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287 | 9 Lessons I Learned After Tearing My ACL Twice · The ACL Athlete Podcast

• 0:18
  SPEAKER_00: Welcome everyone to the ACL Athlete Podcast.
• 0:22
  SPEAKER_00: This is the podcast where we talk about everything related to the ACL, whether that's the injury itself, the rehab process, return to sport, and more.
• 0:31
  SPEAKER_00: I'm your host, Dr.
• 0:32
  SPEAKER_00: Robbie Patel, performance physical therapist and coach.
• 0:36
  SPEAKER_00: Between myself and fellow guests and experts, you'll learn through the lens of the patient, the healthcare professional, and the coach.
• 0:43
  SPEAKER_00: The goal of this podcast is to equip you, the athlete, with the education to make the best informed decision about your care and your ACL journey.
• 0:54
  SPEAKER_00: Thanks for joining.
• 0:55
  SPEAKER_00: Now let's dive into today's episode.
• 1:00
  SPEAKER_00: So today I want to talk through nine things that both of my ACL tears taught me.
• 1:08
  SPEAKER_00: And so I'm just going to get straight into it today.
• 1:11
  SPEAKER_00: I knew what a torn ACL felt like.
• 1:15
  SPEAKER_00: I honestly, in my first one, I wasn't really sure what had happened.
• 1:19
  SPEAKER_00: I was in high school and I felt the pop, but I wasn't as familiar with it.
• 1:24
  SPEAKER_00: And I mean, who is on their first one?
• 1:27
  SPEAKER_00: Some people hear about that first pop or the audible pop and they're just like, oh, okay, it's an ACL, especially if they're around people who have done it a lot.
• 1:34
  SPEAKER_00: And I wouldn't say that I was so familiar with it in high school.
• 1:38
  SPEAKER_00: And so when I first injured it, I wasn't really sure what happened.
• 1:42
  SPEAKER_00: And then you go through that process, and then you fast forward, I'm in college, I'm in my senior year of college, and I had been familiar with it at that point.
• 1:52
  SPEAKER_00: I'd already been through it once.
• 1:54
  SPEAKER_00: And then when it happened again in college, in my other knee, my brain did something I still can't like really fully explain, but it refused to believe it.
• 2:06
  SPEAKER_00: And I think this was like a denial thing.
• 2:08
  SPEAKER_00: I just remember that moment.
• 2:10
  SPEAKER_00: I remember going down and feeling something in my other knee.
• 2:13
  SPEAKER_00: And I remember my first thought that came to my head wasn't I tore my ACL again.
• 2:19
  SPEAKER_00: It was like, no way, not this knee.
• 2:21
  SPEAKER_00: I would know if this was torn again.
• 2:23
  SPEAKER_00: And it wasn't as obvious because even that injury wasn't as clear as my first one.
• 2:29
  SPEAKER_00: The feeling of it, that sensation of the pop.
• 2:31
  SPEAKER_00: Um, it wasn't as clear on my second one.
• 2:34
  SPEAKER_00: And then there were also some things in my brain that was just kind of denial talking.
• 2:39
  SPEAKER_00: But at the time, it didn't feel like denial.
• 2:42
  SPEAKER_00: It was just like certainty, like, oh no, I'm fine.
• 2:44
  SPEAKER_00: I just kind of sprained it or I tweaked it, right?
• 2:46
  SPEAKER_00: I tweaked it.
• 2:47
  SPEAKER_00: I told myself that's what it was.
• 2:50
  SPEAKER_00: Um I told myself I'd feel it differently if it was really torn, like my first ACL.
• 2:55
  SPEAKER_00: Um, I told myself a lot of things over those days leading up to getting it checked out and getting some imaging because the alternative was admitting I was about to go through this exact same nightmare a second time.
• 3:10
  SPEAKER_00: And that was honestly just too much to sit with, especially the timing of where I was in life.
• 3:15
  SPEAKER_00: I was entering or I was in the end middle of my senior year of college.
• 3:20
  SPEAKER_00: I was thinking about PT school, I was thinking about, you know, just honestly like medical.
• 3:25
  SPEAKER_00: Um, I did not have great insurance.
• 3:27
  SPEAKER_00: As you guys know, I paid$10,000 for my out-of-pocket max.
• 3:31
  SPEAKER_00: So that's the debt that I had for having an ACL surgery here in America in 2013.
• 3:38
  SPEAKER_00: Go USA.
• 3:39
  SPEAKER_00: With that, it's just something that was a really hard timing for me.
• 3:44
  SPEAKER_00: But based on where I was in the context of my life and everything overall, I knew I was still gonna have to do this.
