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225 | Vacation or Setback? Navigating Travel During ACL Rehab · 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.
• 1:00
  SPEAKER_00: What is up, y'all, and welcome back to another episode on the ACL Athlete podcast.
• 1:07
  SPEAKER_00: So today we are talking about all things navigating traveling during your ACL rehab.
• 1:15
  SPEAKER_00: And at the time of this recording, summer is upon us here in the States.
• 1:20
  SPEAKER_00: That means a lot more travel for people.
• 1:23
  SPEAKER_00: So we have ACLers who have these trips planned, and we're talking, you know, whether it's the 14-year-old to the you know 60-year-old to all in between, right?
• 1:35
  SPEAKER_00: And everyone's wanting to get out and do things and be able to go on these trips, whether it's maybe to the lake, maybe it is to go visit some family, maybe it is to go on a trip with their friends and international trips, right?
• 1:50
  SPEAKER_00: And so I just want to talk about this concept in general because I think it's really, really important in ACL rehab because most people are going to deal with this variable, and the timing of it is actually really going to influence things a lot.
• 2:06
  SPEAKER_00: And so what we'll often get asked is, should I go on this trip?
• 2:11
  SPEAKER_00: And the ACLR will ask us this.
• 2:13
  SPEAKER_00: Maybe the parent of the ACLR will ask us this.
• 2:16
  SPEAKER_00: And this can be a really challenging question because of just where the ACLR is in the process, and also what is the trip or the travel or what do they want to do, right?
• 2:28
  SPEAKER_00: And that opens up the conversation with ACLR around this cost-benefit analysis of the trip, right?
• 2:37
  SPEAKER_00: And there's a lot of factors that go into it.
• 2:40
  SPEAKER_00: How long is a trip?
• 2:41
  SPEAKER_00: What is their knee status going into it?
• 2:43
  SPEAKER_00: Like, where are they at in the process?
• 2:45
  SPEAKER_00: What are they doing on the trip?
• 2:47
  SPEAKER_00: Will they have time to rehab or even have the equipment to do so?
• 2:52
  SPEAKER_00: And the thing for us is that we're never going to steer someone away from it unless it is very harmful for their recovery or maybe put them at risk.
• 3:02
  SPEAKER_00: Otherwise, we do try to educate as best as we can and help to game plan what's the best way to manage the knee during this process and essentially keep the rehab process going, ideally.
• 3:14
  SPEAKER_00: And this is just something that can be a bit of a challenge because there are situations where we're like, this is actually going to set your knee back, but they are really set on going on the trip.
• 3:24
  SPEAKER_00: And it's just one of the things that we just have to dance with, right?
• 3:27
  SPEAKER_00: As coaches, as rehab providers, and to be transparent and not sugarcoated to the athlete or their parent, and to be able to share, like, hey, this is something that we're not going to really make progress here, especially if this is what you guys are going to be doing.
• 3:44
  SPEAKER_00: There's going to be a lot of walking, there's not going to be any access to equipment.
• 3:48
  SPEAKER_00: It's just one of those things where it is what it is.
• 3:51
  SPEAKER_00: And so that's where it's just going to be a conversation to have.
• 3:56
  SPEAKER_00: And the thing with traveling is knowing that this just means in general a change for the ACL or day-to-day routine.
• 4:05
  SPEAKER_00: Of course, when someone is going through this process, they are typically doing their rehab and then they are doing their thing, whether it's with school or whether it is with work or whatever their status may be in terms of what they're doing in their day-to-day, but it is a change to their day-to-day routine because of travel, right?
• 4:24
  SPEAKER_00: And so them actually doing their actual rehab is going to really factor in the time availability on the trip.
• 4:32
  SPEAKER_00: The schedule is generally messier.
• 4:34
  SPEAKER_00: It's just harder to navigate because there's a lot of moving pieces.
• 4:38
  SPEAKER_00: Usually there's not a built-in structure for this depending on the person.
• 4:42
  SPEAKER_00: And so then therefore they're just kind of working with what they got and they see what happens when they get there.
• 4:48
  SPEAKER_00: Gym access or equipment access is a big player in this because we know we need external load to get heavier and get stronger.
• 4:55
  SPEAKER_00: And so that could be challenging based on the travel and where they are, especially if they're bopping around place to place.
• 5:02
  SPEAKER_00: And then plus, they are typically on their feet more.
• 5:05
  SPEAKER_00: With travel, you're just naturally on your feet more.
