Episode 97 | Athlete Wins 5.0

What is up ACL athletes? Good morning! It’s a beautiful morning. It’s a little foggy here in Atlanta, Georgia. I’m coming to you today from our podcast studio, our ACL Athlete headquarters (aka my kitchen table). Today, we are talking all about athlete wins. And if you guys have been following along for a while now, you guys know I like to do these types of episodes because we know this process has its ups and downs. It’s super long. I like to highlight athletes we’re working with, walking through their story, and especially coming out on the other side.

And honestly, showing some transparency in this process. I think it’s easy to see from a distance, especially on social media, or maybe it’s even in the clinic or a place where you’re doing your rehab at. And it’s easy to see someone progressing along, not hitting any roadblocks in the road. And in reality, they are and it might not be in their day-to-day, or they might just be highlighting the positives that they see. I want to share this really cool athlete win. And you might have seen me post something on Instagram about this athlete recently. And this is all about Dani who is one of our remote ACLer graduates.

Some background on Dani. This was her second ACL tear, which happened in April of 2021, and then her surgery was in May of 2021. And to back up here, her first one was skiing in 2017. And that’s where she tore her ACL, meniscus, and MCL (the trifecta). And this is something that is an extra layer of, I guess you could say complexity, right? And anytime there is a retear; there adds a layer of fear; there adds a layer of, okay, the knee has gone through something twice. And then you think about the reconstructive process. And then on top of this, Dani actually has low back-related issues that she has dealt with, including a disc herniation. She was coming back from that prior to her ACL tear.

These are some of the things that play into the physical and mental factors. And as she was approaching her physical therapy for her ACL tear, she actually came in with limited insurance visits due to the physical therapy she used for her back. And wasn’t really sure about actually the quality of the care she was getting anyways. She had 12 visits left total for the year and it was early in the year. She had her surgery in May of 2021. Twelve visits aren’t going to give you very much in the rest of that year if you’re talking about insurance coverage. So think about these situations, and this is actually pretty common for people who come into.

They don’t just tear their ACL at the beginning of the year, get their deductible and out-of-pocket max met, and then have numerous physical therapy visits for the rest of the year. This is a real situation that we see a lot of ACLers hop into, where they have potentially used some up or they’re later in the year. And they only have a certain amount of visits which really on average, a lot of people only end up having 20, 30, maybe 40.

And when you think about the 9- to 12-month process, that’s really not going to cut it. It’ll help to get things started, but you understand where people are at when they’re set up with insurance visits. And these are the things that she came in with. Also, she works as an occupational therapist, so she had to modify her work. She was always the go-to person at the hospital and at her work in helping to transfer people. This is where you lift people in the hospital and people are heavy, especially when they are physically limited or maybe they let themselves go in the hospital. It could be a hard thing to do. In my clinical rotations, doing hospital transfers is not easy, it’s very physical. And any of you healthcare workers know what I’m talking about. So transferring people is big. She had to give that up even though she was that go-to person because she felt strong and that she could do those types of things with her clinic and team. And here’s where I want to stop for a second to think about the impact of this injury.

And you think about the ACL tear, the surgery, the costs associated, dealing with another issue, modifying work, and then all these things impacted within seconds. That ACL injury just triggers this cascade of events. The physical limitations, the work limitations, the activity limitations which we didn’t really even talk about. But she can’t ski anymore and she has to get her knee fully rehabbed and back to full functioning. And how does that play into the mental pieces when your physical activity and your physical ability is limited? When your work is limited? Those are two big things that we do in day-to-day life. So that impacts you mentally. These are things to just think about and all you ACLers who are listening to this, you’re probably like, yeah, this is exactly how we feel. It is so difficult to describe this feeling to other people who haven’t really gone through this process. And that’s where the two injuries that I’ve had and the two recoveries, I was in different places of my life. And it’s just so difficult to be able to explain the degree of what happens in this injury.

