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229 | From Stuck to Seen: How Advocating Changed This ACL Rehab Trajectory · 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: What is up, y'all?
• 1:02
  SPEAKER_00: Today I've got a super interesting one, and I wanted to share a story of an ACLer and a case of mine with a 14-year-old female ACL athlete I've been working with.
• 1:17
  SPEAKER_00: It's been a complex one to say the least, especially for a 14-year-old going through this process.
• 1:25
  SPEAKER_00: It's a lot for anyone, but especially in development years, like middle school and high school.
• 1:32
  SPEAKER_00: Also, you might hear some thunder in the background, a little bit of ambiance, if you will.
• 1:37
  SPEAKER_00: But yeah, with her, her parents have been involved and really awesome.
• 1:43
  SPEAKER_00: It makes handling a complex case of a 14-year-old going through an ECL process a little easier for me because they have a great support system.
• 1:53
  SPEAKER_00: And I'll share why it is so important as we talk about it.
• 1:57
  SPEAKER_00: So here is the backstory.
• 2:00
  SPEAKER_00: We started working together during prehab before she had surgery.
• 2:05
  SPEAKER_00: We had all the prehab focused goals and got her ready for surgery.
• 2:10
  SPEAKER_00: She got a quad graph from a surgeon.
• 2:13
  SPEAKER_00: We aimed for our post-op goals, which was all focused on a quiet knee, keeping it super simple because she also had school in the mix.
• 2:22
  SPEAKER_00: So something that was just really challenging from the get-go was getting extension.
• 2:28
  SPEAKER_00: How many of you guys can relate?
• 2:30
  SPEAKER_00: And then getting her quads to wake up and getting her into that extension.
• 2:36
  SPEAKER_00: So another thing super common for ACLers, right?
• 2:39
  SPEAKER_00: Waking up the quads, getting your knee extension.
• 2:42
  SPEAKER_00: Some of you it might be flexion, some of you it might be both, but getting that good heel pop, terminal, hyperextended knee extension, super common, especially with pain and swelling, can make that quad kind of shut down and also not want to activate.
• 3:05
  SPEAKER_00: The feel of it, that mind muscle connection is not feeling there.
• 3:08
  SPEAKER_00: And don't get me wrong, I can definitely relate to this with my own ACLs and trying to get my quads to wake up through this.
• 3:16
  SPEAKER_00: And I actually have a scar, especially on my right side, where they put my femoral nerve block, and I remember why can't I wake up my quads?
• 3:24
  SPEAKER_00: Right.
• 3:25
  SPEAKER_00: And this is something super common.
• 3:27
  SPEAKER_00: And so with her, we had a super high focus on getting this.
• 3:30
  SPEAKER_00: This is always our number one goal.
• 3:32
  SPEAKER_00: Let's get hyperextension, let's get our quads awake.
• 3:35
  SPEAKER_00: If we can get that, I'm feeling really, really solid about how we're starting off.
• 3:41
  SPEAKER_00: And so I'm pulling out all the different ways for us to try and tackle it and getting her extension to really get there, right?
• 3:49
  SPEAKER_00: And it progressed, and we reached kind of a gray area, if you will.
• 3:53
  SPEAKER_00: It was around zero degrees, neutral, if you will, not into hyperextension, and she has hyperextension, about roughly five degrees.
• 4:02
  SPEAKER_00: So we still had a little bit more to go.
• 4:05
  SPEAKER_00: And it could give or take depending on the day.
• 4:07
  SPEAKER_00: She was also doing a lot of walking, especially with school and being up on her feet.
• 4:12
  SPEAKER_00: And she just had an overall sensitive knee.
• 4:15
  SPEAKER_00: So therefore, it responded very quickly to swelling, to stress, um, and especially with that knee being more vertical on it and more step count.
• 4:26
  SPEAKER_00: And sometimes we'd maybe get a little bit of hyperextension on a day or two, depending on how hard it was worked on.
• 4:33
  SPEAKER_00: But it probably fluctuated around that zero degrees, right?
• 4:36
  SPEAKER_00: Not fully hyperextended like we want it.
