Episode 21 | A Simple Tactic for Burnout in ACL Rehab

What’s up ACL Athletes, and welcome back to another episode. Before we dive into today’s topic which is all about burnout in ACL rehab, I just want to talk to you about something that I’m doing each month. I’m picking one person who leaves a review for podcasts. This podcast specifically, and subscribes to my newsletter for a free strategy call with me. We can talk about anything that you want, your ACL case, what to do if you’re stuck, guidance on the next steps, why flower tortillas are better than corn, don’t come at me, anything that you want. I am doing this each month for anyone who leaves a review and subscribes to my newsletter, which you can find in the show notes below.

And for me, I don’t really care about the number of reviews or any of that. I’d love the feedback, which is helpful for me to be able to make this better. But I also care because there is so much information out there about ACL rehab, with recovery. You look in Facebook groups or on Instagram, everyone has got an opinion about it. But there needs to be some sort of reliable resource with things that are up to date. And I just hope that this can be something that can serve people well, to be able to make better decisions about their care. So go and do it. Help me out, help other people out. Love you!

Now, to the main topic for today, which is dealing with burnout or really a simple tactic that I use for burnout with a lot of my athletes in ACL rehab. And this is something that might not get talked about very much. And I think it’s something that does need to be because it’s such a long process. And what really triggered this was having a conversation with someone this past week who reached out and needed some help. You could tell that they were burned out. They were just feeling hopeless, tired of looking for solutions. They felt like they were doing the same exercises in physical therapy for months on end, which to me is very sad. That doesn’t mean every day needs to be different, but there needs to be a strategy and a method behind the program and the exercises, and the movements that you’re doing.

This person was training super hard day after day and was not making progress. And if anything, they had mentioned having some hiccups, so some kneecap pain, some swelling, all of these things that will come, especially when you start to work really hard and don’t allow your body to recover and maybe if you’re not getting proper guidance as well. You could tell this person is just physically burned out, mentally, emotionally, just all the way. And this is completely normal. Everyone is going to feel this at some point in this process. Because guess what? It’s at least a nine-month process. It’s long, it’s hard, insert all the feels about ACL rehab as we all know it. It’s there and it’s real. 

And I remember, for me, even in my first ACL recovery, this was while I was in high school. I tore my ACL at the end of my sophomore year, and then I was trying to play my senior year of high school. I had to skip essentially most of my junior year of playing. And it was tough. I remember all the time that I would try to just push as hard as I can. And there were days where I was like, if I push harder, maybe I’ll get back faster. I’ll be able to catch up a week or two earlier. I would push really hard almost every day. And I started to notice that things would pop up, like my knee would start hurting or swelling would come up, or other parts of my body would start to give a bit. I could tell that I was starting to feel strained and that burnout feeling. And I actually had a conversation with my PT at the time and she was like, you need to find the sweet spot and not push hard every single day. There needs to be a balance and no matter what you’re not going back any earlier, so you might as well take this time to become a better athlete. And pushing hard day after day after day is just going to burn you out. I remember that so I feel you guys on this.

Now, what should we do about it? There’s that saying, “One step back to take two steps forward.” And it seems a lot counterintuitive at times to just take a step back because you’re like, no, no, no, no. This all needs to move forward. One step back means I’m not as close to my goals. But really it’s so true. Maybe it is something to take one step back, be able to evaluate things, to be able to make two steps forward. And I really believe that. When I notice burnout in any of my athletes, something that I will start to notice is strength numbers might not be as high. When I have noticed trends in them increasing, I can tell that they’re low. They might have to exert more. I use an RPE scale or rate of perceived exertion to be able to know the intensity level of a lift or a certain session. And let’s say a normal session will take 7/10 for one specific session. And it takes them maybe 9 or 10. Then we need to take a step back and evaluate why it is, did they have a bad night of sleep, did they not eat as well, or were they just feeling down that day? The most important thing is the trend of that. Is the intensity of those sessions staying high? Because then that lets me know they’re starting to feel a little fatigued and burned out.

The other thing is that you’ll start to see some increased sensitivities or pains or aches, swelling, and things like that start to pop up. The body has been overloaded, it’s been stressed. And this is something that are signs where you start to see that it’s being stressed beyond recovery. So that’s where we need to make sure we are evaluating these things and we’re not just hitting the gas pedal every single day. First taking that step back to know what it is exactly that’s going on. Is it just my plan I’m on, is it just doing the same exercises, is it just pushing super hard every single day, which is one of those things that I see with most of my athletes. It’s one of the conversations that we have to have early on and know that you can’t do that every single day. So that’s important. And see if you notice any of these trends in your strength or some pain or sensitivity. Those are things that just kind of look out for. 