• 3:52
  SPEAKER_00: And so obviously, I had the surgery right after that during my Thanksgiving break, and that was my second ACL surgery.
• 4:01
  SPEAKER_00: And then on went the rehab after that.
• 4:03
  SPEAKER_00: And so today I want to tell you nine things.
• 4:07
  SPEAKER_00: Now, there are 20, 30, 40 different things I could talk to you guys about, and maybe I'll do a further elaboration on this in further episodes.
• 4:17
  SPEAKER_00: But with this, I want to just talk to you guys about the nine things that both of these ACL tears taught me and some lessons I want to share with you that maybe I don't think hit as hard with the first one.
• 4:30
  SPEAKER_00: And as much as I hate to say the second one really ingrained it, it really did.
• 4:35
  SPEAKER_00: Because it starts to make you think about this process a little bit differently.
• 4:39
  SPEAKER_00: And I always tell people this, and it's very important that you hear this.
• 4:44
  SPEAKER_00: When you tear your ACL once, for some people, yes, it is devastating, it is feeling like life's ending, but a lot of times people are like, Oh, it was a fluke, and I'm gonna get through this.
• 4:56
  SPEAKER_00: Outside of like major accidents or like someone like rams into your knee and like slide tackles in soccer.
• 5:02
  SPEAKER_00: If it's a contact thing, it's like you couldn't have done anything about it.
• 5:04
  SPEAKER_00: In that case, you're even more confident, I'll get back to it.
• 5:08
  SPEAKER_00: Whenever it's a non-contact the first time, or you have that first ACL injury, there's a part of you typically that's like, oh, it was a fluke, like it won't happen again.
• 5:18
  SPEAKER_00: When it happens a second time, there's this weird situation of like we still kind of lean more towards like the thought of the first one.
• 5:27
  SPEAKER_00: It's like, okay, it got the best of me again.
• 5:30
  SPEAKER_00: I care about doing this thing and being active and doing all these things, that it doesn't necessarily stand in the way of changing your goals or what you want to do.
• 5:40
  SPEAKER_00: I find that whenever a third ACL tear happens, that is truly the change that people are starting to rethink a lot of things.
• 5:50
  SPEAKER_00: And I don't really share this a ton, but this is something that I even think about as someone who has torn his ACL twice.
• 5:58
  SPEAKER_00: And you know, if this were to happen to me again, what would be my thinking process through that?
• 6:04
  SPEAKER_00: But then just talking to people day in and day out regarding this process, and we have many people on our roster who have torn their ACL too, even three times.
• 6:13
  SPEAKER_00: And there are plenty of people who we've consulted with and worked with who have been in this process.
• 6:19
  SPEAKER_00: And the ones that always baffle me the most are the ones who are on number two and they're not taking the rehab seriously enough, or just saying, like, you know, it's a good enough with the rehab they're getting or or where they're at, even though they're not getting testing, they're not getting, you know, structure or a plan and things like that.
• 6:36
  SPEAKER_00: And I'm like, man, if you get this third tear, it's gonna really influence the way that you look at activity and the things that you're gonna do.
• 6:44
  SPEAKER_00: And so this is something that it sometimes doesn't really get ingrained on the first one, and sometimes the second one ends up being one where you start to like really think because then you have a comparison, and then the comparison kind of sucks because then you're comparing it to the other experience that you had, and it's really challenging because you're probably in a different phase of life.
• 7:08
  SPEAKER_00: Um, you're probably doing maybe a griff different graph type, maybe, but then also it's just gonna be a very different process and recovery overall.
• 7:17
  SPEAKER_00: No ACL recovery is the same, even on the same person, on two different knees, or even the same knee.
• 7:24
  SPEAKER_00: It's not the same.
• 7:26
  SPEAKER_00: And so I think that that's really important.
• 7:28
  SPEAKER_00: And so today I just want to share with you guys these nine things that both of my ACL tears taught me, and some of these lessons that I'm hoping that I can just kind of impart on you just from my experience, and this is also distilling down just all the athletes that we work with and some pretty consistent themes that I see.
• 7:49
  SPEAKER_00: Number one, this injury is more mental than it is physical.
• 7:54
  SPEAKER_00: And I've been reflecting on this a a lot, a lot, a lot, just with our athletes, just with this process in general of just thinking about how much people feel just kind of siloed, and it's easy to see the physical rehab side of things, and have almost like the mental piece be on the back burner, and especially after that like visual thing that I've talked about in previous episodes, where the obvious like brace is gone or crutches or the limp, or you're closer to the surgery date than not, people start to care a little bit less, or they just have no perception of this.