• 4:39
  SPEAKER_00: And this was, you know, two to three months after really consistent hard work, really trying to keep it simple, be able to progress some other areas of the rehab process, manage being on her knee a lot and the swelling and the pain, and also just getting her range of motion dialed in, getting her quads to wake up more and more.
• 5:01
  SPEAKER_00: But that extension just kind of ebbed and flowed a little bit, right?
• 5:05
  SPEAKER_00: And my gut was telling me something wasn't adding up.
• 5:09
  SPEAKER_00: But it was in this gray area, not symptomatic with extension.
• 5:12
  SPEAKER_00: It wasn't like she had this clunk or these weird, like typical issues with maybe some scar tissue, but I just had this kind of gut feeling about it.
• 5:20
  SPEAKER_00: Um and this stuff sadly comes to me now just after seeing so many ACLers, but with that, it just kind of ebbed and flowed with where she was.
• 5:29
  SPEAKER_00: And so I wanted to make sure I give her a fair shot because some people it just can take time.
• 5:36
  SPEAKER_00: There's some people who may get it immediately, and then there's some people who I've seen it just come over, you know, months and months of working on it, and it could just be because of the injury and then going into surgery pretty quickly.
• 5:50
  SPEAKER_00: It could be because just the surgery itself and the way the knee responded to it and the healing.
• 5:56
  SPEAKER_00: So there's a lot of factors, and so sometimes it just takes time.
• 5:59
  SPEAKER_00: Maybe someone didn't do as much of their diligence as they said that they were doing, and so then, therefore, then they start to realize it's a problem and they get on it.
• 6:08
  SPEAKER_00: So lots of things that play into this, right?
• 6:12
  SPEAKER_00: But with that said, I just want to make sure we give a fair shot and we don't want to rush to anything, especially if someone is sitting somewhere around zero degrees, it's in that gray area.
• 6:23
  SPEAKER_00: Yes, if it's like 20 degrees of flexion or 10 degrees and she's still needing 15 more degrees of extension, then that's a problem.
• 6:31
  SPEAKER_00: But when we start hitting around zero, it gets in this really weird gray area, especially with medical providers in this.
• 6:38
  SPEAKER_00: And I'll share more about that.
• 6:40
  SPEAKER_00: And so with quad graphs, this can even take a little bit more time and getting into end-range hyperextension.
• 6:49
  SPEAKER_00: So she saw her surgeon at the three-month mark, and the surgeon said it looked great, right?
• 6:54
  SPEAKER_00: They looked at it, looked at the knee, did their normal five-minute thing, and was like, looks great.
• 7:00
  SPEAKER_00: And then I continued to have my internal concerns.
• 7:03
  SPEAKER_00: I was gonna wait to see what the surgeon said, but I still had my internal concerns about the knee, and we just kind of continued to work on the things that we could.
• 7:13
  SPEAKER_00: And once we did get beyond that three-month mark, I felt like it plateaued, even though the surgeon said it looked great, and she said she thought it was even better.
• 7:22
  SPEAKER_00: And in all honesty, I'm sure some of you can relate to this.
• 7:27
  SPEAKER_00: This was her wanting it to be better than it actually was.
• 7:30
  SPEAKER_00: Again, not terrible extension, but I could tell it was impacting her ability to contract her quads, and sometimes it carried over into her gate where she might limp here or there or walk with a bent knee, right?
• 7:44
  SPEAKER_00: So I shared my concern with her parents privately and not in front of her.
• 7:50
  SPEAKER_00: That was super important to me, especially given her age and where she's at.
• 7:53
  SPEAKER_00: And there had already been many uh sessions where we had to talk through things and some breakdowns and some tears, and we have to navigate this super carefully, right?
• 8:03
  SPEAKER_00: This isn't just someone who can, you know, tackle all this, and you know, their life has been uprooted as a 14-year-old, right?
• 8:12
  SPEAKER_00: It sucks for someone who's in their 20s and 30s, right?
• 8:15
  SPEAKER_00: And I'm not saying that takes away from any of you who might be older who have this, but as we get older, at least we can deal with problems a little bit better, hopefully.
• 8:24
  SPEAKER_00: And so when we're younger, it's harder to process things like this.
• 8:27
  SPEAKER_00: And so when it happens when you're 14, it's something that we want to be very intentional and very delicate with it, if you will.
