I recently had an athlete I was working with tear her ACL. She knew it right when it happened and had all of the signs and symptoms with the injury. Non-contact. Plant. Twist. Pop. ....“I am so sorry!!”
Talking with her about the injury and the process moving forward, more mental than physical, brought me back to my own ACL injury like a flood of thoughts, memories, and feelings. I remember it like it was yesterday… well, maybe not quite like yesterday. Actually, I think that I can remember that day better than I can remember yesterday. A whole other issue. ???
January 16, 1991… a little further ago than yesterday. Wow! Has it been that long?? I am aging myself. 30 years ago - YEP!! But still, just like yesterday… maybe last week.
I was (still am) a skier. I was in a high school ski race in Michigan. One: Yes, high school skiing is a sport; and Two: Northern Michigan has hills, not mountains, but enough for skiing to be popular and a high school sport. I was the defending State Champion from the previous season my Junior year. Following my first slalom run, I was sitting in first place by more than 3 seconds (in skiing that’s a lot! - especially when I won the state championship title the year before by only 6 hundredths of a second - 0.06sec). Going into my second run, I was probably feeling a little overconfident and lackadaisical. The sun had come out some so the snow was a little softer. I was ready for lunch and a break in the lodge. I was mid way through the course when I found myself sitting back and ‘late’ for the next gate about to fall. Literally, through my mind, I recall saying to myself “well, if I fall going through the next gate, I can still get up and finish in first.” So, I pushed my uphill (left) ski forward to attempt to move in the needed direction while also sitting back on my skis and my other (right) ski going in a direction more down the hill than where I wanted to go. Not good - I fell. I did make it though the gate that I wanted to but also continued to slide on my butt past the next one too. “%&$#@!” Neither of my skis came off so that was good, I guess. I could still get up and finish the race, but I was pissed. I was going to have to hike and wouldn’t take first with the time it would take. I get up to begin the hike uphill as quickly as possible and step up on to my left ski. Nope. My knee buckled. Ouch! Hmm… that’s not right. Let’s try this again. Again, nope! Not going to happen. Something is wrong. I can’t do this. Why?? What is going on?? This is not good.
I decide the best option was to not hike (since that hurt) to finish the race and instead just ski down to figure things out. I turned my skis, pointed straight down the hill and headed toward the bottom with all of my weight on my Right. Well, my coach, who was on crutches recovering from his own ACL surgery, starts yelling and screaming, hands waving, and crutching up the hill toward me thinking that I was just giving up because I had fallen and was refusing to hike to finish the race. So, part way down, I sat down… and waited. Really? It was a ski hill in Michigan, so I was practically at the bottom at that point anyway. My coach eventually got to me and the ski patrol covering the race showed up as well. Yep, my knee hurt. I wasn’t giving up, but couldn’t put any weight on it without it buckling on me. I wasn’t skiing down on it. I was slightly stubborn at the time (probably still am) and 100% refused to be taken down strapped in the ski patrol sled - the wounded wagon. Nope, not me. I will ski down on one leg first! We compromised and I caught a ride to the bottom on the back of the snowmobile. Should I mention that my mom was at the bottom finish area and was FREAKING out this whole time as well? That’s what mom’s do.
There was no real pain just that whole pesky giving out, buckling issue, so after being checked out by ski patrol - “nothing obviously broken, nothing bleeding, see a doctor” - I borrowed one of my coaches crutches and we watched the other skiers and teammates make their runs down the hill from the finish area.
By the time I got into the lodge after the first race was done for lunch, my knee was huge - swollen and stiff. I put some ice on it and wrapped it with an ACE wrap putting it up on a chair to rest. On the way home that evening, I was dropped off by the team bus at the hospital emergency room to get my knee looked at. My parents followed and met me at the hospital. The doctor there took x-rays and checked me out. Nothing broken. You’re good. Once the swelling goes down, you’ll be fine and good to go. I should have stuck with that diagnosis!
But, since my coach had just had knee surgery, he said I should follow up with his orthopedic doctor for a second opinion. So a week later, my knee was still swollen but feeling better and I could walk. If I could walk, I thought I can 100% ski - no problem. But instead, we packed up and headed 3 hours south for our appointment. In the office he did a little test, the KT1000… beep…beep…beep; “Yep, you tore your ACL. You’re not skiing until you have surgery.” What!? No other options? The response, “Professional/elite athletes try to come back before surgery, but they never do well.” With that, I walked out of his office on the spot. Nope; that’s not the answer I was looking for. Check please!