• 8:31
  SPEAKER_00: And you know, Bertha, who is at your work, is asking you two months after your ACL surgery, oh, you're you're good.
• 8:41
  SPEAKER_00: Are you back to playing pickleball?
• 8:42
  SPEAKER_00: And you're like, No, like I'm not even feeling like I'm walking normal yet.
• 8:47
  SPEAKER_00: But they don't know that, right?
• 8:48
  SPEAKER_00: So this is a way more mental process, and the graft healing alone it has its own like kind of timeline, right?
• 8:56
  SPEAKER_00: In terms of like that biology and it's controlling some of that healing process.
• 9:01
  SPEAKER_00: But the fear, the doubt, um, the am I going to be the same person again?
• 9:06
  SPEAKER_00: That part doesn't follow a timeline at all, if I'm honest.
• 9:10
  SPEAKER_00: That's the part that I actually was fighting in those first few days of denial.
• 9:14
  SPEAKER_00: Not my knee, but really it's just my own head.
• 9:18
  SPEAKER_00: So if you're an ACL or listening to this, I just I really need you to hear that.
• 9:22
  SPEAKER_00: The mental load is not just this side thing that's happening.
• 9:25
  SPEAKER_00: It's like it's the real deal, it's happening.
• 9:28
  SPEAKER_00: Um, and it's a core part of this process.
• 9:30
  SPEAKER_00: So treat it that way.
• 9:32
  SPEAKER_00: You have a physical rehab that you're working on.
• 9:34
  SPEAKER_00: Please do me a favor and make sure you're working on the mental side of it.
• 9:38
  SPEAKER_00: I talked to an ACL there recently, and she was like, I've been working so much on the mindset side of things, and she's like, it's been so helpful for me because I feel like I've been just kind of detached from everything because of how much it's changed her life and how hard it has been.
• 9:54
  SPEAKER_00: And so she's working on the physical rehab side of things, but then she's also being super intentional about doing certain things to work on the mindset side of things, to being able to do just different exercises related to being able to, whether it's even just as simple as journaling about how you feel, you know, being able to list the wins that you have, being able to be able to have like people you talk to about these things, like there are different ways to be able to tackle that.
• 12:25
  SPEAKER_00: So make sure to treat that as a core part of it.
• 12:28
  SPEAKER_00: Lesson number two is don't rush the first six weeks.
• 12:33
  SPEAKER_00: Do not do it.
• 12:34
  SPEAKER_00: Don't do it.
• 12:35
  SPEAKER_00: I don't care who you think you are, don't rush it.
• 12:37
  SPEAKER_00: This window sets the tone for everything after it.
• 12:41
  SPEAKER_00: And I have seen people who have delayed the hell out of their ACL rehab in their first few months because they thought that they were better than everyone else, and they tried to rush the first six weeks.
• 12:53
  SPEAKER_00: I was one of those people and it delayed me.
• 12:57
  SPEAKER_00: And so this window is gonna set the tone swelling control, range of motion, getting full extension, getting your quads back, getting your gait under control.
• 13:06
  SPEAKER_00: If you overcook this phase, chasing a timeline that was maybe based on a protocol, it wasn't necessarily built to you, it wasn't built to your graph type, your particular case, you're gonna end up paying for it later.
• 13:19
  SPEAKER_00: And it's usually later on down the road when the knee is still just not feeling right, but you feel like you should be progressing.
• 13:26
  SPEAKER_00: And I find that a lot of physical therapists too, they will just progress athletes because you know they're far enough along post op, they're like in that month four or five, and they'll still be kind of limping around.
• 13:38
  SPEAKER_00: And people come to us on calls and they're like, I'm still limping, and I'm four months out, and I'm eight months out, and I'm like, You have got to be kidding me.
• 13:45
  SPEAKER_00: How is this possible?
• 13:47
  SPEAKER_00: And so this is something that we find that people are not being checked early, but then also they're just rushing that period, they're rushing off their crutches, they're not doing their due diligence, they're not being checked appropriately for their range of motion, things like that.
• 14:03
  SPEAKER_00: That is influencing a domino effect of things that are impacting them later down the road.
• 14:08
  SPEAKER_00: And so don't rush that.
• 14:10
  SPEAKER_00: You will not win this entire war in those first six weeks, but you will absolutely impact it and delay this process.
• 14:18
  SPEAKER_00: That is 100% true.
• 14:20
  SPEAKER_00: And so I have been on both sides of this.
• 14:22
  SPEAKER_00: I rushed it, like I said.
• 14:24
  SPEAKER_00: The thing is, is that I was more respectful on the second time and it paid dividends by being able to not rush it.