• 8:36
  SPEAKER_00: And so I wanted to make sure I talked to the parents, they're informed and know where my head's at with these things, and wanted to basically share that I think she has a cyclops lesion, and I wanted to get in front of it.
• 8:48
  SPEAKER_00: And after working with ACL or so much over the years, and I've done episodes on cyclops lesions, and our team, I think personally, that cyclops lesions, the numbers are underestimating the number of actual cyclops or scar tissue that people deal with whenever they're post-op ACL.
• 9:11
  SPEAKER_00: And this is just me throwing this out there, and I'm just speaking this from anecdote.
• 9:17
  SPEAKER_00: I don't have any research to back this up.
• 9:19
  SPEAKER_00: Um, this is just exposure, to be completely honest, and being in this space.
• 9:23
  SPEAKER_00: But there is something about quad tendon graphs and the relationship of scar tissue laying down a little bit easier, and maybe a cyclops forming alongside of it.
• 9:34
  SPEAKER_00: And so I don't know that there is any connection with this.
• 9:37
  SPEAKER_00: There may be, and I hope that there's future research on this.
• 9:40
  SPEAKER_00: I hope I'm wrong, you know.
• 9:42
  SPEAKER_00: But with that said, I just see a relationship.
• 9:45
  SPEAKER_00: If those of you have a quad tendon, which I guarantee you a lot of you are listening, don't go running and saying, like, I got a cyclops.
• 9:52
  SPEAKER_00: I've seen plenty of quad tendons who don't have cyclops.
• 9:55
  SPEAKER_00: But with that said, I can see this more associated with that quad tendon graft, and our team as a whole has seen this a little bit more with that quad tendon graft.
• 10:05
  SPEAKER_00: Now, with that said, that is something that I just wanted to make sure that I shared with that the parents.
• 10:13
  SPEAKER_00: And if I can be transparent with all of you for a second, we find that sometimes ACLs get stuck and suspect a cyclops lesion.
• 10:24
  SPEAKER_00: There's no way to prove it besides an MRI.
• 10:27
  SPEAKER_00: And oftentimes surgeons are reluctant to do anything about it, especially if that extension is close to zero.
• 10:35
  SPEAKER_00: It's not so aggressively obvious where they are walking with a very bent knee, like I said, plus 10 degrees, plus 15 degrees.
• 10:43
  SPEAKER_00: It's around zero, but it is not hyperextension and it is not matching the other side.
• 10:49
  SPEAKER_00: And what I see a lot of times is that they just refuse or they're just very reluctant to order an MRI to confirm it, even though they're super quick for an MRI to diagnose an ACL tear, but not for a potential problem or complication, unless it's gone on long enough.
• 11:08
  SPEAKER_00: And sometimes, you know, the reasoning is is like, why do an unnecessary image?
• 11:12
  SPEAKER_00: And I'm like, man, like if this could save this person three months of just like wasting their time whenever they're running into this issue, I think is well warranted.
• 11:21
  SPEAKER_00: And if anything, they get the MRI and it comes back negative.
• 11:25
  SPEAKER_00: That's great, that's information for us to move forward.
• 11:28
  SPEAKER_00: So I don't understand it, and I think it's more so of like they just don't want anything to impact their overall process.
• 11:35
  SPEAKER_00: And yeah, I get situations where people come in suspecting things and maybe it isn't there, right?
• 11:41
  SPEAKER_00: But when this has been worked on consistently and it's not adding up, let's try to do what we can to get more information.
• 11:50
  SPEAKER_00: And the thing is, is that it's a gray area, and some surgeons think zero is great.
• 11:55
  SPEAKER_00: They actually think you don't need hyperextension.
• 11:58
  SPEAKER_00: It's not, and I'll stand by this forever, given that our knees are naturally having some hyperextension, and humans are naturally born and built this way.
• 12:08
  SPEAKER_00: If you extend your elbows, you have hyperextension.
• 12:10
  SPEAKER_00: If you extend your knees, you have some hyperextension.
• 12:13
  SPEAKER_00: This is something that I'm not gonna waver from, and zero is not okay.
• 12:18
  SPEAKER_00: We want to match the uninvolved side, unless you're a very hypermobile person, meaning you get to minus 15, minus 20 degrees.