• 5:07
  SPEAKER_00: You got to go to the airport, even if you're in a car, you know, you're going to just be on your feet more in the day-to-day versus not, because travel typically equates to just more step counts.
• 5:20
  SPEAKER_00: It's just by nature of the task itself, unless you're somehow managing getting in a car, going to a beach, sitting at the beach, and not doing very much, even within that, you're probably taking a lot of steps in the totality of the day.
• 5:34
  SPEAKER_00: And so that brings me to my next point: having a game plan.
• 5:38
  SPEAKER_00: That's what is so key with travel here.
• 5:41
  SPEAKER_00: Travel is not one of these things where it's like, all right, let's just take a break and be done.
• 5:45
  SPEAKER_00: And that's what I'm going to talk about next is the caveat with this.
• 5:49
  SPEAKER_00: But travel, there needs to be a continuation of the game plan.
• 5:52
  SPEAKER_00: And that's where it's important to talk to your provider.
• 5:55
  SPEAKER_00: Ideally, they can provide an adaptable plan with this.
• 5:58
  SPEAKER_00: And so that's where having a game plan around this is so key based on what is coming up with your schedule, the travel, or whatever that may be that is coming up.
• 6:08
  SPEAKER_00: And this is where we want to continue that rehab process while the travel is in play.
• 6:14
  SPEAKER_00: I gather there are some trips or situations where it is less ideal.
• 6:17
  SPEAKER_00: And sometimes it just is what it is.
• 6:20
  SPEAKER_00: It's like you can't really rehab, you're going to be gone for this period of time, you're not going to have access to anything, you're going to be on your feet moving around a lot.
• 6:28
  SPEAKER_00: And so then therefore it's just a challenge, right?
• 6:31
  SPEAKER_00: And I think we have to sometimes accept that for what it is.
• 6:34
  SPEAKER_00: But if we can sometimes maybe set ourselves up a little bit better, that's what's going to be ideal, especially if you're saying, Hey, what is going to make this successful while I travel?
• 6:46
  SPEAKER_00: And the goal is going to be to keep the rehab process going while you're away.
• 6:51
  SPEAKER_00: And coming back to that caveat, there might be around the length of the trip as well as where you're at in the rehab process, where it could be understood to do maybe less or even take a break, for example, is when it's a shorter trip.
• 7:07
  SPEAKER_00: Of course, if it's like three days, don't sweat it.
• 7:10
  SPEAKER_00: Like you're good.
• 7:11
  SPEAKER_00: But if we're starting to teeter into, you know, four or five, seven days, there's time and place where it might actually be beneficial to take a break during this time.
• 7:21
  SPEAKER_00: And it has to be very intentional.
• 7:24
  SPEAKER_00: So, for example, when athletes are maybe in a stuck point or they are just kind of burned out a little bit from ACL rehab, when maybe they are transitioning out of a heavy block and they just kind of need a break to just be able to transition.
• 7:38
  SPEAKER_00: Maybe they're at the three-month mark, the six six-month mark.
• 7:41
  SPEAKER_00: You know, it could be eight months, right?
• 7:44
  SPEAKER_00: And there's no time sensitivity to getting back to something, then it could be beneficial.
• 7:49
  SPEAKER_00: And I typically see this coinciding more with ACLers being more mid to late stages in the process.
• 7:56
  SPEAKER_00: For post op, probably not, um, because we are working on the early phase components like range of motion, swelling, gait, quads, etc.
• 8:05
  SPEAKER_00: And this needs very consistent daily frequency, especially in the early parts of the process.
• 8:11
  SPEAKER_00: So when you take seven days away from working on extension work, that's going to honestly be a very, very big thing that is going to impact potentially gaining that extension back because every single day is moving the needle, especially from a range of motion standpoint or navigating your swelling and whatnot.
• 8:29
  SPEAKER_00: So things to just consider here.
• 8:31
  SPEAKER_00: We actually plan in breaks for our ACLers, as I shared, since they've been in this process for a minute, whether it's a longer end of the week during a certain period of the block, or maybe it's an entire recovery week, as I shared, where we tell them to get out of the gym and enjoy life and to not think about their knee in the ACL.
• 8:49
  SPEAKER_00: And we can find that this is mentally helpful for our athletes because of the long process, and oftentimes they come back stronger because of how the break benefits their mental health and the physical health.
• 9:02
  SPEAKER_00: And so you're not also going to lose your gains in these stages, either based on not lifting for a week, for example.
