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300 | Losing Your Outlet After An ACL Injury · 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: Ravi 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.
• 1:01
  SPEAKER_00: Okay, so it's typically the time you're physically active.
• 1:05
  SPEAKER_00: You're doing your thing, whether it's early in the morning, it could be around the lunchtime, it could be in the evenings, maybe for some of you it's after school, after work.
• 1:18
  SPEAKER_00: It could be any part of the day.
• 1:20
  SPEAKER_00: And it could be at the gym, it could be running, it could be at practice, it could be on the trails, on the mat, the court, whatever your version was.
• 1:32
  SPEAKER_00: And let's just throw out five o'clock, right?
• 1:36
  SPEAKER_00: Five o'clock p.m.
• 1:37
  SPEAKER_00: And now it's five o'clock p.m.
• 1:40
  SPEAKER_00: or whatever time it is.
• 1:41
  SPEAKER_00: You're on the couch, your leg is up, and you have no idea what to really do with yourself.
• 1:47
  SPEAKER_00: The day was stressful, you had a lot going on, the pressure's kind of still sitting on your chest, right?
• 1:54
  SPEAKER_00: And the one thing that always took the edge off isn't necessarily there anymore.
• 2:00
  SPEAKER_00: It's not available.
• 2:02
  SPEAKER_00: And if that's where you are right now, this episode is for you, where you do not necessarily have that thing that you have cared about so much that allows you to be you, allows you to move.
• 2:15
  SPEAKER_00: That's what we're talking about today.
• 2:17
  SPEAKER_00: So let's get into it and thank you guys so much for being here.
• 2:22
  SPEAKER_00: Today is episode 300 300.
• 2:27
  SPEAKER_00: And that's a pretty big deal.
• 2:28
  SPEAKER_00: It's basically 300 straight weeks of this podcast coming out, and it's something I am so proud of, something I did not even realize what would come of this podcast, besides me just putting this out there, trying to put some things together just for me to make sense of it, and it has become useful for you guys, which has been so valuable to hear, and I'm so appreciative of what this has become.
• 2:54
  SPEAKER_00: And this is not stopping anytime soon, but I am so proud of these 300 episodes.
• 2:59
  SPEAKER_00: So if you're listening to this, thank you so much for supporting.
• 3:02
  SPEAKER_00: If you just started, thank you for joining us.
• 3:05
  SPEAKER_00: I hope that you get something out of this that allows you to just feel in a better place.
• 3:10
  SPEAKER_00: I feel like in the world right now, it can be heavy.
• 3:13
  SPEAKER_00: In the ACL rehab process, it's more heavy than not.
• 3:16
  SPEAKER_00: I'm hoping that this gives you some answers or some clarity or just feeling seen more than anything.
• 3:22
  SPEAKER_00: And that's really my focus and purpose for today's episode is just to feel seen, to feel heard.
• 3:30
  SPEAKER_00: Also, some practical approaches to this, but I think it's very important.
• 3:34
  SPEAKER_00: And I'm gonna keep this one short today because I have been on some tangents on some previous episodes.
• 3:41
  SPEAKER_00: So I'm gonna apologize, y'all.
• 3:42
  SPEAKER_00: It is not usually something that I am like trying to stretch these episodes out, but I have a lot to say recently.
• 3:48
  SPEAKER_00: But with that said, my goal is to keep this super short, and so let's do that.
• 3:52
  SPEAKER_00: But I want to do two things.
• 3:54
  SPEAKER_00: First, I want to say out loud that losing your outlet is one of the hardest parts of an ACL injury, and it's not discussed very much, it's just kind of like a you deal with it, right?
• 4:07
  SPEAKER_00: But you lose something that is so important to you, or if it's seasonal based, you lose that thing when it comes up.
• 4:14
  SPEAKER_00: But for most people, whenever you have this injury, your life changes drastically, and it's not talked about enough.
• 4:22
  SPEAKER_00: And I see you guys.
• 4:24
  SPEAKER_00: I have personally dealt with this many of times in my life, even last year with my own major hip procedure.