• 12:27
  SPEAKER_00: You have a different genetic composition, or if you will, more so of like your connective tissue.
• 12:33
  SPEAKER_00: So you're technically a more just hypermobile person, so maybe there is room there.
• 12:37
  SPEAKER_00: But for 90% of people, you're probably not going to need to deal with it.
• 12:42
  SPEAKER_00: And you have a normal hyperextension, which is typically around minus 5 to minus 10.
• 12:47
  SPEAKER_00: So why not restore it back?
• 12:50
  SPEAKER_00: And there's research to show problems in quad strength and long-term osteoarthritis if your knee extension is not restored.
• 12:57
  SPEAKER_00: They want to assume it's not their surgery, they being the surgeons, or their graft, that's the issue.
• 13:03
  SPEAKER_00: And that's not it.
• 13:04
  SPEAKER_00: We're not here to call out and say, like, hey, you did a bad job in the surgery and this is your problem.
• 13:10
  SPEAKER_00: It's just that there is a physical block, right?
• 13:13
  SPEAKER_00: And no one could have controlled this.
• 13:15
  SPEAKER_00: It just happened, right?
• 13:16
  SPEAKER_00: Literally a watt of scar tissue, a brick wall, if you will, that is stopping this knee from going any further.
• 13:22
  SPEAKER_00: So the only way to improve it is to remove it and clean it out via surgery.
• 13:28
  SPEAKER_00: And I just want to stop here and say, I'm not here to say this that it's all surgeons, right?
• 13:34
  SPEAKER_00: But working with ACLers in this space for a pretty decent chunk now, all over the world.
• 13:40
  SPEAKER_00: And if you guys have followed me at this point, 229 weeks straight of this podcast and episode without expecting anything back from you, right?
• 13:50
  SPEAKER_00: Like I'm here to just share this because it means so much to me.
• 13:54
  SPEAKER_00: And because this is the honest to God truth of what exists in this space, because I just don't want you to fall to what cracks I had to fall through, and the reason why I may have had my second ACL injury, and why these athletes are going on to have their lives completely uprooted and messed up because of this injury.
• 14:14
  SPEAKER_00: And yeah, we can't prevent the first ACL injury potentially, but we sure as hell can do something about the second one.
• 14:21
  SPEAKER_00: And I will stand by that, and that's where good rehab, good surgical processes, good teams are going to really be able to get you back to what you want to do, but then also prevent and minimize the risk of that second ACL or hopefully third ACL, right?
• 14:37
  SPEAKER_00: And so, with saying this, I'm not saying all surgeons do this, but this is something I see as a pattern and so consistent.
• 14:44
  SPEAKER_00: And with working with ACLers all over the world, there seems to be resistance to it often, more often than not.
• 14:52
  SPEAKER_00: So that's why we have to advocate for ourselves.
• 14:55
  SPEAKER_00: And hopefully, as a provider to our athletes, we can advocate for you, right?
• 15:00
  SPEAKER_00: And so coming back to this client's case to help kind of bring this around, I shared it with her parents and discussed the next steps, right?
• 15:08
  SPEAKER_00: I told them, look, like I have this feeling that it's a cyclops lesion, it's not consistent with all the cyclops lesion, clunking, um, regressions, and all that, but it's something that I think could be there.
• 15:21
  SPEAKER_00: And I want to get in front of this.
• 15:22
  SPEAKER_00: So I shared with them the next steps, and I will often share it with the surgeon and the team, but this was a case where the surgeon wasn't as receptive.
• 15:31
  SPEAKER_00: And so, in situations like this, sometimes we just have to empower the patient, their parents maybe if they're involved, to take matters into their own hands because a lot of times they will listen a little bit more because you are the patient, versus if you are another medical provider, sadly, in this world with just a lot of, you know, egos, time limitations, other stakeholders involved that unless you're the elite of the elite, it can often just be disregarded.
• 16:01
  SPEAKER_00: So then, therefore, we have to make sure our patients feel like they can advocate for themselves and feel educated to voice their opinion.
• 16:08
  SPEAKER_00: And so they messaged a surgeon's office and scheduled a visit to evaluate the knee right after I shared that with them.
