If you're an amateur athlete in the US and you unfortunately tear your ACL you have a big task ahead of you. While working with the general population I get the question all the time why some athletes (Adrian Peterson) can come back ready in 6 months or less.
1. AP (or whatever pro/NCAA athlete) has access to PT/ATC 5-7 days a week and typically starts seeing a strength coach 2-4 weeks post op 3-5 days a week. Most people, on typical insurance in the US, see a PT 1-2 times a week for 4-6 months and never see a strength coach.
2. Prior to surgery AP was stronger, faster and bigger than most athletes. Being strong can not only protect you from getting injured but it can help you heal faster after one occurs.
3. Sorry, but very very few people have the genes of some elite athletes. As hard as it is to hear, everyone heals different and there SHOULD NOT BE A TIME TABLE FOR YOUR RETURN TO SPORT.
It drives me crazy to hear physicians, clinicians and strength coaches tell their athletes a specific time table. That's just not the case. Athletes need to have a clear and concise plan to progress rehab with specific goals to achieve to progress.
Having a continuum of care in the gen pop similar to that of a pro team is the only way athletes will get the rehab they really need. From day one Athlete, Physician, PT and Strength coach need to be on the same page. What are the goals for this specific athlete, how do we plan to get there, who is the lead for the rehab at each phase, how do we progress from each phase? What does return to sport look like?
Once this is set into place we can then talk about what this type of rehab will really look like with today's insurance. Unfortunately, we will not change the number of sessions allowed by insurance, but we can utilize strength coaches to help improve muscle size and strength along side therapy from their clinicians. This will give the clinician more time to spend doing work besides routine strength work and it just gives another set of eyes on the athlete outside of their PT/ATC visits.
To give an idea of the differences in these types of care. When I was a strength coach with the US Ski & Snowboard team we would test strength asymmetries at 4 and 6 months. I generally saw athletes achieve our strength symmetry goals of 92% at 5-6 months. However, when doing the same testing for athletes going through general population I generally saw strength symmetry numbers closer to 80% symmetrical at 6-7 months.. many hadn't seen their clinicians more than twice a week and never saw a strength coach until 6+ month. i believe this shows how needed early strength work is needed in rehabbing an ACL.
The scary part to me is some of these athletes in gen pop are cleared from a date rather than a physical test. In my mind this is just leading tore-injuries or other compensation injuries. If you're rehabbing a knee, take the time to put in real strength work with someone who know how to properly progress and test athletes.
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