• 4:30
  SPEAKER_00: So I see you guys, and I really resonate with this because it sucks.
• 4:34
  SPEAKER_00: I get it.
• 4:35
  SPEAKER_00: And second, I want to give you a few things you can actually do about it, not just complain about it, but it's something that feels practical, but it's okay to feel that way about it.
• 4:46
  SPEAKER_00: It's okay to complain, it's okay to be frustrated, it's okay to just just let it out there.
• 4:51
  SPEAKER_00: That's okay, and I think that's important in this process versus just being like, let's get through it, small wins, yes, let's do it.
• 4:56
  SPEAKER_00: Those things are important and it helps to keep the momentum going, but it's also okay to have those moments.
• 5:03
  SPEAKER_00: And I think as athletes going through this process, it's important to be able to have those moments and then get out of it quickly.
• 5:10
  SPEAKER_00: Not stay in the misery of it, get out of it quickly.
• 5:13
  SPEAKER_00: But sometimes it could be cathartic, and I think that it's really needed because a lot of times people don't really understand what people are going through as they're walking in these shoes.
• 5:23
  SPEAKER_00: You just don't get it.
• 5:25
  SPEAKER_00: And as much as I would love to say you do, you don't really know until you've walked in those shoes.
• 5:31
  SPEAKER_00: And even every single shoe has a very different journey to it.
• 5:35
  SPEAKER_00: So it's even harder to spread that across every single person going through this process.
• 5:41
  SPEAKER_00: But I want to be just very transparent and real about this.
• 5:46
  SPEAKER_00: When I people hear the ACL process, they think the knee, a physical injury, the ligament, the surgery, the rehab, the physical stuff.
• 5:56
  SPEAKER_00: What they don't see is what you actually lose in this.
• 6:00
  SPEAKER_00: You lost the thing that may get you out of bed, right?
• 6:06
  SPEAKER_00: The thing that really drives you, the thing that made you feel strong, confident, capable, and like yourself.
• 6:12
  SPEAKER_00: Because this injury doesn't happen to someone who's on the couch.
• 6:15
  SPEAKER_00: Now you can have some freak accidents, and we've had people who are completely sedentary who tear their ACL with just random accidents, whether it's a car, falling off a chair, you name it.
• 6:27
  SPEAKER_00: But I would say 95% plus of these people who have this injury are doing something physical.
• 6:34
  SPEAKER_00: So that is the thing that is challenging with this because that is something that you lose.
• 6:40
  SPEAKER_00: And the place you went when maybe work was crushing you, or kids are melting down, or school is a lot, or you're feeling the pressure of your peers, whatever context it may be, it is something that I totally get.
• 6:56
  SPEAKER_00: Like your brain won't shut off.
• 6:58
  SPEAKER_00: You know, there's so many things that the just existence of life is weighing on you, right?
• 7:05
  SPEAKER_00: Yeah, I've been there.
• 7:06
  SPEAKER_00: I tore my ACL, my first one, whenever I was 16, and then I couldn't play sports my junior year.
• 7:13
  SPEAKER_00: And at that age, sports were basically my whole personality.
• 7:16
  SPEAKER_00: I was the athlete who played year-round sports.
• 7:18
  SPEAKER_00: My friends were all doing the same sports.
• 7:21
  SPEAKER_00: So whenever I tore my ACL, I would have to be on the sidelines and I would have to participate.
• 7:26
  SPEAKER_00: I wasn't able to be active, I wasn't able to exert myself.
• 7:30
  SPEAKER_00: Like it sucked, and it's something that didn't feel awesome.
• 7:34
  SPEAKER_00: And then I had to take time away to go rehab and try and get this knee in a better place.
• 7:38
  SPEAKER_00: So I also didn't necessarily get to do some of the hangouts that maybe some of my other friends would do, or some of the things that they were going to do, like go to the lake or go to the beach, or even just go hang out with some friends and ride bikes or whatever it is when you're, you know, that age and just kind of hanging out.
