Episode 197 | “How Are You (Really) Doing?” Navigating the Emotional Check-Ins During ACL Rehab

What is up to you all and welcome back to another episode on the ACL Athlete Podcast. You may hear some lovely background noise—it’s a leaf blower and a lawn mower—perfect timing for the recording of this podcast and just enjoy the little background, if you will. 

On today’s episode, this is a question and this is something that ACLers deal with all the time, and it’s answering the question: “How are you doing?” This is something that you will get from all the people who you interact with, from your closest people to your physical therapist, to your surgeon, to all the different people, friends and family, maybe people that you periodically see or have been acquaintances with. They will just say how you’re doing if they know you had ACL surgery. And it’s one that could be good timing and it could also be the worst timing for when people ask you this question. And it’s always hard to read that. What I want to do is dissect this a little bit because this one struck a chord with me recently, after having some conversations with my ACLers. It is that, how are you doing question, or something along that line. How’s it going, how is the rehab process, basically asking how this process is going for you and your recovery overall. Frame it however you want, but it’s asking you about that. 

I am very careful and intentional about asking this question and finding the right time points to do so as well as our team, as this is a question itself that can get really exhausting from the perspective of the ACLer. It’s also a little different, depending on who it’s coming from. As the coach and as the rehab provider and working with ACLers, you are supposed to be asking, how things are going, but it’s always needs to be very, very intentional in terms of the process and where they’re at. And sometimes there is a deeper check-in of,  “Hey, how are you doing?” Like how are you doing.

We go a little bit deeper. and so there’s a time and place for that. But what I’m more so referring to is one of my athletes actually was talking about this and they’re just in the midst of ACL rehab and they’re making some progress. They’re also seeing some stuck points sometimes. And so while they are moving forward, it’s just not as fast as we like, and they’ve been in it for a minute. And their teammate asked them, how are they doing right. And this athlete didn’t really want to answer the question. And I don’t blame them. I’m sure many of you probably resonate with this a good bit. It depends on the timing, the day of it, the season you’re in and all those things that play into when someone does ask you this. The thing that I’m referring to in terms of who is coming from is more so meaning that people in your circles who may not “get it” and it’s not their fault. It’s no fault to them. They’re checking in on you and most don’t really understand this injury or process. They don’t understand the length of it, the physical recovery of it, but especially the mental difficulty of it. And while we want our people checking in on us, it can get challenging. When everyone on your team is asking, how are you doing? Or random people at work, school, family, etc. 

I find that the timing of this is so important. Initially, you might be totally fine when people ask you. You’re on the front end of this ACL rehab process, whether it is the injury or especially postop, you’re in that honeymoon period where you’re making progress, you’re hitting some milestones and feeling that momentum in the early part. You feeling that energy, it’s like I’m going to hit this hard, make sure I do it right. But as you get out of that initial bubble (that honeymoon period) this question gets a little bit harder to answer, the how are you doing, because this process is so long. You also don’t notice as many day-to-day changes and probably feel some sort of what I call the stall or that was her reference from cooking a brisket. A little while ago, I did an episode on this, but there’s almost this stall period in ACL rehab. There can also be setbacks that obviously people will encounter in this process because of the challenges of working with the human body and testing it and really trying to stress it through this process so that’s going to inevitably happen at some point in the process. So that’s really challenging, especially once we get out of the initial phases. What I want to do is help answer this question for my ACLers who get asked this. Maybe they want to ignore it, but obviously you can’t ignore it because you don’t want to be rude. You understand people are checking in on you. 

The thing that’s important here, first, is to say that it’s okay to be annoyed by this, if you will, or it’s just you don’t want to answer it. I think that it is very warranted and I think the most important thing is to understand the season that you’re in for when this is good and when this could be counterproductive, if you will, for you. This is where communication is going to be so key with those particular people who are asking about this. Sometimes you just got to deal with it and just be like, ah, it’s fine or whatever, or brush it off and move on. 

I know a lot of times whenever we could be in this stall or maybe in the setbacks, the last thing you want to do is talk about the ACL rehab process. You want your mind off of it. You’ve been on it for a minute and you’re just like, the last thing I want to do is think about my knee and potentially how negative it feels. I enlist call a spade what it is. There are so many times where it just feels like you’re stuck. It’s negative. It doesn’t feel great. I remember so many times that this happened during this process. To give you guys just some real life stuff here, this is essentially an example of what it is in life. You’re not going to always be linear progress. You’re not always going to keep moving forward all the time every single day. There are days where there are low days. There are days where you just feel like doing nothing. There are negative days where you don’t know for any reason or maybe something has happened in your life. When we zoom out, when you take just life in general, these are the realities of it is that you’re just going to have moments like this, when someone asks you how you’re doing, even despite being in ACL rehab, if that has nothing to do with you, it’s still going to exist where you don’t feel like answering the question. 

