every athlete is always looking for the latest strategy to improve their game and reduce their risk of injury. One of the most imperative and beneficial strategies to stay on top of your game is something that is often overlooked and disregarded. The answer is simple …. sleep.
But how much? 6 hours? 8 hours? 10?
To get this answer and more about the importance of sleep to an athlete’s success read Sleep – The Overlooked Fuel.
December 2013 Issue – Ali Krieger suffered in 2011 a serious ACL injury and missed the 2012 Summer Olympics. Working with Spirit partner Metro Orthopedics and Sports Therapy, Ali recovered to play this past year with Spirit, the U.S. WNT, and now in Europe for Tyreso.
You can watch a video of Ali demonstrating the 7 exercises that can help female players of all ages strengthen their lower body to recover from such a devastating injury. The seven exercises are the:
– Basic squat
– Jump squat
– Lateral bound
– Step up
– Hamstring curl
– Ball walk out
– Dead lift
Watch video: http://youtu.be/xWBSf4BfKRk
