Hi folks,
So before going into the details of the surgery, I wanted to describe my injury and show some other examples in professional sports.
In terms of ACL tears, athletes who practice a sport or activity that requires a cutting motion (i.e. soccer, football, basketball, rugby, squash) are at higher risk than those that are involved in sports that rely mostly on a gliding motion, (i.e. hockey, skiing, cross-country skiing, running, and baseball), however, in any sport excessive twisting will cause hyperextension of knee ligaments and potentially serious injuries (i.e. many serious ski crashes, Montreal Canadien’s defense Andrei Markov’s second knee injury).
Furthermore, it has been shown scientifically that women are also more susceptible to ACL tears for several reasons, including smaller ligaments, under-use of their hamstrings, and greater muscle flexibility. I myself have met many girls, who have had ACL reconstructions from tears due to playing soccer. Some of these have even had multiple injuries on the same or both knees. Promising Canadian striker Kara Lang had to retire at the age of 24 due to recurring knee injuries. In fact, there are serious long term health concerns involving early osteoarthritis in women. Thus, ACL injury prevention specific training programs for female programs have been developed all across universities in North America with the aim of reducing this common and painful injury.
Still, while you may be a professional or college athlete with years of top-notch physical training, legs the size of tree trunks, and a medical staff surrounding you, you can still suffer an ACL rupture. Personally, I think it’s a combination of physique, genetics, and most importantly, bad luck. In my case, I have been told that I have rather lax ligaments, which would fall into the genetics category. When I got injured, I was probably in the best physical shape of my life, and was having a great time playing soccer and hockey. However, as I learned, all you need is a little bad luck.
My Injury
So when and how did I suffer my injury? Over a year ago, playing a friendly pick-up game of beach soccer in Mar del Plata, Argentina with my uncles, cousin, and some other beach-going youngsters . As I took a pass, I moved the ball slightly ahead of me and then lifted my left leg to take a step forward. My right leg was firmly planted and the sand underneath my foot gave under my full body weight. Unfortunately, it gave in the direction away from my body’s side and this put my knee in an unstable position, causing it to buckle thus hyper-extending my ACL. I could hear a definite pop and immediately knew something was wrong, and that I likely tore something. Within the next hour, my knee swelled up and I was left hobbling around Buenos Aires with a swollen knee under a knee compression sleeve until my return to Waterloo, ON. After icing the knee for hours and hours over days upon my return, the swelling was eventually reduced and after consulting a sports medicine doctor, who detected the instability, it was recommended that I do some physio, get an MRI, and a brace.
An MRI back home in Montreal revealed (photo above) the damage to be a high-grade ACL tear (nearly fully ruptured), along with meniscus tearing, which is common to this sort of injury. I must note that while this all may seem to be very painful, it really wasn’t. Once the swelling was reduced, I was left with some acute pain on the inside of my knee but I could still walk and bike comfortably. Luckily, the damage to my ACL and meniscus was “clean” and I hadn’t hurt my MCL or anything else very severely. Still, the implications were serious. If I wanted to ever play certain sports again (i.e. soccer), I would require a reconstruction. I consulted a top-notch orthopedic surgeon in Montreal, who specializes in these types of reconstructions, and over a full year later, he finally performed the procedure on me. While I waited to get the surgery organized, I was able to run, bike, and work out. I had a custom brace made, which I wore depending on the activity. In fact, while I was incapable of playing a sport like soccer or basketball, I was still able to do quite a bit despite the injury and most of the time, my knee wasn’t in any pain. It would still give out on occasion, which is painful, but nothing compared to the original injury and rarely was the swelling bad. This type of buckling seemed to happen most when I least expected it (dancing, walking, taking an awkward step) and probably could have been prevented with my brace. Furthermore, sometimes my damaged meniscus would click, however, the pain wouldn’t last. The laxity in my right knee joint was also quite noticeable. In short, my knee was unstable and if I wanted to play certain sports and try out new ones, I absolutely had to get the reconstruction.
Knee injuries in Pro Athletes
While most ACL reconstructions are likely performed on amateur athletes, it’s worth talking about professional athletes since there’s a lot of footage and they are after all getting paid millions to play a sport. Generally, they get their surgery within days of sustaining their injury and are expected to come back ASAP to help their teams and earn their paycheck. While people often accuse Andrei Markov’s surgeon of doing a shoddy job on his reconstruction, I would probably put the blame more on rushing him back too quickly from the first injury. Now that he’s back and healthy, he looks a lot more like the player he was. That being said, it is important that the person is 100% ready to go back to the sport.
Earlier I mentioned that athletes practicing gliding motion sports where at less risk of suffering tears. While this may be true, it still happens, as Andrei Markov would know. But conversely and rather incredibly, Montreal Canadiens defenceman Josh Gorges played on a knee with a torn ACL for over eight years. After originally injuring his knee back in junior with the Kelowna Rocket in 2002, Gorges played hundreds of games with an ACL knee brace until finally being forced to get a reconstruction after tearing his meniscus earlier in the Habs 2010-2011 season. In fact, this is probably not altogether too uncommon in hockey players since they rely much less on their ACLs to skate. Several hockey players, such as Dan Cleary during the 2012 NHL playoffs, have been known to play through knee injuries in important games and get them fixed in the off-season. While it is unclear whether Gorges or Cleary had complete or serious tears, there are certainly some hockey players who are playing with braced weakened ligaments from less serious knee injuries but you just don’t hear about them and they are certainly not advertising this to the opposition.