With my programming, I incorporate intentional deload weeks in each training cycle. This is from early rehab into the later training phases. And a deload week is essential, so let’s say for the three or four weeks we’re accumulating and we’re building up the volume, which is the amount of work that we are doing, and then also the intensity. So that’s where we’re maybe doing higher intensities in weights or even in some of the more dynamic stuff. And then we incorporate the deload week where we reduce the volume and potentially the intensity. It just kind of depends on where they are. And that allows us to create adaptations that we want, allow the body to recover, and really minimize that burnout feeling. This has to be placed methodically within the program. We call it strength and conditioning periodization, where there’s a strategy of stress and recovery, stress and recovery. And that might mean a high-intensity day followed by a low-intensity day or a low-intensity week followed by a low-intensity week. It just depends on who is creating this program. And a lot of times in rehab, this can look very monotonous. It can look very repetitive week after week, but it needs to be strategized. And as it continues along the rehab to training and performance continuum, it should look pretty much like strength conditioning. To me, that’s what rehab is. It’s just how things are scaled. 

We incorporate deload weeks. But the main tactic that I love to use after maybe two or three training cycles, so we’re talking maybe two to three months, is an actual weeklong break. And that is strategically placed into an athlete’s program, where it’s an actual recovery week or deload week or an off week that is very much intentional of really just keep moving, stay out of the gym, actually. Or if I can tell someone really needs to continue doing something, we’ll just program in some low aerobic work or some easy recovery circuits, more mobility style. But nothing that’s intense with strength or even dynamic stuff because this process is so long. And when you think about it from a 9 to 12-month perspective, if you go hard every single day for weeks and weeks and weeks, there is going to be a point where your body’s going to start breaking down because it is just so fatiguing. And that also is so taxing mentally and emotionally.

So these week-long breaks that I have learned to incorporate have been so beneficial to allow an athlete, to essentially just take a step away from everything that they’re doing. Enjoy life a little bit because so much of the focus is, let me get this knee stronger, I got to get back to sport. There might be other things that you’re juggling, like school or work or kids, whatever phase of life you’re in. But sometimes those breaks can be just what someone needs to break through those plateaus. Or to be able to allow some sort of nagging, aches, or pains to be recovered. And it makes a huge difference. And just know one week will not throw off your gains or your progress. Our bodies are not that fragile. It does not decrease in strength that drastically because you’re going to continue to keep moving. The goal is just getting away from the things that you have been doing and getting out of the gym, get out of the weightlifting, get out of the high-intensity stuff that you’ve been pushing yourself with. And I will almost bet you you will come back that following week and be ready to go, have more energy, and more motivation, your body feels better, and you’re probably going to be stronger. It’s essentially addition by subtraction. We’re going to take some things away and you’re going to make gains from it. And I think that is something that is incredibly underutilized in our rehab process when we are in physical therapy. And let’s say it’s usually the three-month deal with insurance usually, that’s not thought of. And most physical therapists aren’t thinking from a strength conditioning perspective and this long-term plan. 

These types of things are important, it’s important to consider. And it’s something to think about, especially if you are someone who is dealing with this right now. You’re feeling burned out, you feel hopeless. You feel like you’re pushing day after day and nothing is getting better and it’s only getting worse. See, if you can incorporate this. If you feel like this isn’t what’s going to help, then figure out why. If you feel like it’s the plan that you’re on, if you feel like your physical therapy is not what is best for you, then I suggest thinking about that. And figure out another way to get better care, whether that is through remote coaching, whether that is something else that is not necessarily right down the road. So have that conversation. Think about it. Legitimately write it out, why you were feeling this way. And if there is something where you’re just going hard day after day, maybe this recovery week or this week off will help you. If it’s not, then figure out the other reasons. 

That’s it for today, guys. I wanted to come in here and talk about this because this conversation with this athlete this past week really made me think about wanting people to know about this. It’s an important tactic that I think can really make a huge difference. It’s something that I use with my athletes all the time. And the thing that allows me to know this is those things about the strength, about how they’re feeling if things are popping up, higher intensities for things that don’t seem like it needs it, but then also communication. I think that that’s underutilized. Being able to talk to my athletes and know how they’re feeling. It might not even be at the two or three-month cycle mark. They might just be feeling really burned out because they’ve been doing extra stuff compared to what we programmed. I talk to them and just tell them to take the rest of the week off, or maybe next week it’s going to be a really low-intensity week. And they’re just going to have to deal with it because I am noticing all these things come up. So that’s where having a coach is important. 

All right, so as a reminder, each month I’m picking one person to have a free strategy call. All you have to do is sign up for our newsletter. The link is in the show notes below. Leave a review. Takes one to two minutes max. That’s it. So go and do it. But that wraps things up, guys. Thank you all so much for listening to the ACL Athlete Podcast. This is your host, Ravi Patel, signing off.