• 7:56
  SPEAKER_00: It's just the small little things, and I know that seems very little, but for someone who is, you know, 16 years old, 14 years old, 13 years old, or even 18 years old, like in those ranges, like that's a lot.
• 8:10
  SPEAKER_00: Like there are certain things that it could be the social pressure of things that are really frustrating that you're losing alongside this physical ability that you really rely on.
• 8:19
  SPEAKER_00: And again, my world was not that big at that point, right?
• 8:23
  SPEAKER_00: But it still is big to that person.
• 8:25
  SPEAKER_00: So that's really important here for the young athletes, right?
• 8:29
  SPEAKER_00: And then when you're looking at my second ACL, right, it was my senior year of undergrad.
• 8:35
  SPEAKER_00: Completely different context of life, round two.
• 8:38
  SPEAKER_00: It was harder, more setbacks.
• 8:40
  SPEAKER_00: And getting through it twice did not make it easier.
• 8:43
  SPEAKER_00: So that was really hard because I didn't necessarily have people there to care for me like I did when I was in high school.
• 8:49
  SPEAKER_00: I had to kind of navigate this alone.
• 8:51
  SPEAKER_00: Financially, I was in a much more stressful position.
• 8:54
  SPEAKER_00: I was someone who had taken a lot of effort into taking care of my body and getting in good shape.
• 9:00
  SPEAKER_00: And that was derailed because I had my ACL injury.
• 9:05
  SPEAKER_00: And it was my second one.
• 9:06
  SPEAKER_00: So I started to rethink a lot of things as well.
• 9:08
  SPEAKER_00: So it made me a little more scared of the process and re-injury.
• 9:12
  SPEAKER_00: And with this second ACL injury, it was really challenging because I was also applying to grad school.
• 9:18
  SPEAKER_00: I was trying to figure out what to do and trying to see if this is all gonna work out.
• 9:24
  SPEAKER_00: So I just felt so much stress.
• 9:25
  SPEAKER_00: And the hard part about it is that I couldn't get that stress out because I couldn't be as physically active.
• 9:31
  SPEAKER_00: I couldn't just go on a run.
• 9:32
  SPEAKER_00: I couldn't just go to the gym and do a full intense body workout, right?
• 9:36
  SPEAKER_00: So there were a lot of things I felt limited by that I could typically do to be able to get stress out.
• 9:42
  SPEAKER_00: And so that's something that I know a lot of you relate because doing physical activity allows you to feel like yourself, but then also being able to just let that steam out.
• 9:52
  SPEAKER_00: And then the same thing with my hip last year.
• 9:55
  SPEAKER_00: So crazy, so different.
• 9:56
  SPEAKER_00: I had a kid, I have a business that I'm running.
• 9:59
  SPEAKER_00: Like there are a lot of moving pieces, and it's just something where, again, different context of life, but I felt very limited by this.
• 10:08
  SPEAKER_00: And I have always had like weight-related challenges, and I've had to work really hard to do well in terms of trying to maintain that, and in terms of like, I can easily just like sit around and gain weight really easily.
• 10:20
  SPEAKER_00: So that is something that I've always been self-conscious about, and is something, especially as a young kid, I was very overweight and picked on.
• 10:27
  SPEAKER_00: And so that's always been a sensitive thing for me.
• 10:29
  SPEAKER_00: So those feelings kind of started coming back, right?
• 10:32
  SPEAKER_00: And I know for some of you guys, like that might be something that crosses your mind of like whether it's like, yeah, maybe it is something from like a personal identity thing or a physical thing, those things layer into this.
• 10:43
  SPEAKER_00: And I just want you to know, uh, I feel you, like it's something that is real, and I just, you know, it's just something that in this process, it just becomes very physical, more so focused to the knee, and everything outside of it gets kind of like pushed to the side.
• 13:02
  SPEAKER_00: And I talk to Asailers every week, and the story's the same, even when people's lives look very different, right?
• 13:10
  SPEAKER_00: The context of them.
• 13:11
  SPEAKER_00: It could be the med student who hit the gym between lectures to keep their head straight.
