10 Things I Learned About ACL Tears

By Jen Adams, Head Coach, Loyola University Maryland, @LoyolaWLax

By the time I graduated college and worked my way in to coaching I assumed I had gained all the perspective I needed to relate to my student-athletes. After all I had walked in their shoes, knowing all too well the early morning workouts, the dreaded “end-line” calls, the juggling of academics with traveling and lacrosse. I would be able to lend a sympathetic ear to the array of really important issues that others might not understand; banquet dresses with hideous sun tan lines and bruises, calloused hands and blistered feet that lead to embarrassing trips to the salon. “I feel ya sister… I know your pain!” The one thing I struggled to relate to early in my career was injuries. Aside from a couple of stitches and a broken finger here or there, for all intents and purposes, I avoided the training room like the plague as a player. I was blessed with an injury free college career. I didn’t even take the time to wear such immunity like a badge of honor. At the time I truthfully had no idea how lucky I was.

Photo courtesy of Loyola University Maryland Athletic Communications.
 Photo courtesy of Loyola University Maryland Athletic Communications.

It was in my vintage, aka foot out the retirement door that I heard what many describe as the infamous “pop.” The day me and my ACL parted ways is one I’ll never forget, in one of those bitter-sweet kind of ways. I was gearing up to play for Australia in a pre-World Cup practice when I planted during a shot and went down. While I had never torn my ACL, I knew in that moment what I had done. Most people will tell you that. It’s a sixth sense that immediately kicks in. It’s usually followed by a sense of denial: “oh wait, no I’m ok, I just hyper extended it or something!”

But despite the forced denial, the Lachman test and good old MRI are the final daggers that propel you into intense prehab, surgery, and then countless months of grueling rehabilitation back to full mobility and motion. In this time most people will experience some form of ACL identity theft. It’s inevitable. For most of us we made the choice to play in college because we wanted that 24-7 lacrosse experience. When that is taken away from you and your stick gets replaced with a Robocop knee brace, it’s easy to lose your sense of purpose. It can be frustrating watching from the sidelines.

People telling you to “be patient” begins wearing thin when the date you have circled to get back to what you love doing is more than six page flips of your planner away. It can be easy to steer yourself down a negative path… to want to give up. To feel lost in the one-step-forward, two-step-back process that is rehab. To feel guilty over needing so much help. How many times was I told not to take anything for granted? Why did I not pay more attention to that? All of these thoughts can be overwhelming and anyone who has torn an ACL can probably relate in some way or another to these things. Season ending injuries just plain suck… well they do if you let them anyway!

This is where I gained the greatest perspective for myself as both a player and as a coach. Your attitude is 100% the driver as you choose which paths you want to take when facing this kind of adversity.

Every ACL injury and story is so unique and I certainly am no expert in the field. I’ve tried to translate my perspectives and lessons from my own ACL injury sustained as a player with the unique twist on also being a coach into the following ACL crash course.

10 THINGS I HATE LEARNED ABOUT ACL’S

  1. Avoid the “everything happens for a reason” speech. This one of the most frustrating phrases to be hit with every 2 seconds post ACL tear. Really? What possible good reason is there for that to happen? Replace it instead with a “make something awesome come of this,” or go with the truth about how much it blows. Some of the most refreshing conversations at this time are the most honest and candid about the situation without trying to sugar coat it.
  1. There is an immediate grieving process that sinks in when you really realize the gravity of your injury and what it means. You can’t pretend that it doesn’t exist and bottle up those feelings – they will find a way to rear their ugly head. I like to tell my players to take 48 hours of feeling sorry for themselves and acknowledging how cruel and unfair an injury like this. After 48 hours they need to draw the line in the sand and start looking forward, not backwards. That can even be writing down all the negative association with the injury, then literally drawing a line and then writing down all the positive things that will happen next.
  1. Make sure someone takes the cheesy mandatory hospital gown, shower cap photo. That’s totally insta-essential! Having a coach go out of their way to visit pre or post-surgery is meaningful. It can also provide you with some funny anesthesia stories that you don’t want to miss out on.
  1. One of the best presents you could ever give someone post ACL surgery is a body pillow. Trust me! It should be mandatory for the hospital to send you home with your brace, crutches, pain meds, and a body pillow!
  1. Organize a solid a crew of people ready to help out. Have a plan in place for the early weeks back on campus with rides, food, and other life tasks that can no longer be easily carried out alone. Teammates usually have this more than under control, but having conversations early on so the injured player doesn’t have to ask will help them feel like less of a burden. They would do the same for their teammates if the roles were reversed and that always serves as a good reminder.
  1. It is very easy to take a wrong turn and end up in “Miseryville”… population – you. Wrong turns are part of the journey; you just can’t set up camp there. You cannot afford to linger in self-pity for long. It will not help you, nor will you attract many fans. Before I was injured myself, I unknowingly left my players at the wheel. Now I’m just far more in tune with when I need to jump in shotgun and help navigate out of there.
  1. Players can start to feel a sense of detachment from the team. It’s easy to feel this way when you go from doing the same things with the same group of girls all the time and then all of a sudden that things are drastically different. More often than not the players will not realize that they are in fact causing a lot of the drift themselves. Sometimes that’s as simple as finding ways to get them more involved at practice. Taking stats or helping with a drill so they continue to feel a part of things is helpful. If it’s a younger player, make them an understudy for one of your older players. If it’s one of your older players, have them take a freshman under their wing.
  2. Quotes and affirmations are golden nuggets. As a coach you can’t be on call all the time for these pick me ups. Fill a bag with a bunch of your faves and your players can go to them as needed. Alternatively sending them motivational videos or messages is a nice reminder that you haven’t forgotten what they are going through.
  1. Goals – Being aware of timelines and what they are trying to accomplish so you can help celebrate hitting milestone moments of rehab – getting to full extension, getting rid of the brace & not having to elevate through the night (ahhhh, heaven), getting muscle size back, jogging, dodging, non-contact, full play (ahhhhh, something beyond heaven).
  2. Oh and there will undoubtedly be a time throughout the process when a player will question whether they can do it. Take that doubt and look no further than the star studded ACL club membership who have walked in those shoes and come out on the other side. It’s unfortunate that we have so many in our sport, but nice to know that they are not alone in anything they are going through. Strength in scars, not numbers!
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10 thoughts on “10 Things I Learned About ACL Tears

