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ACL Injuries Amongst Athletes: Rehab & Prevention


I think a very good example of an injury that most of us thought as severe, but turned out not to be was in last night’s Superbowl with Dion Lewis (RB #33 New England Patriots).

Dion caught a pass in the flat and as he spun to make a football move toward the sideline, planted his right foot, and the world saw his foot catch, and knee buckle and twist while planted on his right foot, and then immediately go down in pain.

All of my ortho/sports medicine colleagues down here in Florida were texting back and forth immediately after it happened, that it was a catastrophic knee injury, based on the mechanism and the immediate pain reaction from Dion Lewis, to the quick response to from the New England Sports Medicine staff to attend to him on the field.

Those of us who have spent time on a football field as a part of a sports medicine staff, know when there is a significant injury…again from the reaction of the players, to the mechanism of how the injury occurred. In last night’s case, Dion Lewis looked like what to have appeared to have been a torn ACL in his Right knee.  Lewis had a torn ACL in his Left knee which he had back in November 2015 in a non-contact injury against the Redskins.

It is common to see bilateral ACL tears in elite athletes, due to biomechanical issues from the feet as well as anatomical biomechanical deficits (ie narrow bony tunnels where the ACL is housed in the bone)

We see them frequently in physical therapy for post surgical rehabilitation.

A high percentage of these athletes, under the proper course of rehabilitation and alternate endurance training, can achieve full return to sport at the level in which they were prior to injury.

There is, however a small percentage of athletes that do not return to their original level of performance for a variety of reasons.

In the last few years, post surgical physical therapy of catastrophic knee injuries in sports has come along way, with the introduction of new pieces of equipment such as the Alter G AntiGravity Treadmill which allows us to get athletes weightbearing and running safely and earlier in their post surgical rehab process, as well as research based, functional therapeutic exercises to enhance strength and endurance of muscles.

This approach is essential in a smooth and effective return to sport.   As physical therapists, we are also developing more detailed and enhanced “Return to Sport Guidelines” to help progress athletes through their phases of post surgical knee rehabilitation.

Emphasis has also come full circle on injury prevention.  More physical therapists are working with sports performance professionals to develop knee injury prevention exercise protocols for non-injured athletes, to decrease the likelihood of a non-contact catastrophic knee injury, and the results have been very good.

The bottom line is, Dion Lewis, by all accounts, looked like he sustained a season ending injury last night to his right knee.  But because he went through extensive knee rehabilitation for his left knee after ACL Reconstruction, was able to strengthen both, probably preventing the same catastrophic injury on his right knee.

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