I think a lot of outsiders looking at someone who hasn’t essentially experienced this specific injury, try to sympathize but they can’t really understand. And it’s one of those things and not to be harsh here, but when someone passes away it’s something where there is a moment of grief depending on the degree and where they’re at. But then people move on. This is a very lesser degree to that. You have your ACL injury, people can physically see you’re limited. They ask you how things are going. And then once you’re able to start walking again, which most people get surprised, like, oh, I can walk after an ACL stereotypically. After the surgery, you’re in your brace, crutches. But if there’s no physical warning for them to see like, oh, they have a brace on, or they have a crutch on, then a lot of people start forgetting that you’re going through this process and they’re like, oh, they’re back to normal. They’re walking. They could probably do most of the things that they want to do. And that’s outsiders looking in because they might not be familiar with the process or they just don’t physically see a limitation. 

Let’s say someone in a wheelchair. And that’s not to say anything bad about that. It’s just more so of like, there is a physical understanding of a limitation there. And that’s what like a crutch or a knee brace or something like that. It cues us in our environment. So that’s what makes this process so tough. And I think it can make ACLers feel bad about themselves because they have all these things taken away from them. But it’s not as bad as the person over there who’s dealing with more complex issues. But that doesn’t necessarily mean that you just need to shrug that off. And that you’re like, it’s fine, it’s whatever. You do have to have a good mindset in this. But just understand and know that there is a lot that’s taken away from you and you have to work through that. And it’s really hard for people to see that because they just don’t know.

I’m just here to share that as a side note in this Athlete Wins because Dani went through a lot. I know I went through a lot with my two ACL injuries and it is a fair feeling. To end this tangent, don’t discredit yourself and don’t feel down on yourself about it. It does take away a lot from you. And to give you guys some examples. I’m working with a mom right now who had a complex ACL injury. And she is having trouble just being able to walk because of some of the surgical procedures that were done. Not to be named here. But these are the things she can’t run with her kids right now. I’m working with a BJJ athlete who is having some delayed issues with some swelling that’s going on. And then I have this other ACLer who has been working through this process, has come back, and then has other complex issues that have arisen.

These are not just things that are just, oh, this is an ankle sprain. It’ll get better in like four to six weeks. Or, a hamstring strain or shoulder impingement or whatever you want to name it. It’s a little different. And I think it’s okay to recognize that and to recognize that people outside of that won’t see it. And to know that something was taken. But use that as your fuel to be able to move forward, focus on what you need to focus on, and get back to what you love. So that’s the end of that tangent there, but I hope that that relates to some of you.

Getting back to regular programming here with Dani’s story. She had those limitations and it changed within seconds. She was honestly pretty skeptical about remote coaching. We connected and she was like, I don’t know, this is different. But she did say, she was like, I don’t trust my physical therapy. She didn’t feel like it was really that great before. And clearly, it didn’t work, at least from what it shows. If she retore that happens. But usually, if we do really good rehab, then your chance of that happening is decreased. We won’t know the answer.

But based on what she had said about her previous rehab is like, okay, maybe there could have been some things done to help prevent that second one. She trusted the process. She was like, all right, I’ll give it a shot. And one of the big things that we had to work on was the fear of re-injury. When you tear your ACL more than once, that thing starts to sink in like a big monster because, after that one time and the second time, you’re like, okay, it’s happened twice. What’s likely to happen again? What are the odds? And that’s one of the things that we have to address in this process, not only through the physical training and the preparation but also the mental side. She had her surgery. The goals that she set for herself were advanced skiing, running, biking, agility with her pup, soccer, and transferring patients in her job.

And one of the things I always ask our ACLers, each one of them is to explain their why. Why are those things important to them, why do you train for life and health, why do you train in general, why do you do what you do? And this is something to dive a little bit deeper as to why those things, why do you enjoy them, why do you like to transfer patients, why do you like to go advanced skiing, why do you like to agilities with your dog? These are just different things to dive into, to connect our why to our actions. And it’s huge in this process. And Dani really connected those things, and I think that’s why she had the outcomes that she did.