Enough banter on hockey players, here are some videos of pro athletes that have had bad luck with their knees. Some have come back just as good or better, and some have faded ungracefully.
Notable ACL injuries
Here I will show some pro athlete injuries from various sports. I have opted not to include Andrei Markov’s injuries because all Habs fans such as myself are sick of seeing them and they bring back unpleasant memories of two relatively bad seasons after a great conference final run.
Tom Brady (Football)
Probably the highest paid and highest profile athlete on this list when he was injured, Brady was clipped on his forward facing passing leg by a defender trying to make a sack, while he was in the pocket. This type of injury is actually very common and has prompted certain big name universities such as Stanford to force their quarterbacks to wear a preventive brace on their forward passing leg. In fact, if you check out Andrew Luck’s left knee, he’s still got one on for this very reason.
Paul Gascoigne (Soccer)
In the 1991 FA cup final, Paul Gascoigne (or Gazza as he is known) managed to blow out his own knee going in for a very dirty tackle against Nottingham Forrest. Did he get what he deserved? Probably not but what’s impressive is that Gazza actually came back strong from that injury despite being (and he still is) a complete psychopath off the pitch.
Evgeni Malkin (Hockey)
Perennial NHL all-star Pittsburgh Penguins center Evgeni Malkin suffered an awful knee injury in 2011 after Tyler Myers fell into his planted right leg along the boards. The force of the impact on his knee caused him to tear his ACL and MCL. After sustaining the injury, Malkin sent a text to his team’s General Manager, apologizing for getting injured. Now that’s the kind of player you want on your team. Malkin came back to dominate the NHL the next season scoring 50 goals and posting 109 points in just in just 75 games.
Adrian Peterson (Football)
Here’s one I forgot and thankfully my buddy Dan reminded me! Minnesota Viking’s Adrian Peterson is another superstar who came back to have a monster season following a reconstruction. Following his awful knee injury, where he was tackle right on his left knee with his foot firmly planted, he came back to run the ball for the second longest yards in NFL history. As the Youtube video title wrongly suggests, his career certainly isn’t over.
Alex Galchenyuk (Hockey)
Current Montreal Canadiens star rookie tore his ACL in a freak play when his skate caught a rut in the ice, while playing for the Sarnia Sting. His recovery forced him to miss nearly the entirety of the 2011-2012 season yet he was still picked #3 overall in the same draft year. Despite the concerns related to his injury, the Montreal Canadiens saw that the talented 18-year-old, once projected to compete for the #1 pick with junior teammate Nail Yakupov, came back even stronger from his serious injury and impressed everyone at the draft combine. His successful recovery proved to Habs management that he had the work ethic and desire to play in the NHL, and they were happy to select him over several top prospects.
Michael Owen (Soccer)
Another freak injury, Michael Owen was simply trying to make a pass when his knee gave out from under him at the 2006 World Cup. Once a dynamite player for England and Liverpool, he’s never quite been the same player since the injury and seems a lot more interested in horse races than playing top level soccer in England.
Derrick Rose (Basketball)
The Chicago Bulls star point guard, Derrick Rose, tore his ACL on a seemingly benign play in the dying minutes of an NBA playoff game that was already sealed. You can clearly see the knee give as he stamps down before making the pass. He is only making his comeback this month after months of recovery.
Rajon Rondo (Basketball)
Another star point guard that comes to mind is Rajon Rondo of the Boston Celtics, who tore his ACL just recently in a regular season game against the Atlanta Hawks. There is no clear instant where this occurred in the game, however, SBnation has found two plays that might have led to the injury, which suggests that he may have been playing injured (a huge no-no) prior to the first knock.
http://www.sbnation.com/nba/2013/1/27/3922456/rajon-rondo-injury-celtics-reaction
Willis McGahee (Football)
And now for probably the most gruesome knee injury I’ve seen. Willis McGahee was projected to go in the top 5 (or even #1) in the NFL draft and with his team competing for the 2003 NCAA National Title, he suffered this horrific injury (WARNING: not for the faint of heart). The Buffalo Bills gave him a chance and drafted him 23rd overall, and has had a relatively successful career in the NFL but who knows, he may have been that much better had he not suffered the knee injury.
Tiger Woods (Golf)
You think he tore it playing golf? Nope. He was running around his mansion in Florida. Also, earlier I mentioned that Tom Brady was probably the highest paid athlete on this list. Well I stick by that because tearing your ACL while jogging around your house is probably the weakest example I can find. No offense Tiger but you’re barely an athlete.
The case for good genetics, or is it just growth hormones? Leo Messi as a case study
And then you have a little guy like Leo Messi, 4-time Ballon D’Or winner and star striker for Barcelona and Argentina, who is seemingly indestructible despite the incredibly dirty knocks he’s taken over his career. If anyone was to suffer a serious knee injury it’s this guy. Check out the tackle at 0:58 for a great example of his resilience. He got right back up after that one. He is obviously very strong but what gives him that extra bit of strength in his knees? Is it the growth hormones back when he was in his teens or just amazing genetics combined with amazing fitness?
Tom's Post ACL Reconstruction Rant 