  1. Hi, my name is Arianna and I’m an upcoming senior at Manhattanville College in New York. I have torn my acl twice now in college once my freshman year and then again fall ball my junior year playing lacrosse. It is tough that I have been at school for 3 years and have 1 spring season only under my belt. Reading this I have never read anything more true. It’s comforting that people feel the same way and though I’m trying to get my playing career back I am also looking to start a high school coaching career because my love for the sport will never go away. This is advice that I can attest to and will definitely come with me in the future. Beautifully written, I felt like it came straight from my head. I often feel alone but I know that wasn’t true. Everything you learned is 100% accurate and I couldn’t explain it any better.

    Thank you for putting it into words.

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  2. Nice job, Coach! Didn’t see the Hospital Gown pic anywhere? lol..well written and wise words. My biggest take away..have those key people in your life that you can count on. If we treat our family and friends well, in times like this you don’t have to ask. We miss you, Coach! Been to any Sweet 16’s lately?

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  3. Jen,
    Great article! Always great playing against you in college. I think you really highlighted the mental aspect of recovering from an ACL rupture. It’s not just the physical graft reconstructing the athlete but getting through the mental game as well!
    Cheers,
    Karen (Duke 1999)

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  4. Jen.

    This translates in so many ways for everyone facing the adversitIes life inevitable places before us. Your insights reveal why you are such a great coach.

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  5. I was not a college athlete- but I was athletic from elementary school on, playing tennis and running cross country throughout high school and continuing those favorite sports non competitively as an adult. Once while running with my dog in the rain, I hit a decline and the dog bumped my lower left leg pretty hard as I planted- I heard the pop, hyperextended and …well it goes from there. Unfortunately I didn’t know anything about ACL tears and when I went to an orthopedic, he x-rayed but it ended there. For some reason (it was in the 80s) there just wasn’t enough information about sports med where I was at the time…so ignorance meant I managed on my own but have never played tennis again. But I did my own rehab (I don’t recommend this to anyone else) and eventually ran on a tread mill and continued to hike etc. It was years later when I tore my meniscus on the left knee that I discovered the truth. I had, by that time I had read a lot about knees, pain, tears…and self diagnosed, but seeing it on a MRI brought a lot of feelings up. The PA and I talked about the meniscus and what to do about that without surgery. She was apologetic about the missing ACL in the picture and offered a pretty cool knee brace. I left her office and went straight to get ice cream. I had to finally grieve, 21 years later, the loss of that ACL. I did feel sad. It was weird and nobody really understood that. Anyway, now I have had left hip replacement and gotten some amazing therapy that has benefitted the knees and hip and I feel really good. All this sharing to say, this article is really good and those 10 steps are excellent. Surrounded by team mates, wisdom from coaches, friends and mates will make a huge difference in the recovery…I would also add that pain meds can go too far. I understand the need early on, and I understand that every person is wired differently, but as soon as possible it is wise to wean off and move to Aleeve and Tylenol. Those stronger meds cover up helpful pain and they can be very addictive and are far more unhealthy to the whole body than these other lesser pain meds. As a coach I hope you will guide your student athletes in this way, too. I know some amazing student athletes who went through all that ACL rehab and ended up struggling MORE with getting off the drugs than anything else. Wean sooner than later. For my hip surgery I got off in a few days (literally 4 days because they were just too much for me) not a few months. They are pushed by doctors and nurses more often than necessary, in my opinion. The drugs keep a patient quiet and less anxious in hospital but the fear of pain and a lack of understanding how to work with and through it causes more addictions than anything. Thanks for a great article. I will share it with the young people I work with.

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  6. Great article! My daughter tore both her ACL’s, the left one as a sophomore in high school and the right one in her freshman year of college. Unfortunately the coaches treated it like it was no big deal, which crushed her spirit and drive. I wish she had more support from her coaches and teammates. Tearing an ACL is a traumatic experience especially as a teenager. The road to recovery is at least six months long and a teenager thinks it’s the end of the world. Maybe coaches to be educated on how to treat such a severe injury in the mental aspect.

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  7. Jen,
    Great article! I’m also a post-collegiate player and during my time, I tore THREE ACLs in a year and a half! I got back up on the field my junior year with TWO braces! I write a blog called B’s Knee’s Blog about my journey beginning in 2012, and what a journey it has been! Life changing!

    Love it!
    Bari aka B’s Knee’s

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  8. Great article! I played against you and you were a stud! I tore my ACL my senior year! I can relate 100%! Body pillow key~ wish i had the quote bag!! Again, thanks for sharing!
    Jennifer Edens Daher
    Temple 99

    Like

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