• 9:10
  SPEAKER_00: Residual training effects for our body take longer than just a week.
• 9:14
  SPEAKER_00: So that's why I'm kind of giving the rough week time frame.
• 9:18
  SPEAKER_00: But I will say and be honest here that most people aren't here in their ACL rehab, especially if you're in earlier phases, as I mentioned.
• 9:28
  SPEAKER_00: This needs to be very intentionally designed and it needs to be structured and given to the athlete.
• 9:34
  SPEAKER_00: And yeah, you can communicate with your physical therapist, rehab provider to talk about an option like this, but we need to make sure you've earned it, to be honest.
• 9:43
  SPEAKER_00: And I think that's the thing here is that that can make it challenging because with a trip, we are trying to look at essentially is this longer than seven days?
• 9:53
  SPEAKER_00: And that's where this is going to be really important because we need to have a structured game plan.
• 9:59
  SPEAKER_00: Ideally, within those seven days, unless you've earned it to take that break, then therefore it might be something to still embed in some things to keep things moving along.
• 10:09
  SPEAKER_00: So when our athletes say they're going to be traveling, we build this out so we can keep the compounding effect going and we make sure we get their schedule, equipment access, the time availability, even if it's like a 20-30 minute window that they have, we try to build this in and build it to them.
• 10:25
  SPEAKER_00: And sometimes that might be just focusing on some bodyweight isometric work, and there's ways we can manipulate the physics to make it a little bit more challenging on the areas we want to.
• 10:37
  SPEAKER_00: And then sometimes it's literally a full-blown SNC program because they have a gym, they have access, also depends on the type of travel and the trip itself.
• 10:46
  SPEAKER_00: But we have a lot of ACLers where they're just like, Yeah, I've already looked up the gym at this hotel, or I can do a guest pass at this gym.
• 10:53
  SPEAKER_00: And it's clutch because we can keep things moving along and there's no hiccups, and these people tend to come back just continuing on smoothly in the process, versus having these very abrupt stops and starts, and it ends up just delaying longer than we think it does.
• 11:10
  SPEAKER_00: And we do have people who we work with who are travelers working in different places, and then also people who travel for work weekly.
• 11:19
  SPEAKER_00: So we make sure the programming is as adaptable as possible, no matter where they are, keeping the focus on the main things.
• 11:28
  SPEAKER_00: And the last point I want to make here is that often because we're human, that people will just not want to do their rehab or get a bit lazy.
• 11:37
  SPEAKER_00: I get it, the schedule is a little different, you're not in your normal environment.
• 11:41
  SPEAKER_00: You don't want to be in this process to begin with, let's be honest.
• 11:44
  SPEAKER_00: And you feel some freedom with travel where you're just like, all right, I need to just disconnect.
• 11:49
  SPEAKER_00: And honestly, it travel can be a little bit of an excuse.
• 11:54
  SPEAKER_00: And don't get me wrong, y'all go enjoy your stuff, do the thing, but if you can bake in some movement, guys, it will help you in the long run.
• 12:02
  SPEAKER_00: I promise you this, unless you're someone who's like, I'm burned out and I just need this break, and it's a like a week, as I said, maybe five days, a week.
• 12:12
  SPEAKER_00: I get it.
• 12:13
  SPEAKER_00: But in most situations, I find that ACLers they just kind of want to disconnect from it, and the trip is something that is a good excuse to disconnect from it, but then that really does impede their progress, and especially when they get back, it's a lot harder to get back going.
• 12:31
  SPEAKER_00: And I'm going to share this based on working with a lot of ACLers.
• 12:34
  SPEAKER_00: Whether it's the 14-year-old that has these seven thousand 7,000 trips that are planned in the summer, it's wild, y'all.
• 12:42
  SPEAKER_00: Kids are busy, high school kids are busy, and trying to manage their schedules and get them to do this stuff while they're traveling with their parents or friends is challenging.
• 12:53
  SPEAKER_00: And then, therefore, it's also going to the person who travels maybe two weeks at a time and you know they have a working job, it's remote or flexible, or they're just taking the time off.
• 13:03
  SPEAKER_00: So those are things that I just want to share here because if you don't plan intentionally, your progress will be impacted.
• 13:11
  SPEAKER_00: And I think it's important to understand this.
• 13:13
  SPEAKER_00: And more importantly, is that even though the trip is two weeks, for example, it tends to run into the next week when you get back.