In a sense, to some degree, no different. But of course, we’re talking about a recovery process, an injury and a surgery, potentially. We want to make sure that we can attack this properly and you have some understanding around it. I want to give you some examples of this and a few perspectives to tackle this. Because I think it’s better to not just completely ignore it, but just know it’s okay to feel this way. I think sometimes I’ll talk with my ACLers and they feel almost guilty or bad about it. But it’s like, hey, it’s okay, and is honestly normal in this process. I think the biggest thing is to just be aware of it. That’s the biggest thing and to communicate about it, especially to these people and especially ones that have more regularly happens with. 

Let’s talk about this, number one, if it’s people you’re close to, let’s talk about parents, best friends. just people who are close in your inner circle. This question is doing more harm than good for you during a certain season, whether that’s a few days, a week, maybe it’s a month plus. There are times where people are just dealing with it and they feel they’re in this limbo or purgatory, if you will, and it happens. I think the biggest thing is for you to be able to recognize that— I see if it’s doing more harm than good. I would be honest and share that with them and say, hey, I appreciate you checking in and asking. Right now for me, it’s hard to answer that. Maybe we can revisit that later. At least they know that, you’ve shown appreciation for it and it’s something that I think if you’re being transparent about it, then maybe they can kind of back off a little bit. If the person knows you really well, they will just back off. If it’s something where they feel like, hey, like I need to tap into this a little bit more because you’re my friend or you’re a relative of some sort, whether it’s a sibling or parents, brother, sister that’s a way for you to be able to tap into that. Maybe they probe a little harder. But at least you have communicated that over to them because sometimes it’s just like, I don’t want to talk about it as much as I know you’re being caring. I don’t really want to talk about this conversation. It’s something that I would like to ignore for a minute. I think communicating that and appreciating that they’re howing care is important. 

Number two, if it’s people less close to you and this one’s kind of harder, honestly, because people you’re close to, you could be a little bit more transparent with. Whenever it’s like that second layer of friends or people, this can be a little bit more challenging and you don’t want to explain anything or just say it’s good to avoid how you really feel or lie to them, then you can use some of these examples. You could just say, “it’s going. I appreciate you asking. Taking it step-by-step. Thanks for asking. Appreciate you.” I find a short, whatever you want to say about it. I think saying something along the lines of thank you of some sort helps to redirect and let people know you don’t want to chat about it, but also don’t want to be rude. And that’s a way for you to keep it short, show some appreciation because the person is showing caring. And especially if they’re not in that inner circle, they’re probably not going to probe as much. So then therefore you can just kind of redirect the conversation. 

Then number three, is of course, there’s the option to share. You can choose how much or how little you want to share based on the person, the timing, season you’re in. Sometimes this could be a bit cathartic, even though it seems like you don’t want to talk about it and blank it out. Sometimes it is just good to vent it out or sometimes it’s good to just get it out there, even when you do not feel like talking about it. This is something that you go based on a feel thing with this process, and it can be good for someone to just be an ear for you. And so that’s where I think also picking and choosing the person that you do this too, is going to be completely important. 

There are times where my wife wants to let me be an ear for her. And even though I am very problem solution oriented, sometimes I just need to be empathetic and I just need to listen and not have some sort of solution or hey, this is what we’re going to do. And it goes a long way for her. I’ve learned that over time. But there are also times where she does need help with a solution so I’m there to also help. Be someone to try to provide that in addition to just being an ear and hearing them out. But a lot of times in this process, you just need people to hear you out because sometimes it’s just moving fast. People don’t know what’s going on. And you haven’t been able to necessarily express that. I think that could be super helpful. And this goes across the board, it’s not just youth athletes, it’s not just a mom raising three kids with a torn ACL, it’s not just a construction worker dad or the recreational soccer athlete in college, it goes across the board. I think that this is something that is super important to make very clear is that it’s not just good for one group or one population. As human beings, we need to be able to communicate and share these things. But this always comes back that is totally on you for doing that and finding the right time and being around the right support system or person to do that. 

