Episode 204 | Gains Over Gaps: Shifting Your Mindset in ACL Rehab

What’s up team? We are rounding out 2024. This will be the last podcast episode that is released. As the end of the year approaches, we’re going to do a little bit of a mindset episode. As you guys know, I love to really round things out, looking back on things, and then being able to set some intentions for the New Year. 

Now, some of you listening, you might be listening to this one—it’s not the end of the year or the beginning of the year. And that’s okay, because it’s still going to apply. But with that said, for those of you who are in this period at the end of 2024, let’s dig into it because I think this will be a really good one to really just look back at things and really be able to set our sights for this New Year coming up. 

I’m going to kickstart this with a story. One of my youth ACLers, youth athletes cried in our session this past week. Now before you’re like Ravi, what’d you do? The thing that happened here was she’s only a few weeks post op and she’d been struggling with some extension. As I’m sure a lot of you ACLers, some of you get your extension back quick and then some of you, it takes a minute. If you have a PT who is in this process and with you, they’re like, let’s get that extension. Some of that could be in your control.Some of it honestly is the body, the graft type, the knee responding to the post-op process. And so you’re really getting after it and it can be a lot. And some of that’s out of your control. 

Now with that said, we worked hard in this session and also joked around. It’s important not to only work hard, but play hard too. I want to make sure I’m connecting with my athletes, having a good time. And again, she’s early post-op so it’s still a little bit more of a sensitive stage. When I say youth athlete, this athlete is also 14 years old. At the end of this session, I told her what changes we were going to make to the upcoming program after some of the stuff we had looked at and worked on. And then she had jokingly said something about, oh, and then what about my downtime? When I get to do X, Y, and Z. And then she kind of looked away and exhaled and then just kind of started tearing up. And what this was, was the culmination of what feels like months and months of a scary process. 

In reality, it was just a few weeks, but it feels like a long time. Especially when you’re in the throws of it, day in and day out, especially to a 14-year-old female athlete. But honestly, it doesn’t matter age or gender or who you are, this is a lot. I know a lot of you in this process can really relate to this. I know I relate to it. I remember in those first weeks, those first months, especially early post-op you’re just kinda like, man, it feels like a grinder nonstop. You’re also kind of dealing with this ongoing anxiety fluctuations and feelings of fear. You’re also just trying to build, and especially if it’s not going as smooth as you expected. And everyone’s like, oh, cool. Yeah, post-op, I’ll get through it. It’s your first major surgery usually, which it is for this athlete. And not to mention how much it’s impacting her life, from school to being able to hang out with her friends. She would walk home and to school with friends. She can’t do that right now. You think about all the stuff and all the things that she’s doing, and it just makes sense. It has been a lot for this athlete, nonstop work, some of those fears of the ACL injury, that surgery, getting some tricky extension right now, and she’s been working really freaking hard. You combine that with life, school, homework, rehab. And honestly, just getting a freaking minute—it’s a lot. That’s the big thing here, is needing a break if you will, or just feeling like you’re constantly on this grind. You’ve got the energy for it, but then maybe the progress doesn’t necessarily align with how much work you’re putting in.

I know some of you even with flexion. You’re like, man, I’m really pushing flexion, working on it hours and hours a day, and sometimes it doesn’t seem to budge or when it does it just kind of regresses back and it can be frustrating. Instead of focusing hard on the next thing, we really celebrate her progress in this session and since the last time we met. And that was the big focus for me coming into this session, making sure that we set that intention. And while yeah, there was at the end, some emotion around this. That’s the thing is like, it just kind of culminates. We make sure we circle back to thi is how it looked before and look at what it looks like now. And so we’re really trying to focus on instead of like, alright, cool. Let’s get this heel pop and extension. Yeah, that’s the goal. And she knows that. I didn’t belabor the point in this session. My goal was making sure, hey, let’s continue to work on these things, here’s where we can find some really productive movement. And let’s really celebrate how far you’ve come since the last time I saw you. 