• 16:14
  SPEAKER_00: And so after the visit with the surgeon, the mom of the athlete emailed me and then called me to say that the surgeon was visibly pissed off.
• 16:25
  SPEAKER_00: I was like, what?
• 16:27
  SPEAKER_00: He said he didn't think there was a problem, and that since this thought had been put in her head, she thinks it won't be fixed until there's something done about it, until it is cleaned out.
• 16:39
  SPEAKER_00: And then he said that there's too many cooks in the kitchen, you just need to keep going with your rehab process and just not worry about that.
• 16:48
  SPEAKER_00: But what's funny is that I'm streamlining this entire rehab for her, and so there's not too many cooks in the kitchen.
• 16:56
  SPEAKER_00: It's actually a very cohesive and dialed-in rehab process and what she's getting with this more than most, right?
• 17:03
  SPEAKER_00: And the mom said that she had to redirect the surgeon to focus on her daughter and the problem versus complaining about these cooks in the kitchen and the fact that, you know, we put this thought in her head.
• 17:16
  SPEAKER_00: And the thing that just baffled me the most was the next part.
• 19:25
  SPEAKER_00: The surgeon evaluated her knee after you said all that and said, yes, it does seem to look like she has some scar tissue and restriction and extension.
• 19:35
  SPEAKER_00: He said he didn't even need to get an MRI for her and to schedule the cleanup because he felt confident she had scar tissue.
• 19:42
  SPEAKER_00: And as the mom shared this with me, I'm just shocked by this, honestly.
• 19:46
  SPEAKER_00: I get it if he disagreed with me because he did think it was wrong and that she didn't have a scar tissue or cyclops, and her extension was fine.
• 19:56
  SPEAKER_00: But in that visit, he agreed that she had a cyclops, she had scar tissue, her extension was not looking right.
• 20:04
  SPEAKER_00: So why say what he did?
• 20:06
  SPEAKER_00: And who knows, honestly, but this ACLer had the clean out procedure the week after, and they found a massive cyclops lesion in front of her ACL and scar tissue.
• 20:19
  SPEAKER_00: And don't get me wrong, y'all.
• 20:21
  SPEAKER_00: I'm not here to say I'm right, he's wrong.
• 20:23
  SPEAKER_00: Like, we just came to this conclusion of like, hey, there's a problem and we just need further detail.
• 20:28
  SPEAKER_00: And I wasn't even saying, hey, she needs a clean out.
• 20:31
  SPEAKER_00: We just need the next step of let's get some more information and maybe that's an MRI to rule out that there's a cyclops, right?
• 20:38
  SPEAKER_00: That's all I'm asking for, just to make sure we are not, you know, ramming our heads into the wall and she feels like she is working so hard yet not making the progress we want.
• 20:47
  SPEAKER_00: And we're seeing that translate into her strength, her rehab, and how her knee feels, right?
• 20:52
  SPEAKER_00: Whenever you have a 14-year-old walking around with a slight bent knee and it just doesn't feel great and it kind of limps a little bit, that's not cool.
• 20:59
  SPEAKER_00: No one wants to walk around like that, especially not in middle school and high school, right?
• 21:03
  SPEAKER_00: And so then, therefore, let's try and find some solutions and get more information.
• 21:08
  SPEAKER_00: And that's all the goal was.
• 21:10
  SPEAKER_00: And so here she had that cleanup procedure, they got the cyclops out on the scar tissue, and now she's got her hyperextension back, and we're working on more strength and fun stuff and progressing her rehab.
• 21:24
  SPEAKER_00: So, what would have happened had she not gone and had this looked out?
• 21:31
  SPEAKER_00: And this is something that's always interesting to just kind of think about, right?
• 21:36
  SPEAKER_00: Like, what would have happened if she just kept working at it after that three-month mark?
• 21:40
  SPEAKER_00: And typically the next surgeon visit isn't until six-month mark, right?
• 21:44
  SPEAKER_00: So she would have kept working on it, it would not have gotten better, and the problem she was dealing with would have persisted.
• 21:52
  SPEAKER_00: And I've seen this where people come in to work with us six months out, nine months out.