• 13:15
  SPEAKER_00: It could be the busy mom whose you know, 6 a.m.
• 13:18
  SPEAKER_00: workout was the only hour that she would actually get to be able to take to herself that made her feel like herself before a crazy day ahead.
• 13:26
  SPEAKER_00: The CEO who ran at night to process the day, the nurse who came off a 24-hour shift and needed to move, the software engineer who sat at his desk all day for 10 hours and lived for the evening lift or getting out there to be able to go climb.
• 13:42
  SPEAKER_00: The high school athlete whose friend group, the whole friend group, is the team.
• 13:47
  SPEAKER_00: The skier staring down a winter that they might miss because seasonally it makes it really hard.
• 13:52
  SPEAKER_00: You can't do it year round.
• 13:54
  SPEAKER_00: The hiker, the climber, the lacrosse player, the weekend warrior who just wanted to feel like an athlete, different lives, same exact just challenges, y'all.
• 14:04
  SPEAKER_00: The same exact thing where they are feeling limited in some of the things that they can do, especially the outlet that they care about.
• 14:11
  SPEAKER_00: You know, here's what I want you to hear with this.
• 14:13
  SPEAKER_00: You're not necessarily being dramatic, you're not weak, and you don't necessarily have a bad attitude.
• 14:18
  SPEAKER_00: Like I said, it's fair to feel these things.
• 14:21
  SPEAKER_00: You lost something that did a lot of work for you, and you don't realize it until you lose it.
• 14:26
  SPEAKER_00: You really don't.
• 14:27
  SPEAKER_00: Even the simplicity of being able to walk, right?
• 14:29
  SPEAKER_00: And you're on crutches and you might not be walking normal.
• 14:32
  SPEAKER_00: That is something that people take for granted until they have to deal with it, and then they're like, wow, I really underestimated that.
• 14:40
  SPEAKER_00: So glad I could do that now, right?
• 14:42
  SPEAKER_00: But this is all just about something that was important to you.
• 14:47
  SPEAKER_00: It helped you.
• 14:48
  SPEAKER_00: And feeling that loss makes complete sense in a situation like this.
• 14:53
  SPEAKER_00: So you give yourself a day, a week to be mad about it, right?
• 14:57
  SPEAKER_00: You don't have to find the silver lining today.
• 14:59
  SPEAKER_00: Just know that.
• 15:00
  SPEAKER_00: And I think that's important.
• 15:02
  SPEAKER_00: You might be in a certain period where you have a setback and you're maybe not having as much flexibility or direction around how to be active.
• 15:10
  SPEAKER_00: Or maybe it's just as soon as you are, you're getting this thing flared up, or it's just not going the way you want it.
• 15:16
  SPEAKER_00: So that's okay.
• 15:17
  SPEAKER_00: But I tell all my athletes when you feel this, let's feel it and then get through it and move fast through it, right?
• 15:24
  SPEAKER_00: If you need more processing time, then that is totally fair.
• 15:27
  SPEAKER_00: People can get burned out by this process.
• 15:29
  SPEAKER_00: There can be a lot of weight outside of just the process itself.
• 15:33
  SPEAKER_00: We have people who lose family members, we have people who are going through pregnancy-related things.
• 15:38
  SPEAKER_00: We have people who have other life stressors like work, getting laid off.
• 15:43
  SPEAKER_00: We have people who are trying to get into schools that are important to them or certain levels of sport.
• 15:49
  SPEAKER_00: So there are so many layers that can compound on top of just this feeling of not feeling like yourself.
• 15:55
  SPEAKER_00: So you can give yourself that time and opportunity to be able to do that versus feeling like you have to just be strong and push through it immediately and just push, push this stuff to the side.
• 16:05
  SPEAKER_00: So I think feeling it sometimes can be helpful as long as we just don't wallow in it too long.
• 16:10
  SPEAKER_00: Now, follow me here though.
• 16:13
  SPEAKER_00: Picture this pressure cooker, though.
• 16:15
  SPEAKER_00: It's got a little valve on the top that lets that steam out.