And it was actually pretty crazy, immediately post-op, she actually had her dog run into her fresh, new post-op knee, and it scared the crap out of her. She felt like a hyperextension and almost like this weird like pivot sensation. We had a call, we checked things out, and turned out everything was good. And if you are an ACLer in this process, you probably had some sort of scare like this where you might have tripped or the knee tweaked a little bit. But usually, in most scenarios, most people are good unless it’s a pretty extreme shift. And that’s the natural piece to this process.

And I think it’s one of those things that we don’t talk about enough and aren’t prepared for enough. But if you are listening and you are fresh post-op and you have a dog, just beware. But to bridge into this whole, Dani set her goals. And then we anchored this and each of our athletes to our three-step process. We test, plan, and program and we support them. And those are the big pieces and we repeat that over and over and over. Testing to anchor us, we plan, and it’s agile. We got to pivot as we need to and we make sure we support our athletes. They know that they have an individualized plan and that they have guidance along that.

We tested some of her baselines prior to the surgery, and then we tested after each training block as we went. We laid out the game plan program block-to-block, supported each day and each week, adjusting as we needed to based on her schedule. Because that changed once she got into work. Her goals for that specific phase and for the other things she wanted to do and so on.

And one thing that was tough for Dani, and she would even say this was going back to work sooner rather than later. And this is so different for people who might have a remote job or maybe a job where they aren’t on their feet as much. When you’re on your feet in a hospital or working with people, it’s tough. Because especially in the post-op process, early on when you’re on your feet, that can add a lot of weight and a lot of steps and a lot of stress to the knee, especially as it’s healing from the surgery. And this is what we notice a lot, especially with people who work in hospitals or maybe in schools as teachers, where that can impact the swelling. And due to the number of steps they take in a day or just being on their feet all day. So this is just one piece. And so you could say that this was something that we had to navigate versus her being at home, hanging out, propping her leg up, reducing that swelling, and us slowly progressing her steps. She had to ramp up her steps pretty freaking quickly, which impacted her swelling.

We had to pivot and adjust a lot. There were still some days where we planned where she planned to train hard, but she really couldn’t because she was on her feet all day and her knee was bugging her. It was stiff and swollen after a long shift at work. These are real-life things that a lot of people face that we have to make sure we adjust to and that a protocol isn’t necessarily just going to fix it. We worked within her limits, progressed, pivoted, adapted as we needed, and tested after each block to make sure we were continuing on the right track. Two things that Dani absolutely crushed. 

Compliance: She always showed up even if it wasn’t the best workout when she felt down about her progress, or her knee was super grumpy. She always showed up and did what she could, and she communicated super well. She would often make sure to share how she was feeling or the feedback, and she was very open about it. And that helps us from a coaching standpoint to help guide her. At the end of the day, a coach is there to help, to allow you to guide you, and to also make sure you don’t overdo it. That’s a big piece with her coaching is that when you’re given vague guidelines and you’re just like, hey, do these exercises or go and run these curves and jump these certain blocks. It’s like, okay, great, but there needs to be some specific guidance and feedback in place for athletes to be able to adjust as they need to. And that’s exactly what we did with Dani, which is that she gave great feedback. We were able to help her to find the sweet spots, allowing us to adjust and keep that needle moving. This led to her passing all of her criteria to get cleared.

And that’s why she posted a pic this past week of her skiing. And if you think about her story and the timing, she tore her ACL at the end of ski season last year. Given it was a second ACL injury and some of those other complications post-op, it 100% had its ups and downs. It wasn’t this smooth nine-month process. And she’d tell you that, and most ACLers, if you’re listening, you’re probably like, yeah, that’s usually how it goes. She wanted to make sure she came back as strong, as prepared, and as resilient as possible, and she freaking did. Seeing that picture of her on the slopes, doing her thing, shedding some tears, saying she felt so strong and so confident, it goes just beyond just the knee. She now steps into a gym with complete confidence. 

