ACL Tear: Pivoting Away From Fear

Nothing quite fills an athlete with dread as much as an ACL injury. And especially in a country like Australia where we are particularly over represented when it comes to ACL injuries. Seriously, we have the highest rates of ACL injuries and ACL reconstructions per capita in the world (I know, we are a competitive bunch, but there are some titles that you don’t necessarily want to win!).

Everybody knows someone who has had an ACL injury. And the numbers over the past 15 years have increased by 70%. 

One thing I have noticed with my patients is that those that have injured their ACL have a fear that grips people like no other injury. Part of this is the lengthy rehabilitation rates post surgery, the concerns of developing arthritis, media coverage of athletes’ injuries, or even lengthy times away from doing what they love with the people they love. 

The silver lining that comes out of the news regarding Australian ACL injury rates is that Doctors, Specialists, Physiotherapists, Exercise physiologists, and S&C coaches as professions all have large experience working with patients from all walks of life recover from ACL injuries. 

And compared to previous history, there are far more options that are on the table for patients and athletes. 

It wasn’t that long ago that the only option was to proceed to surgery. But now we have excellent non-surgical options such as the Cross protocol, different bracing strategies, and a strong focus on the role of gym based rehabilitation. Depending on the extent of the injury, your goals, age, and lifestyle these non-surgical options may be a strong and viable choice. 

I must stress that these options do not take anything away from surgery. Surgical intervention still has an important role and may be the best option for a lot of patients (multiple ligament injuries, accompanying meniscal tears, under 18, likelihood of returning to high impact sports..etc). 

The take away point is that your recovery regarding your ACL injury has a greater degree of personalisation to you and what you want to achieve!

Another concept that does not get discussed alot in the ACL rehabilitation world is how to best reframe the injury and the rehabilitation time. This has worked for me with my injuries and it is a principle that I attempt to pass on to my patients. For example, if you have had an ACL injury and are going down the surgical option, you could view it as “I’m going to lose 12 months”. That sounds pretty bleak. I felt bad even just writing that sentence. 

Or you could pivot by saying “I have 12 months to work on myself and come back a better athlete than before the injury.” 

You could write it off as a nice musing to put on a bumper sticker. But seriously, people who have achieved much more than I have put this very principle into practice.

Bruce Lee after sustaining a severe lower back injury was bedridden initially and experienced a massive halt to his life. He did not rot but instead used this time as an opportunity to study, develop his own ideas, and ultimately use it as a spring board for his future development. 

Afterall, you must draw the arrow backwards in order for it to shoot forwards. 

If you would like to maximise your ACL rehabilitation to make you the best possible feel free to reach out to us at Top Performance Physio Chatswood.