• 16:19
  SPEAKER_00: Take the valve off, and the pressure doesn't disappear, right?
• 16:23
  SPEAKER_00: It just keeps building, it keeps building slowly and slowly, right?
• 16:27
  SPEAKER_00: Your training was that valve, right?
• 16:29
  SPEAKER_00: It helped to release it.
• 16:31
  SPEAKER_00: The injury essentially took that off, right?
• 16:34
  SPEAKER_00: There are other ways, yes, to relieve the stress, but the injury really removed that valve or your ability to control that valve.
• 16:41
  SPEAKER_00: But the stress didn't go anywhere.
• 16:42
  SPEAKER_00: Your life still carried on.
• 16:44
  SPEAKER_00: You still have the school stress, the work stress, you have the family stress, you have the all the other personal stress that you might be dealing with or professional.
• 16:53
  SPEAKER_00: That didn't go anywhere.
• 16:55
  SPEAKER_00: It's still building, and that's why you can sometimes feel so wound up, along with a very challenging, long up and down process.
• 17:03
  SPEAKER_00: So you can be feeling irritable, you can feel off, and that is normal to be feeling that way.
• 17:09
  SPEAKER_00: But the goal is to get a new valve on as soon as it's safe to do so, if you will.
• 17:15
  SPEAKER_00: And here's the way I think about it your outlet was doing jobs for you, right?
• 17:20
  SPEAKER_00: Stress relief, confidence, your identity, the I'm a runner, the I'm an athlete part, structure to your day.
• 17:28
  SPEAKER_00: And for a lot of you, time with people, right?
• 17:31
  SPEAKER_00: There is a community aspect to being able to be active, whether it's your sports team, whether it's you know the skiing group, whether it is being out on the trails, whether it is the tennis club that you're a part of, maybe it is being able to be a part of like some intramural team.
• 17:49
  SPEAKER_00: Like there's so many layers to this that community connects to this.
• 17:53
  SPEAKER_00: Even just getting to the gym to be able to lift and see your familiar people that you like to talk to, right?
• 18:00
  SPEAKER_00: Most ACLers try to replace the exact activity, can't, and decide there's really no placement.
• 18:06
  SPEAKER_00: So let's replace the jobs instead.
• 18:09
  SPEAKER_00: You can get the activity back later.
• 18:11
  SPEAKER_00: And I think that's something important here.
• 18:13
  SPEAKER_00: First, the mental side.
• 18:15
  SPEAKER_00: Grab a notebook and write down what training did for you.
• 18:18
  SPEAKER_00: Write those things out.
• 18:20
  SPEAKER_00: Then, next to each of those, write one thing that could do it this week.
• 18:25
  SPEAKER_00: I know it's not the same thing, but it is something that could help serve to fill that gap.
• 18:30
  SPEAKER_00: And before there's eye rolls about this, just give this a try.
• 18:34
  SPEAKER_00: So it could be a walk with a friend, covers the people part, or even on the phone.
• 18:39
  SPEAKER_00: Maybe it's a cathartic text to somebody.
• 18:41
  SPEAKER_00: Write down three wins from rehab, maybe covers the confidence piece, or at least gives you a little bit of a nudge in that positive direction.
• 18:50
  SPEAKER_00: Journaling or gratitude work sounds cheesy, I know, but in my experience, it gives the brain somewhere to put the pressure.
• 18:57
  SPEAKER_00: Try five minutes at the same time you used to train, for example, and that hour starts to mean something again to you.
• 19:03
  SPEAKER_00: So that could be something to put into place for that mental side.
• 19:06
  SPEAKER_00: Second, keep moving.
• 19:08
  SPEAKER_00: Everything I'm about to say lives inside what your surgeon and, of course, your PT clear you for.
• 19:13
  SPEAKER_00: The knee is gonna set the boundaries around this, and the rest of your body still gets to train.
• 19:18
  SPEAKER_00: It's just the knee, right?
• 19:20
  SPEAKER_00: So it doesn't mean that you're needing to be a couch potato here just because you tore your ACL.