• 14:31
  SPEAKER_00: So that's gonna help with the compounding effect of what the first phase of this process is and as the other ones build off of it.
• 14:40
  SPEAKER_00: Lesson number three the DIY do-it-yourself rehab will not get you there.
• 14:48
  SPEAKER_00: It's not gonna get you there.
• 14:49
  SPEAKER_00: I'm a physical therapist, I know the movements, I know all these things that are typically gonna go into what it is to assess and build out what you need.
• 15:00
  SPEAKER_00: I am very familiar with the research.
• 15:03
  SPEAKER_00: As you guys know, I am weirdly obsessed in this space.
• 15:06
  SPEAKER_00: So, this is all that my brain thinks about.
• 15:08
  SPEAKER_00: I don't think about shoulders.
• 15:09
  SPEAKER_00: If you want me to treat your shoulders, good luck.
• 15:11
  SPEAKER_00: I don't think about them at all, but I think about knees 24-7, and it's really weird.
• 15:17
  SPEAKER_00: All I think about is ACLs and this whole entire thing.
• 15:20
  SPEAKER_00: I'm very obsessed with it, so I know a lot about this process.
• 15:24
  SPEAKER_00: And I still would not do it alone.
• 15:28
  SPEAKER_00: And I have a lot of people who are on calls with me sometimes who are like, yeah, I I know how to work out, or like I did some fitness classes, or I did some personal training, and they are like, I can they're trying to convince themselves that like I can probably do it.
• 15:43
  SPEAKER_00: I could use AI and figure it out, right?
• 15:46
  SPEAKER_00: And it's just hard for me to sometimes fathom that because people who are doctorates of physical therapy who spend hundreds of thousands of dollars to go to PT school, and majority of physical therapists, I would say if I had to ballpark, 80 to 90% of physical therapists are not equipped to rehab an ACL.
• 16:06
  SPEAKER_00: Now, the volume of ACLs that are done, the surgeries are so high that regardless, you're gonna have to see a physical therapist who may have never seen one, or we've only seen a few of them, and have not specialized, who have not been able to spend time being really good at it, right?
• 16:25
  SPEAKER_00: And they still have a problem trying to do this rehab.
• 16:27
  SPEAKER_00: And so me trying to be my own PT is not something that I want to do if this happened to me again.
• 16:33
  SPEAKER_00: I would outsource it just like I've outsourced my hip rehab for the past year, having a remote coach who's guiding me, who is who is clearing the way, testing me, all those things.
• 16:43
  SPEAKER_00: And it allows me to exhale, knowing I have an expert in my corner, and I am not the one coming up with these hip programs or or processes to do that.
• 16:52
  SPEAKER_00: They are able to assess my blind spots, they're able to kind of put me at ease with things and being able to provide the structure and the programming.
• 17:01
  SPEAKER_00: Every decision became a question mark because I had no outside eyes checking my blind spots, and that's really, really important here, especially as I was kind of trying to do it, DIY it.
• 17:13
  SPEAKER_00: And so this is what I see a lot.
• 17:15
  SPEAKER_00: So having that expert and structure around you, it shouldn't be a luxury.
• 17:20
  SPEAKER_00: To me, that should be the standard.
• 17:23
  SPEAKER_00: It's changing things from, you know, I think I'm doing it right.
• 17:27
  SPEAKER_00: Like this position looks good or this feels right to you feel confident knowing that that's what's right, and you're given that feedback for that.
• 17:34
  SPEAKER_00: The certainty is worth more than a lot of people give it credit for.
• 17:39
  SPEAKER_00: And the DIY rehab is one thing that gets people into a very stuck place because they don't know where to take things, or they're trying to piece together things they're doing at PT, but then also trying to do them do programs at home for themselves.
• 17:54
  SPEAKER_00: And it just doesn't work out.
• 17:55
  SPEAKER_00: It needs to be someone who is guiding and steering the ship.
• 17:59
  SPEAKER_00: Lesson number four consistency wins.
• 18:03
  SPEAKER_00: It's not intensity, it's not perfection, it's honestly consistency.
• 18:07
  SPEAKER_00: This is the stuff that really shows up, is showing up every day, day after day, even on the days that you might not really feel like it.
• 18:15
  SPEAKER_00: My best stretches of progress were never the weeks where I really trained the hardest.
• 18:21
  SPEAKER_00: They were the ones where I was just training more consistently.
• 18:25
  SPEAKER_00: And that's really the boring lesson here for this one is that consistency is one of the truest and truest things.
• 18:32
  SPEAKER_00: And you look at that across all domains of life.