After a good 5, maybe 10, minutes seeing the doctor, we loaded back up and drove the 3 hours back up north. Instead of going home, my parents thought it would be fun to take me directly to the ski hill during practice for team pictures!! Seriously!? Crying. Puffy face. Teenage girl. No longer able to ski. Devastated. “I am NOT a part of the team and will NOT take pictures.” I refused to get out of the car and hid in the back seat. The only thing that I cared about had been taken away from me. I was nothing and had nothing. No sport. No identity.
Well, during my big fit, my mom talked to an athlete’s parents from our rival town/team and their older daughter had recently had ACL surgery with another physician after being able to ski in a brace. So another physician, and another trip south. This time to UofM - 4 hours away. New doctor. Same test… beep… beep… beep… Same result. A torn ACL and will need surgery to repair. But, the big question… Can I ski and finish my senior season before surgery? Not exactly recommended but could be possible with building strength and use of a custom stabilization brace. Perfect!! Sign me up! That was just the beginning…
The next few weeks consisted of trips back and forth for physical therapy, brace fitting, and focus on rehab and strength training to get my hamstring to quad strength ratio adequate to pass “the test” and be able to be cleared to return to my sport, my team, my identity, my self.
How did it go?? Well, I built strength to stabilize my knee - I wish I would have known about and done that BEFORE my injury. But, live and learn, I guess. I passed “the test” which, back in the day, was an isokinetic resistance on the Cybex that printed out a cool graph chart that showed the ups and downs of the strength resistance and provided feedback on the max quad and hamstring resistance and the difference between the two. So, strength increased - check. Test passed - check. Custom brace received - check. Doctor cleared - Woohoo! Let’s go skiing!! Straight to the hill (after the 4 hour drive back up north) to get back on the slopes with a huge smile and all the confidence in the world.
I raced in the final two races of the ski season: Regional and State Final Championships. I was able to at least have the opportunity to defend my title from the previous year. I did not win again but I was myself again, and I placed 3rd in both slalom and giant slalom (GS). Not bad for coming back and skiing without an ACL. I just wanted to say “So there!” (just to keep the language clean) to the first orthopedic doctor that I saw. Even more of a victory was the mental and physical strength gained from the experience as an athlete - and I hadn’t even had the surgery yet!
Following the season, I was able to enjoy a few short weeks of skiing and training. I will be honest, I took every opportunity to be on the snow since I had missed so much and in my brain, my thought process was: “Well, they’re going to go in and fix it anyway.” So, I skied my heart out.
Then there was the surgery. I went in for my scheduled surgery almost 2 months after that fateful day with my fall. My parents so lovingly decided to schedule surgery right before spring break so I would have time to recover without missing school. “Thanks a lot.” But as a family, we had always travelled to Disney World for spring break and I wasn't going to miss my senior year of that just for some silly knee surgery. After surgery and recovery, we loaded up and headed south for some much needed sunshine and Mickey Mouse. Let’s just say that crutches at Disney World, not the greatest but taking advantage of being in a wheelchair and backdooring the ride lines - so great!! (again, this was back in the day when they still allowed that). Hanging out poolside with a gnarly fresh surgical scar and stitches isn’t great with the sun but also other people definitely look at you funny! Then there was the whole, I can’t actually go into the pool in the 100 degree heat with my knee. Simple solution, just go in upside down and keep the knee out. Also, I was suppose to be getting a minimum of 4 hours per day on this little Continuous Passive Motion (CPM) machine - well, this cut into my daily activities so I adjusted and slept with it on through the night. Did I do my ROM? - of course I did!!
The ACL journey for me (and anyone) was a long physical and mental process… I feel as though it is always there and will always be a part of me. It was my first introduction to an injury and to Athletic Training and what led me to pursue this as a career. Yes; it will always be a part of me and my care for others. So, THANK YOU to all of those that were there and supported me through my injury, getting back on the hill, my surgery and my rehab. I hope that I can pass that on to others.
And for anyone going through an ACL injury and rehab - you will survive. 100%. It will make you stronger both physically and mentally. Advice: Use your resources for support! Your favorite AT/PT, strength & conditioning coach, nutrition, sport psychology - any and all of the people that will provide knowledge and experience. Soak it up and take it all in - you will continue to use all of this information well beyond your injury and rehab to level up your performance in sport... and life. Lastly, I highly recommend journaling your experience and progression. Looking back it will be amazing to see how far you have come and can inspire you to keep moving forward.
YOU'VE GOT THIS!! #ACLclub