• 19:25
  SPEAKER_00: Even the people who are post-op, post-injury, depending on where you're at, that can mean upper body work, training the other leg, a mix of machines and free weights, isolating specific muscle groups, or conditioning that gets your heart rate up without loading or stressing the knee.
• 19:40
  SPEAKER_00: We do this with our athletes all the time, and we start early as long as there's no restrictions.
• 19:45
  SPEAKER_00: And we have had people locked in a brace, non-weight bearing, being able to do some biking, some ski erg, if you will, and being able to do different modalities to be able to still get a stimulus and still train around this.
• 19:58
  SPEAKER_00: It doesn't mean you need to stop.
• 20:00
  SPEAKER_00: And then, third, get someone who knows movement to make it intentional.
• 20:05
  SPEAKER_00: This is where programming matters.
• 20:07
  SPEAKER_00: Someone who can look at your phase, your restrictions, that your actual life, and build something specific so your fitness doesn't just sit, you know, on pause with a situation like this while the knee is having to heal, right?
• 20:21
  SPEAKER_00: There is going to be an appropriate amount of stress and stimulus that anyone can have.
• 20:25
  SPEAKER_00: And I promise you, there is no one that we know of that is just like you have to sit and do nothing.
• 20:31
  SPEAKER_00: And that is actually the most counterproductive thing to do, even though it feels right after you have an ACL injury or surgery, is to just rest and let it heal.
• 20:41
  SPEAKER_00: Yes, respect and protect that healing process, but at the same time, your fitness at the floor and your ceiling needs to stay up.
• 20:49
  SPEAKER_00: So that way the climb back isn't so hard.
• 20:51
  SPEAKER_00: So there is a way to do that and get that feeling of an effect of feeling like an athlete.
• 20:57
  SPEAKER_00: And I think a lot of our athletes value this because we can still keep them training without the knee paying for it.
• 21:03
  SPEAKER_00: And that is where you need a unique process to do this and someone to help guide and know this process really well.
• 21:10
  SPEAKER_00: We work with all of these people: the med students, the moms, the CEOs, the healthcare workers, the engineers, the high school student.
• 21:17
  SPEAKER_00: We had an engineer sign up today, and we had a healthcare worker sign up today.
• 21:22
  SPEAKER_00: And they were part of this conversation where I was talking through to them about this outlet that they have lost, and it actually spurred this conversation and this podcast episode.
• 21:32
  SPEAKER_00: And I thought it was just perfect to be able to bring on today because I feel like a lot of you in this are just kind of going through the motions of this and trying to get through the ACL process and get there to do those things.
• 21:46
  SPEAKER_00: But it doesn't need to sit on pause.
• 21:48
  SPEAKER_00: And I think that's something that's really important here is that the knee rehab stays the same, but what changes is the stimulus that we build around your life.
• 21:57
  SPEAKER_00: So then that way you could still get what you need from this to fill that gap, right?
• 22:02
  SPEAKER_00: And that's gonna be really important for you to be able to feel that while you're on this journey versus having to put that on the shelf until later.
• 22:11
  SPEAKER_00: So coming back to this timing of whenever you usually do this physical activity where it feels like you to be able to exert that.
• 22:20
  SPEAKER_00: Whenever that hits, do one small thing, write down the jobs your outlet did.
• 22:25
  SPEAKER_00: And next to each one, pick one thing for this week, and that's it.
• 22:28
  SPEAKER_00: I know this part of the ASL rehab is brutal, it sucks.
• 22:32
  SPEAKER_00: And I see you guys, you'll get your outlet back, I promise.
• 22:35
  SPEAKER_00: And in the meantime, you don't have to go without one.
• 22:39
  SPEAKER_00: So find what that alternative is.
• 22:41
  SPEAKER_00: And if you want help building around this process, just reach out to us, and we're here to help if you're needing it.
• 22:48
  SPEAKER_00: So thanks for listening.
• 22:50
  SPEAKER_00: I see you guys, and if you need anything, please reach out.
• 22:53
  SPEAKER_00: This is your host, Robbie Vitel, signing off.