• 18:35
  SPEAKER_00: Usually, when people are consistent, social media is another good example.
• 18:39
  SPEAKER_00: When people are consistent, no matter what, if you stay consistent, people just give up too early.
• 18:46
  SPEAKER_00: They give up way too early.
• 18:48
  SPEAKER_00: If you stay consistent, it's gonna work out.
• 18:50
  SPEAKER_00: It is going to work out, you're gonna learn from it and you're gonna adapt and you're gonna get better, and whatever you're working towards because of that consistency is gonna pay off.
• 18:59
  SPEAKER_00: And is one of the truest ones on this list of lessons.
• 19:03
  SPEAKER_00: Number five is that the process is not linear.
• 19:06
  SPEAKER_00: You know, you picture a staircase, you know, some of the steps go sideways, and every so often, you know, one goes down and then it goes backwards and then it goes back up.
• 19:17
  SPEAKER_00: That's ACL rehab, right?
• 19:19
  SPEAKER_00: I've kind of alluded to that drawing of like the perfect line versus the staircase.
• 19:23
  SPEAKER_00: You really don't move in a straight line from this whole injured and then surgery and then onto the path of recovery, and it's this beautiful little you know, process, right?
• 19:33
  SPEAKER_00: You move in a pattern that is gonna look more like weather than it is a true schedule, it's gonna be variable, there's gonna be a lot of inconsistencies in terms of patterns, and it's really challenging.
• 19:47
  SPEAKER_00: And the process is just not going to be linear, and I didn't understand that as much the first time.
• 19:52
  SPEAKER_00: I tried to beat it, and every time it would set me back, and the second time I expected it a bit more.
• 19:58
  SPEAKER_00: I still had a hard time with it.
• 20:00
  SPEAKER_00: Don't get me wrong, because personalities play into this no matter how much you can expect.
• 20:04
  SPEAKER_00: But that single shift did help me in the expectation of just changed of how I was experiencing any setback that I had.
• 20:13
  SPEAKER_00: I was less hard on myself because I knew that this was gonna be a part of this.
• 20:19
  SPEAKER_00: Number six is that you can do everything right and it still doesn't go to plan.
• 20:25
  SPEAKER_00: I'm gonna repeat this because I feel like a lot of you need to hear this.
• 20:28
  SPEAKER_00: You can do everything right, all of your controllables, you could hit every single one, and it still doesn't go to plan.
• 20:37
  SPEAKER_00: It's still not hitting as linear as you hope.
• 20:39
  SPEAKER_00: Perfect compliance, perfect programming, perfect attitude.
• 20:43
  SPEAKER_00: Let's say you even have the most perfect coach, yeah, whatever that is.
• 20:48
  SPEAKER_00: And your knees still can have some of this stuff, right?
• 20:52
  SPEAKER_00: Like, because there's an element of this that is, yes, their knee has its own biology and it is healing.
• 21:01
  SPEAKER_00: And then you have the components you control, whether it's like movement, rehab, nutrition, the recovery, the stress, the sleep, the ability to manage the load on it.
• 21:12
  SPEAKER_00: All these things are gonna really influence, yes, like the controllables.
• 21:16
  SPEAKER_00: And then the other thing is that life is also not gonna happen in just a vacuum, right?
• 21:22
  SPEAKER_00: This rehab isn't gonna happen in a vacuum.
• 21:24
  SPEAKER_00: It's happening while life exists.
• 21:26
  SPEAKER_00: And so that's something that is really important to be able to factor into this is that there are times where your knee can still swell for no clear reason, right?
• 21:35
  SPEAKER_00: You could be doing all the right things, and there could also be not an increase in workload and it can increase.
• 21:41
  SPEAKER_00: Now, I would say majority of the times it could be tracked back to probably something that could be picked up on, but sometimes it's not always as clear.
• 21:49
  SPEAKER_00: Your numbers can still plateau, you know, they can hit the 80% symmetry range, and then that it could take some time, right?
• 21:56
  SPEAKER_00: This isn't always a reflection of you failing.
• 21:59
  SPEAKER_00: And I think sometimes people, especially certain types of people who are working really hard, who have those personalities, and they're like, Well, I'm just not doing enough, or I'm just not doing this right.
• 22:09
  SPEAKER_00: And sometimes it's not a reflection of you.
• 22:11
  SPEAKER_00: And it's really hard to swallow this as a high performer.
• 22:16
  SPEAKER_00: It's sometimes a reflection of dealing with the human body, the biology, it's outside of your control sometimes, no matter how disciplined you are.
• 22:25
  SPEAKER_00: And I had to make peace with that.
