Anterior Cruciate Ligament (ACL) injury is very common, especially in those who play sport, and it is if you don't know, extremely traumatic. From the initial injury and pain, to the surgery, to finding the confidence to get back to whatever it is you were doing, it is a long road and requires a lot of work. That is why Becky, my partner, who is recently going through all this for the second time, has decided to share her story with you. We are in the very fortunate situation that we are both well versed in ACL rehabilitation; Becky is a long time qualified physiotherapist who specialises in ACL rehabilitation, and I also worked in the NHS on ACL rehabilitation, as well as completing my Masters thesis on the work I did with the NHS. We want to share as much of Becky's journey as possible, we know that there are plenty of other people out there going through the same thing, and the more information we can give out the better. Additionally, we want to show what the body is capable of after such a significant surgery, it seems crazy that she will be getting back to where she was before (hopefully further!), and we want to show you that it's not crazy at all. Hopefully many of you will have seen the Aspire Performance Instagram and Facebook stories sharing the early days of the rehab and we will continue to add to that as we go on so please do go check that out. On this blog Becky will go into more detail about her rehabilitation and how she's feeling, as well as giving you a little research where she can on why we do what we do, we hope you enjoy and if you have questions or want to see anything in particular please let us know! With that being said, I shall stop, and let the star of the show take over!
Becky's ACL story:
I feel like I should start from the very beginning, which is when I first injured my knee in 2015. I was playing Netball and I was jumping for a ball whilst running backwards. I had just come off the bench, I hadn’t warmed up properly and I was playing for a new team so naturally I was trying to make a good impression. Unfortunately, I didn’t make quite the impression I wanted. Let’s just say that the jump I made was not well controlled and when I landed, I felt that gut wrenching ‘pop’ that everyone remembers all too well when they tear their anterior cruciate ligament (ACL).
Was it painful? Yes for a few seconds. As a Physiotherapist myself with experience in rehabilitating these injuries, I knew straight away I had torn my ACL… Bollocks! I hobbled off court with a knee that felt weirdly loose inside and went to A&E.
Warming up is important!
What I found interesting is that my knee didn’t swell straight away which is what normally happens when you injure your ACL. The ligaments inside your knee have lots of blood vessels inside them and when they are damaged, they bleed into the joint. Looking back, I suspect that taking Ibuprofen prior to the game for my headache may have influenced this. This led me to take a personal interest in non-steroidal anti-inflammatory drugs (NSAIDs) and their effect on healing- which I will talk about later on.
So, one MRI later it was confirmed that I had indeed torn my ACL. There was actually a little relief I had my diagnosis right, however that feeling was quickly lost when I realised that I may not be playing sport for a while…
Despite having a little knowledge about ACL ruptures, I was still surprised at how common an injury it is. It is the most commonly injured knee ligament. In the US, there is an estimated 200,000 ACL related injuries every year.
On top of this, women are 2-10 times more likely to injure their ACL than men. What a way to make a woman feel special eh? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4805849/
So, I had a decision to make. I chose to have an ACL reconstruction with a Hamstring graft in April 2015. I chose this because I wanted to return to netball as soon as I possibly could.
All I can say, is that despite it being ‘keyhole’ – arthroscopic surgery is not to be sniffed at. It HURTS. If you go online and check ACL reconstructions on YouTube you will see why. I can remember waking from general anaesthetic with my knee in agony, I remember the breathing tube being removed (which isn’t common so guess I was unfortunate), I remember the opiates they gave me post-op making me sick and I thought that I don’t ever want to go through that again (as you now know, I did, but that’s what a love of netball will do to you and you will read about this later).
This is Rosie (short for Rosemary)- my mum has always got me a cuddly toy for every surgery I have ever had.
The first few weeks were hard work. Slowly over time things got easier. I rehabilitated HARD. I was at the gym 4 times a week, I went to spin classes, I did home exercises, I attended an NHS ACL rehabilitation class for 6 months and I eventually got back to netball. Hurrah!
My First game back!
Looking back, I would say I had knee pain for the best part of 2 years after that operation. It is definitely not a quick fix and I would encourage people before having an ACL reconstruction to really consider their options and talk them through with their Surgeon and a Physiotherapist/ Sports therapist/ S&C coach. But I had achieved my goal, I was back to Netball, Happily ever after…. OR not.
It was about 18-24 months ago I started to notice some slight instability again. I would have little wobbles on the netball court and feel a tugging sensation in my knee but I overlooked it and carried on playing. Then in December 2018 I was playing netball again when I landed from a jump and felt a loud clunk in my knee. The knee gave way underneath me and my first thought was of my ACL. I stood up and tried to change direction- nope the knee was having none of it and again it gave way. I was devastated and cried in the car all the way home.
After that, the instability became a nuisance. I stopped netball for fear of further injury. I would go to the gym but struggled with dynamic exercises as my knee would give way. It definitely got in my head. I admit that so much of this was psychological too, I had lost all trust in my knee. I had an MRI and had the most informative appointment I could have hoped for with an amazing Consultant in Bristol who took the time to explain that my graft had failed and wasn’t functioning properly. He gave me options to think about which would be to stop pivoting activity to avoid further injury or have further revision ACL surgery. I decided initially to try and rehabilitate and get as strong as I possibly could as I wanted to avoid surgery if possible.
With Dan’s help, I got STRONG. I was squatting heavy, working on my unilateral exercises, doing straight line plyometric exercises where stability allowed. I reached the strongest I have ever felt in my life. Did my knee seem to care though? Not really- I had around 7 or 8 episodes of significant instability before I decided to have my operation. That’s where this blog really begins- to go through my experience of revision surgery knowing all that I do now, in a much better place than I was the first time. I hope you enjoy the read and if you are experiencing any of this too, try to enjoy the process of making yourself better.
Stay tuned for the summary of the first week of Becky's rehab!
Aspire for Better.
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