The gain, if you will, not the gap, which is the main focus for this episode. ACL rehab honestly, can feel nonstop in this process, as I shared earlier. And it’s always the next thing and then the next thing and then the next thing. The moving goalpost, if you will. This is a personal struggle I have, I’m always looking to the next thing. And so that’s great whenever you’re trying to grow something or get towards something. But then sometimes you can almost lose sight of the process or how far you have come. I know any of my ACLers know exactly what I’m talking about—you’re aiming for extension; you’re aiming for flexion to get a full bike revolution, to get off your crutches, to drive, to get down your stairs without feeling like you’re going to fall down or that your knee’s going to give out or that you have to hold on for dear life, to jump, to run and it keeps on going. It’s the next goalpost or it is the next gap, if you will, between where you are and where you want to be. It’s focused on that and that’s how we look at life as human beings where you are and where you want to be. 

I want to focus on the gain rather than the gap in this episode. I talked about this concept before, but as we’re nearing the end of this year, or as I said, if you’re listening at some other point in time. Honestly, this is still very applicable. And this all comes from this idea and this book, The Gap and The Gain by Dan Sullivan and Dr. Benjamin Hardy. It’s a great book. What they talk about is that gap mindset and a gain mindset. For the gap mindset, it’s focusing on what’s missing or what hasn’t been achieved yet, can lead to this feeling of being dissatisfied and these negative emotions, if you will, comparison can kind of sneak in seeing where people are ahead of you and then where you are. Versus there’s the gain mindset focusing on the progress made and your wins so far. It provides this feeling of gratitude, feeling positive, and you get a little bit more fulfillment out of this perspective and looking through this lens. Growth comes by reflecting on how far you’ve come versus how far you have left to go.

This is huge in ACL rehab. We can get really bogged down by the next thing or the gap, if you will. Sometimes we just need to take a second and appreciate the gain or the wins, whether it’s a small win, it can be a big wind, it could be a big milestone. It could literally just be showing up. I talk about this a lot, but this is something that we really need to look at and be able to revisit often. This book talks about measuring backwards. Success should be measured by comparing current achievements to where you started, not against this kind of ever evolving ideal, this moving target. And that’s the thing that we’re always after an ACL rehab is like, all right, there’s this moving target or goalposts are constantly achieving or trying to achieve.This is where we want to almost measure it backwards instead of measuring forwards. Because we’re always going to feel like there is that gap, or we’re not attaining what we need to versus being able to look backwards and be like, all right, cool. This is where I was and this is where I am now, and looking at the growth and the achievement in that. And there’s gratitude in this gain mindset that helps to fuel and reframe certain challenges along the way, focusing on the progress. 

And that’s really big here in ACL rehab and especially as we are kind of setting our sights forward and now don’t get me wrong. There is value in looking at that stuff. We want to make sure we are aiming towards things. But I think when we’re constantly in this mindset and in this state of like the next thing, the next thing, the next thing, you’re always feeling like there’s a gap. It makes it hard to honestly be happy in the moment or in the process. You almost feel like I need to get to this point in order for me to feel happy or to be able to feel content. But in reality, when we get there, it’s the next thing, and this is just human logic in a weird way and the way that we are programmed. But in reality, what I want us to do is take a step back, especially as you’re going through ACL rehab and be able to look backwards.

From a practical application standpoint, regularly, reflecting on your past wins, achievements, milestones that you’ve hit. Journaling about these gains that you make each day or each week. And for us, this is celebrating those wins, writing these down even if it’s like a simple note in your phone. I’ll tell my athletes to literally have a note in your phone ongoing, or maybe you set a reminder at the end of the day, or maybe the next morning, at the end of the week, whatever your cadence might be, to keep that momentum going because this process is long and is hard. And whoever tells you different is honestly not living it or they are an anomaly because we know that it is those things have long and hard. The thing is when we first started this process, there are gains quickly from the range of motion pieces and this isn’t everyone, but most people you’ll start making progress on range of motion, your flexion, your extension, pain goes down, swelling goes down and you get off your crutches. You life starts to get back to normalcy a little bit. And it’s that honeymoon phase that I talk about where you’re starting to see all these different progression milestones. And then it hits this phase where you might not hit it as much. You almost feel like maybe you go a month, maybe a month and a half and you don’t see that noticeable progress. You might make a little bit more weight on some sort of movement, or you’re able to do things a little smoother, but it’s less objective and it’s less your ability to notice your day-to-day life changing. And so then therefore that’s where some of this stuff can really come in because especially when you hit a setback or in progress isn’t as noticeable. It’s good to be able to look back at these things and continue to keep the thing going. This is where you focus on where you’ve come versus that moving goalpost, the gap, if you will, that constantly striving for more, getting more fulfillment in this way and building confidence via your own self image. 