I do think it’s important to talk about this and have your closest people in your support system in and be there for you. Keep them in the know. And then maybe you can even set up some regular cadence to check in on you. Ask them and say like, hey, can you like, not every week, maybe every couple of weeks or every three weeks monthly, whatever it is that jives best for you and your mental health in this process, or maybe a certain season. Set up that cadence with your closest one to three people to be able to do that. But I think it’s important to have your support system locked in with you and clearly communicate those expectations so they could be there for you, whenever you are feeling a little bit more beat up. But also knowing it’s okay to let them know when you don’t want to talk about it. I think that’s just creating a safe space and a good support system. If you communicate any of that from the front end, that can really help, instead of having people constantly ask you, how are you doing? How’s it going? All this stuff when you don’t want to always entertain it. It can prevent that from building up in frustration and it’s not directed at them necessarily. It might be, especially for close people, but it’s really just frustration of the whole thing. It’s just real with this process. My goal is always keep it real with you guys. It’s something that you just want to make sure it doesn’t build up and it’s not feeding into a negative cycle you could be in. So that’s something that I know that we have all been there. If you are someone maybe early in this process, just wait, at some point it rears its head, especially once you’re out of this initial phases and just be aware of it. And again, it’s no fault to the other person for asking because they are just caring and they’ve never experienced this injury or potentially ever heard of it. People see someone walking around assuming they’re back to normal. 

I can’t tell you the number of times people, even in my early ACL recovery, they’re just like, oh, well, you’re going to get back on the field, or you’re going to be able to get back to sport. It’s only been like two months. But the thing is I got off crutches for my first ACL, for example, in one week. I was walking around. If people didn’t see a brace or people didn’t see a wrap or if my knee just looked normal and I just had shorts on, or especially pants on with nothing underneath it, in terms of a brace, then people are just going to assume, oh, that’s normal and if they have no understanding of this process. We can’t always blame people, but they can’t see what’s internally going on. People might see you walking around and you might be one month post-op. They assume you’re normal and you’ve still got eight-plus months ahead of you, for example. And that’s challenging when someone’s like, I thought you’d be back at this point because you look so good. But it’s like, nope, I’m just getting started. And so that’s where having communication and making that very key in this process over communicating if you will, with especially the people who might bring this up, who might be in your circle more often. This even goes for people who are in your rehab process. 

There are certain people I know I’ve worked with in the past where sometimes we don’t check in as much on that stuff during certain seasons. Now I try to feel that out based on body language and where they’re at and whatnot, and have certain touch points. But we might not do that because we’re trying to establish, okay, hey, this isn’t productive for right now because we’re working through a hard point with them. So that’s important for me to make sure I understand what my athletes and it’s okay to communicate that to your rehab provider, your coach, in case that is something that almost feels like a little bit of friction. I would encourage you to define your boundaries during certain seasons, you might be in during this process feeling this and not wanting to answer it or just not in the best head space. When you define this boundary, what I would encourage you to do is revisit it often, especially if you notice it’s affecting your mental health.

The last thing I’m going to mention here is that we are big on helping our ACLers from a mindset perspective, the mental health piece is so important. We had folks who have worked with sports psychologists and other mental health professionals, and this is something that we are very big supporters and proponents of, and there’s a lot of power in working with a legitimate professional who understands this stuff. Do we work with our ACLers on this? Yes. But if there is another layer we need to tap into, or we notice that is becoming a bottleneck in this process, or really struggling with, we have no hesitation referring out. And that needs to be very normalized because this injury does so much to our lives. It disrupts everything. If it is a big part of who you are, I get it guys, I get it— it sucks. And so therefore that is something to acknowledge and also know that if we need some help, we need to get that help because I’ve shared with you guys that your mindset will really impact your actions. If you’re stuck in these negative loops and especially if you feel like it is really impacting your progress and motivation and making you feel anxious or depressed or fear of reinjury, all of these things are real. These are the things that I want you to be able to keep note of and I want you to try tackle that head on and that’s where that can really be helpful. Maybe it’s the kick you need in order to get over this hump and be able to really get into this process and really dial in. This is something that I was hoping that could bring this around in terms of answering a question like this. I know that this is very specific in terms of the scenarios people get into, but this is such a big mindset injury. This is something that I want to make sure that you guys have some tactical approaches, also understand and know like what you’re feeling is real and you don’t have to always play nice or always just share and be open. So that’s something that’s really important in this process. 

If you need help finding someone, please reach out and we can connect you with someone from our community that we trust. That is something that is really important to us. We want to make sure you have the resources you need in order to keep going with your ACL process and also making sure that your mental health is in checked because that is something that we are always wanting to make sure is just dial it in as best as possible, depending on the seasons that you’re in. 

If you guys have any questions, please reach out. I’ve been loving all the messages and all the questions I’ve been getting recently. Please continue to keep those coming. I read everyone. I reply to every single one. I appreciate all of you guys for the support and we’re going to keep doing the thing. Until next time team, this is your host, Ravi Patel, signing off.