And I’ll never forget this comment that I want to share with you guys. This is what hits. She said: “Thank you, you rock! I also want to thank you for bringing weightlifting into my life. I have a feeling this may have a similar narrative you’ve heard before. But I used to do so much cardio and use super lightweight, now lifting heavy heavyweights. I feel stronger and more capable of doing hard things than I ever have before. It’s building the confidence for the long-term management of my knee that I thought I could not be trusted for so long.” That’s wild. And that’s what this is all about. This is why I do this, this is why we do this, and this is why the ACL Athlete exists to help ACLers who don’t get the care they deserve, get back what they love most to become their best selves.

And I am not bringing this up for the services that we provide; I’m bringing this up and sharing this, the story, this message because this is what ACL rehab should be. We have been saying we’re trying to define and redefine ACL rehab. And that’s what we’re trying to do here at the ACL Athlete, and this is exactly what it should do. You should come out on the other side better as an athlete, as a human being than you were before the ACL injury. And that’s our goal and that’s what Dani is showing here. And that’s what I’m hoping you guys are getting the care that you deserve, in order to be in this place to be equipped for life if a setback happens, if something comes up outside of your ACL injury. You know how to handle it because you’ve been equipped and educated to do so. And you’ve been given good care and good guidance when you step into a gym and take care of yourself. You know that you need to push weights in order to increase muscle mass and strength to be as resilient as possible against injury and to do the things that you love to do. Lightweights aren’t going to do it, cardio isn’t going to do it, you got to have the best of all of it, and that’s what Dani did. 

The big takeaway from this episode is, that it is possible to get back to your dreams even after your second or third ACL tear, despite what people say. So don’t let this injury define you. You can have the perfect plan. But without execution and communication, it won’t do much. There’s plenty of perfect ” programs” out there, but if you’re not compliant with it, if you don’t show up if you don’t have it specifically tailored to you, or pivot and adapt it as needed, then it’s not really that perfect. And at the end of the day, you’re going to need to make sure that you follow through with it. So that’s what’s going to be really key. The execution, communication, and that guidance will help so much. And make sure you’re working with someone who knows ACLs, who will test you, who will individualize a plan for you, and who will support you.

It’s our three non-negotiables at the ACL Athlete: Test. Plan. Support. Repeat. And if you’re not getting this, then reach out to us and we would love to help you. Even if that’s just pointing you in the right direction to find someone potentially local or to find a remote service. It does not have to be us, just find good care. And be like Dani, don’t settle. Be skeptical as everyone should. Push your limits. Follow through and communicate. I hope this helps encourage you ACLers out there listening who feel like this is an endless journey. It’s long, but don’t get me wrong, it’s worth it.

After 600 days of the ins and outs, ups and downs, Dani would 100% agree. Dani, if you’re listening, shout out to you. I’m so proud of you. And there might be some of you ACLers who are listening to this, who are like, I’m not getting this care and I need better. And you kind of needed a little kick in the butt. Well, this is your kick in the butt. Take control of this process. Learn as much as you can. Find any resources that you can be able to make sure you don’t keep spinning your wheels, especially if you feel lost. There are plenty of options out there. And local proximity is no longer the excuse for us to just… we’re just going to go down the road because it’s convenient and our insurance will cover it. Well, it’s your health and it’s important, so make sure you do everything you can to make this a one-time deal and come out better on the other side. 

As you guys can tell, I’m pretty fired up. And I think that I’ve just had some moments here with this ACLer. But all the ACLers we work with and these conversations we have on the weekly and daily, where I’m just shaking my head. And I’m like, man, we have to do better. I’ll be completely frank, I don’t think that healthcare is going to improve drastically in this care in the next 5, 10, or 15 years. I really don’t. Because of the model we have, the insurance system, and the fact that it is a business. This is why I care about educating you as the consumer, the ACLer, maybe you’re the parent, maybe you’re the clinician, coach, or surgeon listening. But this is where we can make a difference and I care about you as the ACLer to feel equipped to make these decisions and not just be reliant on our healthcare system. When at the end of the day, It’s just treating you as a number and there is good help and good care out there, whether it’s local or whether it’s remote. Don’t settle. Take control. We’re here for you.

All right guys. That is going to do it for today. Thank you all so much for listening to my rants today, until next time.