• 22:27
  SPEAKER_00: I think that that was really important to process through because I thought that working harder means that I would make more progress.
• 22:33
  SPEAKER_00: And that is not always the case, even if I was doing everything right.
• 22:37
  SPEAKER_00: The effort and the outcome are definitely related, but it's not the same thing.
• 22:43
  SPEAKER_00: It doesn't mean effort means more better outcomes.
• 22:46
  SPEAKER_00: So that's just something to keep in mind is that you can do everything right, and it still doesn't go perfectly to plan.
• 22:53
  SPEAKER_00: And just remember that, especially for my type A high performers.
• 22:59
  SPEAKER_00: Number seven, manage your expectations.
• 23:02
  SPEAKER_00: This one for me is personal.
• 23:04
  SPEAKER_00: Timelines really crushed me, especially in that first ACL rehab.
• 23:09
  SPEAKER_00: I'd hear, you know, at three months we're doing this, or X months we're doing that.
• 23:15
  SPEAKER_00: And you kind of build your identity around that, hitting that number.
• 23:18
  SPEAKER_00: And especially being like a you know, a student in our education system, you're always trying to excel and trying to be ahead.
• 23:27
  SPEAKER_00: Everyone always loves to say I'm ahead of the timeline and where I should be.
• 23:31
  SPEAKER_00: And when I didn't, I felt behind.
• 23:34
  SPEAKER_00: And it's crazy.
• 23:35
  SPEAKER_00: I felt behind more than I felt ahead.
• 23:38
  SPEAKER_00: And if every one of you had to ask yourself, do I feel ahead or do I feel behind?
• 23:44
  SPEAKER_00: I would put my hat on most of you are saying, I feel behind.
• 23:48
  SPEAKER_00: Every single one of you, you're probably nodding your head, I feel behind.
• 23:51
  SPEAKER_00: And that's what's challenging about this process.
• 23:54
  SPEAKER_00: And when you're also getting trapped in comparison of watching other people, you don't often see as much of the people who are lagging behind you, if you will.
• 24:03
  SPEAKER_00: And again, everyone's kind of on their own timeline.
• 24:06
  SPEAKER_00: But with that said, it's hard because you will notice more so the people who are doing the things that you want to be doing, or quote unquote ahead.
• 24:15
  SPEAKER_00: And so I was watching essentially everyone passing or being able to progress.
• 24:21
  SPEAKER_00: And I was failing, right?
• 24:23
  SPEAKER_00: And so that was something that I had to like really come to terms with and manage my expectations, especially of this timeline, because it can really get the best of you.
• 24:31
  SPEAKER_00: And it's probably one of the things that our ACLers, especially first coming in to work with us, are having the hardest time with.
• 24:39
  SPEAKER_00: And a lot of times it's because of what the traditional system has equated it to, especially, you know, the outdated protocols.
• 24:47
  SPEAKER_00: The surgeons say, like, oh, you'll be back in six months, or you'll be back in nine months.
• 24:51
  SPEAKER_00: And it just doesn't work out.
• 24:53
  SPEAKER_00: It doesn't work out that way.
• 24:54
  SPEAKER_00: Your process ends up being a little bit different.
• 24:57
  SPEAKER_00: And then you add in complications like people will experience, like let's say a cyclops clean out, or something else happens in the knee.
• 25:04
  SPEAKER_00: Like that's going to influence that timeline a little bit.
• 25:07
  SPEAKER_00: And so I think that that's going to be important to factor in.
• 25:10
  SPEAKER_00: Same thing with a meniscus repair.
• 25:12
  SPEAKER_00: If you're non-weight bearing for six weeks, it's going to probably influence things a little bit from the timeline.
• 25:18
  SPEAKER_00: And so while we use time as a healthy proxy, we are not dead set on timelines because everyone is in their own ACL recovery path.
• 25:29
  SPEAKER_00: But the thing is, is that we need to make sure we manage these expectations, which is so important.
• 25:35
  SPEAKER_00: And here's what I now know that I did not know then is that most of my ACLers and our ACLers who we work with, when they're coming in, as I shared, they will feel behind.
• 25:48
  SPEAKER_00: And that's not the sign of you're doing something wrong.
• 25:52
  SPEAKER_00: And I think that's really important to be able to assess here.
• 25:56
  SPEAKER_00: Now, if you're not getting good rehab, if you're not getting testing, like your strength is not being tested, if you're not getting structure, if you're not getting guidance, um, your questions answered, then that is going to be something that, yeah, it could be something that needs to be improved and you could move along in a better form.
• 26:13
  SPEAKER_00: But just know you're not doing something wrong.