• 13:21
  SPEAKER_00: It's longer than two weeks.
• 13:23
  SPEAKER_00: So a lot of times people are like, oh, it'll be two weeks and then I'll get right back to it.
• 13:27
  SPEAKER_00: No, it's not.
• 13:28
  SPEAKER_00: People need to readjust back to life and their routine.
• 13:32
  SPEAKER_00: You'll hear the thing is like, I need a vacation for my vacation, because unless you are literally sitting pullside and you're not doing anything for seven days, then therefore maybe your body is a little fatigued from the trip, your schedule, the adjustments of sleeping, your normal routine.
• 13:48
  SPEAKER_00: And the body is usually the effect of not being in the gym and rehabbing.
• 13:54
  SPEAKER_00: Not saying you're losing all these drastic gains, but you will feel that difference.
• 13:59
  SPEAKER_00: So when it takes another week or longer, it's going to be a little bit normal to feel that if you've been away for especially a longer period of time based on where you were.
• 14:09
  SPEAKER_00: So just something to consider.
• 14:11
  SPEAKER_00: So if you're doing a 10 to 14 day trip, then just know it'll be longer to get back into the groove.
• 14:16
  SPEAKER_00: It might be another week or so.
• 14:18
  SPEAKER_00: Um, it could be even longer.
• 14:19
  SPEAKER_00: We've seen people where it just takes longer, they get sick coming back from the trip, and then therefore it just extends the thing another week or two.
• 14:27
  SPEAKER_00: So in the grand scheme, it can just feel like a long delay of, you know, if you take a 14-day trip, then it takes another week.
• 14:36
  SPEAKER_00: That's three weeks that you haven't necessarily been intentional about your rehab.
• 14:41
  SPEAKER_00: And this is not to mention that if you're earlier in the process, you'll likely see a regression of your range of motion and your knee will feel a bit more tight and stiff because trips usually mean on your feet more and more step count.
• 14:54
  SPEAKER_00: So for people in the earlier stages, it is even more important to make sure you stay as consistent as possible and manage your step count, especially.
• 15:03
  SPEAKER_00: So, my suggestion here, based on this episode today, is to just make sure you talk with your rehab provider and let them know your travel plans.
• 15:11
  SPEAKER_00: Make a game plan to keep the needle moving, most importantly.
• 15:15
  SPEAKER_00: Do your best not to skip things during this time, especially if you're in the earlier stages.
• 15:21
  SPEAKER_00: Expect for the knee to potentially get a bit grumpy and know that it's likely because you've spiked your step count, your daily activity in general, and the way just traveling goes, again, more impactful for the earlier phase ACLers and also ones with a bit more of a tricky, symptomatic, and maybe someone who's dealing with a little bit more swelling that's sticking around.
• 15:44
  SPEAKER_00: The longer the trip, the more you need to make sure this plan is more detailed to not miss a beat.
• 15:50
  SPEAKER_00: And if you're going on a longer trip, add another week at minimum, if you plan not to rehab or you don't really get much done, because it's going to take at least this much time to get back into the swing of things.
• 16:03
  SPEAKER_00: Again, if you don't do anything on the trip, which happens, right?
• 16:07
  SPEAKER_00: Even people plan, like, oh, I was gonna do this, but then you know, schedule or we were doing this, so then I didn't really have much time to do this.
• 16:14
  SPEAKER_00: And so then, therefore, I think it's just important to prioritize this, especially the longer the trip.
• 16:19
  SPEAKER_00: And the people who just stay consistent with this, y'all, they get back and they just it's it's like they were on the on-ramp and they just were on the interstate and they just kept going.
• 16:30
  SPEAKER_00: Versus this, this like abrupt, like if you go on this trip, it's like kind of fighting the city traffic and then trying to get back on the interstate.
• 16:38
  SPEAKER_00: And so you have to take the on-ramp, and that's your week back, and then you're on the interstate again, right?
• 16:43
  SPEAKER_00: So this is just something that we see so so so consistently with athletes and ACLers, and it really does make a huge difference in their progress, in the time frame, and the way that they look at things in terms of their ACL rehab in general, and especially from a mindset component as well.
• 17:03
  SPEAKER_00: So keep this in mind, y'all, um, as you are embarking on your travels, and if you need anything, then please reach out to us.
• 17:12
  SPEAKER_00: Hope that this was helpful.
• 17:14
  SPEAKER_00: This is your host, Robbie Patel, signing off.