• 21:58
  SPEAKER_00: I mean, we've had people a year out, even a year and a half out, and they're dealing with a problem similar to this that never got caught or never got addressed.
• 22:08
  SPEAKER_00: And they're still dealing with the issues, and it makes me sad because no one ever thought to just be like, hey, like let's look a little deeper.
• 22:15
  SPEAKER_00: Let's listen to your story, let's evaluate this knee, let's track and see does it progress at all, what helps it, what doesn't.
• 22:22
  SPEAKER_00: And then let's just kind of create this trend, if you will, and understand what this picture looks like and what is going to be the best solution.
• 22:31
  SPEAKER_00: And once addressed, they can move forward, right?
• 22:35
  SPEAKER_00: It's an opportunity cost, y'all.
• 22:37
  SPEAKER_00: When someone doesn't have this addressed early, it's an opportunity cost.
• 22:41
  SPEAKER_00: If you think about us working for another two to three months more and then having the same problem, finally evaluated, let's say at six months or seven months, that's way too long.
• 22:52
  SPEAKER_00: And the tough part is that this athlete goes through this feeling of almost being feeling gaslit, like a bit.
• 22:59
  SPEAKER_00: You know, they think that they're crazy and they're being told that their extension is fine.
• 23:04
  SPEAKER_00: When they know it doesn't feel right, they're working on it, and then they're told it's fine, but then you know they know it doesn't feel right, and then you know, it's just this like kind of messy situation.
• 23:16
  SPEAKER_00: And what's important here is that she had the support system to help her, she had her parents to make sure she had a voice, especially as a minor.
• 23:25
  SPEAKER_00: I also provided a step-by-step of how to present this, given it was a challenging thing to communicate this to the surgeon myself.
• 23:35
  SPEAKER_00: And this is the reality of healthcare space, y'all.
• 23:38
  SPEAKER_00: Egos, time constraints, money, outcomes, etc., right?
• 23:42
  SPEAKER_00: It's tough.
• 23:44
  SPEAKER_00: And so, what is my point here?
• 23:46
  SPEAKER_00: You're like, cool, this is not the best story.
• 23:49
  SPEAKER_00: You have gone on for 20 minutes.
• 23:51
  SPEAKER_00: Now, what's the point?
• 23:53
  SPEAKER_00: My point here is we have to be our own advocates.
• 23:56
  SPEAKER_00: It's so important for you to make sure you voice things for yourself and in Today's healthcare, you don't have a choice in the system, no matter where you are.
• 24:10
  SPEAKER_00: I can share countless other stories of similar situations where people didn't advocate for themselves and they're not only lost, they have lost time, they spin their wheels feeling stuck, and but also kind of felt crazy for it.
• 24:23
  SPEAKER_00: They have been quote unquote graduated from PT or they've been cleared, but they don't feel like they should be ready to go.
• 24:30
  SPEAKER_00: They know that they feel like they're at 50% or 60 or 70%.
• 24:36
  SPEAKER_00: Heck, it might be even 30 or 40%, right?
• 24:39
  SPEAKER_00: And the thing is, they've been told by the professionals they're working with that, oh, it's good or you're good, just like kind of work into it.
• 24:46
  SPEAKER_00: And the thing is, is that it's not fair to you, as especially the ACL or and it makes me really sad because you deserve better, and it's just not fair.
• 24:55
  SPEAKER_00: And so we have to be our own advocates in this process.
• 24:59
  SPEAKER_00: Now, does this mean that if you don't have extension to run to your surgeon and say that you have a cyclops?
• 25:07
  SPEAKER_00: No, please do not think that that is your number one problem or go chasing all these forums and thinking that's what you have, right?
• 25:15
  SPEAKER_00: The thing is that you need a team and a support system you can trust.
• 25:20
  SPEAKER_00: You have your people, you may have your sports team and coaches, you hopefully have a rehab provider, and usually an ortho or surgeon is a part of this team.
• 25:29
  SPEAKER_00: You want to make sure this team is listening to you and you're not feeling like another part of a conveyor belt.
• 25:34
  SPEAKER_00: Your PT is the one spending the most time with you.
• 25:38
  SPEAKER_00: Your physical therapist, your rehab provider.