Finding happiness and peace now with where you are versus kind of feeling this anxious constantly stressful pursuit of not enough. And this is huge in ACL rehab and life honestly. I’m more guilty of this as I mentioned earlier than anyone. I can always be on to that next thing, treating milestones for myself as “expected behavior.” And my wife gets on me about this. I’m trying to be better about it as I want to practice what I preach because of how much I know is important for my athletes. Now having a sign is important for me to also share with him, like, hey, like you need to be able to look back and be able to appreciate the things that you’ve accomplished and not. think about the next thing all the time.

And just like with the 14-year-old athlete who started crying as we were nearing the end of the session, we really turned that around by really talking about the gain and we didn’t focus on the gap. We weren’t like, all right, you need to hit this extension. This is what’s missing. We talked about really the gain the last time I saw her until now and the work that she’s put in and she’s been putting in work. We’re able to really turn that feeling around and be able to leave the session on a super positive note, laughing. It was just one of those exhales that you kind of feel where you kind of need it when you’re just going full speed, working towards something is not progressing like you expected. But maybe there’s some movement. It’s those 1% gains and that is what we focused on. 

As we round out this year, take a second to reflect on your gain. We are so quick to move towards goals, New Year’s resolutions, the next thing, but I want you to take a second, even if you are one day post-op in this process or post-injury. But if you have been through this process, give yourself a second and reflect on the past year or the past journey of this process and be able to reflect on the gain, write it down and list out these things, recognize all those wins and how far you’ve come. There are goals ahead, but for right now, let’s give this some space to be because that’s important. Don’t rush towards the goals. Because oftentimes when we reflect and look at that gain, it helps to really put in some momentum. Provide some space, set a timer, do whatever it is and just be like, cool, I’m looking at gain mode, gain lens, my reflection mode, and that’s what my focus is going to be for this minute. And then be like, hell yeah, I did that. It’s literally say that. Be proud of it because you should be. Because this is really freaking hard work and every degree and every rep matters, you’re doing it and you deserve to celebrate it. I know this is seems cheesy and some of you might think that. But in all honesty, we need as much encouragement in this world; we need as much encouragement in this process. And this is something that you can just do to just even take a few minutes, just to be like, all right, cool, I did that. I’m able to get my full extension; I’m able to get my flexion; I’m able to go on a walk with my friends at school now; I’m able to get in the car so I can go travel, go and see friends, be able to see some family. I can pick up my kid again. All these things that are in life that we take for granted and this ACL rehab process temporarily takes away from you—you’re like, I’m back there. I’m me again. But then there’s more to gain, of course. But with that said, we want to look at what so far has been gained and that’s what the focus is here. And you’re doing it and you deserve to celebrate it.

I appreciate y’all so much. We have had such an incredible 2024. For me, it has been wild, the busiest year of my entire life with having our son, running a business and growing this business. And just continuing to put everything I can into this. And so thank you all for the support. Before you jump into this New Year or the next thing, appreciate the gain. I’m going to do that. I love this time of year, and I’m going to really try to focus on settling in and appreciating this gain. I’m going to set time aside for this to reflect; look at my gains; look at the gains of our team; look at the gains of what this community has done. And that’s how we can really fall in love with the process and be happy with where we are versus always striving for the product or the next thing. Thank you guys. 

If you have any type of reflection and you want to share with us, please send me a message. You can send me via Instagram, RaviPatel.DVT. You can send me a message in the show notes. There’s a way to text me and I do not see your number, but it gets basically fan mail, if you will, where I can see what it is. If you have some sort of reflection you want to share or some sort of note you want to send us, I appreciate all of them. I read them and save them. 

And last thing, if I can request, as we round out this year and this podcast continuing to go week after week and over 200 episodes. If there’s one favor I can ask you all, it’s to leave us a five star review. It helps us so much to reach more and more ACLers, more and more clinicians, more and more coaches. That way we can just keep doing the thing. If you have a second on Spotify, all you got to do is go up there and literally click rate it. If you want to do it on Apple podcasts or wherever else you are. It means the world to us. And it has such a multiplying effect for what we’re trying to do here at the ACL Athlete and really redefining the way we do ACL rehab, the performance and ultimately, helping ACLers get back to doing the thing. 

Let’s have a good end of the year and/or maybe it’s just the middle of the year for someone else listening. I will see you guys in 2025. Until next time, this is your host, Ravi Patel, signing off.