• 26:16
  SPEAKER_00: It's a sign that you weren't essentially just kind of given a timeline, but it wasn't built for you.
• 26:23
  SPEAKER_00: It was not built for you.
• 26:24
  SPEAKER_00: With the quad graphs, when we look at the Schwery paper, some of them don't hit 70% symmetry until around six months plus, if not longer, right?
• 26:34
  SPEAKER_00: And the thing is that the assumption is everyone is supposed to quote unquote start running around month three.
• 26:39
  SPEAKER_00: And it's so silly to me because all these quad graphs are being told they need to start running around this timeline, and they're not even aligning it with the research, they're just using the protocols that have been used since like 1996, and they're like, oh, well, like 12 weeks, let's start running.
• 26:56
  SPEAKER_00: And we're still seeing this pretty regularly.
• 26:58
  SPEAKER_00: Quad graphs are increasing in terms of the frequency of being done.
• 27:02
  SPEAKER_00: The challenge is that even physical therapists are still following a lot of these timelines, and especially people who just either don't have time or just don't have the experience in ACL rehab, which is most physical therapists, then they are using these protocols where it says, okay, 12 weeks, let's do this.
• 27:22
  SPEAKER_00: So I had a call, two calls this past week, where people were told, even though their knees were swelling, no testing, and they're around like that three, four-ish month mark, they were told that they can start running, even though they did not feel even close to being comfortable to do that.
• 27:37
  SPEAKER_00: And that was all based on the timeline.
• 27:41
  SPEAKER_00: And so the expectation management is going to be really key, and who is communicating that is going to be even more important.
• 27:48
  SPEAKER_00: Because that could be the difference in you being just completely not filled with anxiety because you know that this is your particular process and what your quote unquote timeline looks like, versus like anxiety filled because you're not hitting these markers because of an outdated protocol, an inexperienced physical therapist, or a surgeon who's like seen you for five minutes and was like, okay, now you could start running.
• 28:12
  SPEAKER_00: But you know, they have no context of what you've been doing.
• 28:15
  SPEAKER_00: They just see you in their office, they do a lockman test, and they see how far out you are from your surgery date and make some decisions.
• 28:24
  SPEAKER_00: And so that is one thing that's really important about expectations is that the people who are communicating that to you need to be dialed into this process.
• 28:34
  SPEAKER_00: And that's going to help you to manage that, especially because you're trying to lean into what they're telling you.
• 28:41
  SPEAKER_00: Number eight, celebrate the little wins.
• 28:44
  SPEAKER_00: You guys hear me say this all the time, but this is huge in this process.
• 28:48
  SPEAKER_00: The first time that I could actually extend my knee without thinking about it, you know, being able to get rid of my crutches officially, that first pain-free step, the first time that I was able to run, and my brain didn't immediately just kind of panic.
• 29:02
  SPEAKER_00: None of those moments were like a big chart, like blowing, you know, all these milestones.
• 29:09
  SPEAKER_00: Maybe the running one was a big one, but it wasn't like there was like massive celebrations across all these.
• 29:15
  SPEAKER_00: It was just kind of quote unquote expected, but all of them mattered, and all of them mattered more to me at that time than any, you know, other thing did.
• 29:24
  SPEAKER_00: And I think that's important here, is that you need to be able to build momentum and celebrating the small wins is so key in that because it's going to help you to be able to continue to create a domino effect and positive momentum and allows you to be like, okay, this is still getting me towards the goal.
• 29:43
  SPEAKER_00: And it's that brick-by-brick approach that I've talked to you guys about before is that it's just laying down that brick.
• 29:48
  SPEAKER_00: You imagine building that brick wall or that brick foundation, and then all you do is get so focused on that next brick.
• 29:55
  SPEAKER_00: Just put the next brick down, stack it up, and then keep stacking the brick.
• 29:59
  SPEAKER_00: That is what this process is.
• 30:01
  SPEAKER_00: And eventually you will have that foundation, that that wall that you're building, and therefore that's the whole brick by brick, and allowing that to be through celebrating those little wins.
• 30:11
  SPEAKER_00: That's what's massive here.
• 30:13
  SPEAKER_00: Number nine, you can come back stronger.
• 30:18
  SPEAKER_00: And I'm not saying this here as a slogan, it's not this like cliche thing, but I'm saying it here as someone who has done this twice in two completely different chapters of my life with two different bodies, two different kind of mindsets.
• 30:33
  SPEAKER_00: Both I came out on the other side more capable than I went in, not despite the injury itself, but partly because of what it forced me to learn about myself.
• 30:41
  SPEAKER_00: And there are a lot of people who I talk to who are just like, I just want to be able to get back to like 80% of myself.