• 25:40
  SPEAKER_00: They are the ones to catch it and should be the ones to catch it and be able to make sure you can feel educated about where you are at all times and what's ahead.
• 25:50
  SPEAKER_00: And in a case like this, being your own advocate and helping to empower you to advocate for yourself.
• 25:57
  SPEAKER_00: If we don't do it, no one else will.
• 26:00
  SPEAKER_00: That's why having an incredible ACL team and support system is so key, like this athlete did.
• 26:06
  SPEAKER_00: It will make or break the difference in your overall outcomes.
• 26:09
  SPEAKER_00: But the journey itself is just super challenging.
• 26:13
  SPEAKER_00: And if you feel like you don't have that, please make a change.
• 26:16
  SPEAKER_00: Don't wait, don't hope it gets better, don't leave it to chance.
• 26:19
  SPEAKER_00: That's an opportunity cost.
• 26:21
  SPEAKER_00: You can always get a second, third, fourth opinion.
• 26:24
  SPEAKER_00: There's so many incredible providers in the ACL rehab world.
• 26:29
  SPEAKER_00: And now geography is no longer a limitation because of technology.
• 26:33
  SPEAKER_00: We you can access elite-level care no matter where you are.
• 26:38
  SPEAKER_00: We work with people all over the world, and so do other people in this space who are doing great, great work.
• 26:44
  SPEAKER_00: So follow your gut.
• 26:46
  SPEAKER_00: Worst case, it's nothing.
• 26:48
  SPEAKER_00: Best case, you found it, and it's something that you could have prevented a lot of time loss and opportunity cost.
• 26:55
  SPEAKER_00: So this is something where I really want you to be able to just be in this driver's seat, feel in control, be your own advocate, and make sure you have the right team in your corner.
• 27:07
  SPEAKER_00: Your physical therapist will make or break your ACL rehab process, and I stand by that.
• 27:13
  SPEAKER_00: I hope that this was helpful, y'all.
• 27:15
  SPEAKER_00: This is just something that was weighing on my heart to share a story.
• 27:19
  SPEAKER_00: I'm sure many of you can relate, maybe people that you know feel you haven't heard been heard, right?
• 27:25
  SPEAKER_00: And so then, therefore, you just want to make sure you're working with people who hear you and who understand you, who empower you, and who make you feel like you know where you are at all times in this process.
• 27:37
  SPEAKER_00: And if they don't have an answer, they're going to look for it and find the best solution for you.
• 27:41
  SPEAKER_00: That is what you deserve.
• 27:42
  SPEAKER_00: I don't care where you live, what you do, what age you are, what sport you do, or what activity you do, you deserve elite level care because that is what good healthcare is, and it is accessible more now than ever.
• 27:55
  SPEAKER_00: So if you don't feel like you have that, then make a change.
• 27:59
  SPEAKER_00: Don't let the system be the default for you.
• 28:03
  SPEAKER_00: And I promise you, when you look back, you'll be like, I'm so glad I made that change.
• 28:08
  SPEAKER_00: And I always come back to like choosing your hard.
• 28:10
  SPEAKER_00: You could either choose the hard now, all these changes, maybe it's an investment, maybe it's a change of provider.
• 28:15
  SPEAKER_00: Um, and maybe it's a change of just going to a different clinic or a PT within the clinic.
• 28:20
  SPEAKER_00: Maybe it's changing things altogether, right?
• 28:22
  SPEAKER_00: But it's change, right?
• 28:23
  SPEAKER_00: And that's a hard thing to do.
• 28:25
  SPEAKER_00: Maybe it's a different surgeon, right?
• 28:27
  SPEAKER_00: Or maybe it is going through a different procedure that you need to have done, right?
• 28:31
  SPEAKER_00: But it's choosing your heart now versus choosing the heart later, which I promise you it'll be worse later.
• 28:37
  SPEAKER_00: And that's the thing that you don't want to wait for.
• 28:39
  SPEAKER_00: If it's comfortable now and you have to choose a hard later, it's gonna be much harder later.
• 28:43
  SPEAKER_00: So make that change now.
• 28:45
  SPEAKER_00: Be your own advocate.
• 28:46
  SPEAKER_00: Please reach out if you need anything.
• 28:48
  SPEAKER_00: We are here to help you.