Editor’s Note: Today’s post is written by Jeff Stein, PT, DPT, MS, ATC, who is the team physical therapist for the Chicago White Sox and was the Head Team Athletic Trainer/Physical Therapist for the Purdue Men’s Basketball Team from 2006-2012. Stein helped rehabilitate All-American basketball player Robbie Hummel of Purdue and NBA player Carl Landry after ACL injuries, among many other athletes.
Derrick Rose had done it thousands of times before, a simple jump stop for a shot or pass, but this one was different. With one wrong movement, his season was over. On that fateful night, Rose tore the Anterior Cruciate Ligament (ACL) in his knee, and immediately the questions arose. How long will he be out? Would he ever be the same? Is his career over? The good news is, despite the abrupt ending to the season, with the surgical repair and the rehabilitation Rose undergoes with the Bulls’ athletic trainers and physical therapists, the odds are good that he’ll regain his form and be the MVP-caliber player he was before.
Rose’s recovery began the day he was diagnosed with his injury. Prior to surgery, the sports medicine staff worked to decrease the swelling around his knee and regain as much motion and strength as possible prior to surgery. Prehab (rehab before the surgery) is an essential component to having a successful outcome from an injury like an ACL tear. The better an athlete is going into surgery, the better he or she is coming out.
Following surgery, head team physician and orthopedic surgeon, Dr. Brian Cole, stated that the normal time frame for an athlete of Rose’s caliber to recover from ACL surgery is about 8 to 12 months. Dr. Cole also revealed that the rehab would begin with a knee focus and proceed through whole body conditioning, performance training, and risk prevention strategies.
So what does a general ACL rehab consist of?
The early months of rehab from ACL reconstruction are very similar to the prehab undergone prior to surgery. The rehab involves stretches, exercises, and treatments to decrease post-operative swelling and stiffness to allow the knee to move through its full and normal range of motion. As the motion progresses, strengthening exercises are implemented to enhance the strength and responsiveness of the muscles around the knee. Normal gait is usually attained within the first month, and full motion takes a couple of months, but this can vary widely.
About 3-4 months post-surgery, as motion and strength improve, an athlete will be able to work back into some basketball-specific activities on a limited basis. Activities like cardiovascular conditioning, stationary ball handling, and free-throw shooting will get the athlete back on the court and motivate him or her to keep pushing towards a successful full return.
The Fun Part
Once an athlete regains strength, measured by comparing the injured leg to the uninjured leg, the fun part of rehab begins, which incorporates functional movements that will help the athlete prepare for return to a dynamic sport like basketball. Plyometric activities like running, jumping, and cutting will be gradually introduced by the athletic training staff back into the athlete’s repertoire. Athletes usually progress into these activities around 4-5 months post-op.
This is both an exciting and nervous time for the athlete. Most athletes are excited to return to more sport-specific activities but are understandably nervous about the possibility of re-injury. A skilled athletic trainer will carefully guide the athlete through this time by gradually increasing the difficultly and intensity of the drills. By doing a gradual progression, the athlete regains both strength and confidence.
As the athlete regains the speed and explosiveness he or she is known for, they will gradually be re-introduced into team drills and play. Most athletes are able to work back into all activities between 5 to 8 months after surgery. Even though the athlete returns to team practices and play, the rehab is still not complete. As Dr. Cole stated, it usually takes 8 to 12 months to return to a high level of competition and probably more to get back to the level to which an athlete is accustomed.
ACL injuries are life-altering events, but with the advances in surgical and rehabilitative techniques available to all athletes from Derrick Rose to the weekend warrior, they do not have to be career ending. Recent examples of athletes that have returned to form include Chipper Jones of the Atlanta Braves, Wes Welker of the New England Patriots, and All-American basketball player Robbie Hummel of Purdue.
The rehabilitation and techniques that Derrick Rose will receive are the same that are available to all athletes through the skilled athletic trainers and physical therapists at Athletico.