• 30:49
  SPEAKER_00: But like, I would just love to be able to run again.
• 30:52
  SPEAKER_00: And they cut themselves short.
• 30:54
  SPEAKER_00: And when I hear these things, I understand the hesitation.
• 31:00
  SPEAKER_00: It's kind of like when you take that test in school and you just say, like, ah, I probably got a 70 on it, and you end up getting a 98.
• 31:07
  SPEAKER_00: It's kind of like that, it's kind of like being able to just predict maybe the low blow of not being able to get back to what yourself was once.
• 31:15
  SPEAKER_00: But I don't accept that.
• 31:17
  SPEAKER_00: And it it kind of breaks my heart when people sell themselves short in this process.
• 31:22
  SPEAKER_00: And I think sometimes it's almost a byproduct of the challenges that they have experienced up to the point that we talk that they are like, I don't know if I can get there.
• 31:31
  SPEAKER_00: So I'm just gonna like kind of bring, I'm gonna lower my goals.
• 31:35
  SPEAKER_00: Or they're like, I don't know if I can because I've I've had an injury to this knee.
• 31:39
  SPEAKER_00: I'm like, y'all, if you knew the number of people who are able to get back to crazy, insane, amazing things after one, two, three ACL tears, you'll be shocked.
• 31:48
  SPEAKER_00: And so the only limit is truly our mindset.
• 31:52
  SPEAKER_00: And yes, there are biological considerations to this.
• 31:55
  SPEAKER_00: Don't get me wrong.
• 31:56
  SPEAKER_00: There are challenges that are beyond just our control, as I shared.
• 32:00
  SPEAKER_00: But with that said, you can come back stronger.
• 32:02
  SPEAKER_00: We have coached hundreds and hundreds and hundreds of ACLers through this process who have told us they're stronger than they were prior to going into this injury because they put the most amount of work into this and they believed in themselves that they can come back stronger, and they can.
• 32:19
  SPEAKER_00: We have tons of testimonials of people who have done this, and we have tons of people we worked with.
• 32:23
  SPEAKER_00: So it is doable not only as a byproduct of my own two ACLs, but it is a byproduct of thousands of ACLers at this point who we've consulted and worked with.
• 32:32
  SPEAKER_00: So you can do it too.
• 32:33
  SPEAKER_00: So if you're in the middle of this right now, this is the part where it feels slow and unfair and nothing like what you pictured.
• 32:41
  SPEAKER_00: So I need you to hear this from someone who has been exactly where you are twice.
• 32:46
  SPEAKER_00: You're not broken in this process.
• 32:48
  SPEAKER_00: Just know that you are built to be able to come back from this stronger.
• 32:52
  SPEAKER_00: So you have to stick with this process and just find people that you trust.
• 32:56
  SPEAKER_00: Build out the best team possible.
• 32:59
  SPEAKER_00: And as I shared, have the best physical therapist coach in your corner, and you will get there.
• 33:06
  SPEAKER_00: And you'll be able to get there faster, you'll be able to get there with less anxiety and less stress, and the ability to come back in a stronger place and perform at a better place.
• 33:16
  SPEAKER_00: That can happen if you are able to have the right people in your corner.
• 33:21
  SPEAKER_00: Just don't do it alone.
• 33:22
  SPEAKER_00: That's the thing that is really, really important.
• 33:26
  SPEAKER_00: So if I could go back and talk to the version of me lying on the ground the second time, still convinced that it was just a sprain in my knee, I'd tell him the same thing that I'm telling you today.
• 33:39
  SPEAKER_00: You already have what it takes to get through this.
• 33:42
  SPEAKER_00: You just you really just don't know it yet.
• 33:44
  SPEAKER_00: And so that is something that is going to be really important and to also set as a reminder of these nine lessons I shared with you because they're really timeless, they're going to be really important, and no matter where you are, they are relevant.
• 33:59
  SPEAKER_00: So I hope that this is helpful as someone who has gone through this twice.
• 34:03
  SPEAKER_00: I hope that you guys can relate to a few of these.
• 34:06
  SPEAKER_00: And if there's anything that you need to talk through, if you need more structure, you need more guidance through your own ACL journey, we are here to help.
• 34:14
  SPEAKER_00: You can check us out in the show notes.
• 34:16
  SPEAKER_00: We want to support A SLLers all around, and we love what we do, and we can do it from anywhere.
• 34:23
  SPEAKER_00: So we are here with you.
• 34:24
  SPEAKER_00: If you have any questions, please reach out.
• 34:26
  SPEAKER_00: Until next time, this is your host, Robbie Patel, signing off.