That moment when the athlete falls to the ground, suffering an apparent ACL injury is all too common. As Functional Manual Physical Therapists TM, we've treated thousands of athletes who have suffered various knee injuries. Tearing your ACL, as a young boy or girl is always a life changing event, especially because it happens in the blink of an eye. It can happen in adults or children, however, with children, the adjustment and the process of managing the injury is a challenge to handle for the parents as well as the athlete.
If your child does injure their knee, seeing a physical therapist early is of utmost importance. Improved surgical outcomes have been shown when a patient with a torn ACL is able to participate in a pre-hab (pre-surgical rehabilitation) program that focuses on eliminating edema (swelling), restoring mobility/range of motion, restoring strength in the lower leg and normalizing walking mechanics. By seeing a Functional Manual Physical Therapist TM pre-surgically, you can build a relationship with the therapist that will help you reach your optimal performance in the event that you do undergo surgery. More often than not, an MRI will be performed to determine what kind of damage was done. It is not uncommon for an ACL tear to be accompanied by other soft tissue tears as well, known as the "terrible triad." As a parent, it is important to ask for any copies of MRI/x-rays and their corresponding radiology reports.
When you get treated by a Functional Manual Physical Therapist TM their greatest focus will be to address muscular, fascial, joint, and neurovascular restrictions that could be present, and ultimately could have played a role in the athlete's knee getting injured to begin with. Often, core activation along with hip and knee stabilization exercises are indicated. As the patient continues to improve and meets these goals, rehab can move further along to address balance training from a more functional standpoint.
Surgery isn't ALWAYS necessary. In fact, in one study based on clinical measures of stability and function, adults who had their ACL repaired were "basically the same" five years after the surgery was performed. Additionally, one who has their ACL surgically repaired is at greater risk of re-tearing the ACL, especially if returning to competitive sports. For these reasons, being evaluated by an experienced Functional Manual Physical Therapist TM who can address all of the patients' deficits before allowing them to return to sports is absolutely vital.
As a teenage athlete, it is of utmost importance for the child to be engaged in the recovery process, from asking doctors questions during their appointments, all the way through to home exercise dedication. More often than not, with many of these young athletes, holding back the reigns is more challenging than motivating them to comply with their home exercise program. Additionally, parents have their own work to do as well.
To start with, parents need to be emotionally supportive. It is not uncommon for parents to want their kids to get better, faster, and to try to push the process forward more swiftly than recommended. "Spencer's going to be a Senior next year, and he wants to play in college...do you think he'll be ready in time?" Parents will feed the fire, as the kids are already anxious to get back to the field, and it is important for the parents to listen to the Manual Physical Therapist TM, Team Trainers and doctors, and not push to get back too soon. In the event that surgery has been performed, parents need to realize that it usually appears that "Spencer's knee is healing so well," however, it is prudent to bear in mind that there are always rehabilitation protocols which exist for a reason. The research has been done, and healing times of tissue is well determined. The surgically repaired ACL needs to heal up appropriately before it is stressed by any sort of quick, torque like movements which could damage the tissues.
Lastly, many parents feel guilty when their child is injured. Understandably, it is awful to see your children on crutches, or in pain, but there is an inherent risk involved with playing sports and other exercise related activities that we have no control over. The process of rehab builds courage, strength and determination which are all attributes which will only help the child in the long run, both on and off the field.
