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113 | Athlete Wins 6.0 · The ACL Athlete Podcast

• 0:19
  SPEAKER_00: Welcome everyone to the ACL Athlete Podcast.
• 0:23
  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.
• 0:33
  SPEAKER_00: I'm your host, Dr.
• 0:34
  SPEAKER_00: Ravi Patel, performance physical therapist and coach.
• 0:38
  SPEAKER_00: Between myself and fellow guests and experts, you'll learn through the lens of the patient, the healthcare professional, and the coach.
• 0:46
  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.
• 0:57
  SPEAKER_00: Thanks for joining.
• 0:58
  SPEAKER_00: Now let's dive into today's episode.
• 1:03
  SPEAKER_00: What is up, team?
• 1:04
  SPEAKER_00: We are back with another episode, Athlete Wins 6.0.
• 1:09
  SPEAKER_00: And if you're new to this and tuning in, this is where we like to talk about some of our athlete wins, highlight some of the ups and downs in the process, but especially those positives and those ACLer wins that we're looking for, especially when this process can be so long, so daunting, it's hard to see light at the end of the tunnel.
• 1:27
  SPEAKER_00: So we love to bring to light some of our athletes who are absolutely crushing it.
• 1:33
  SPEAKER_00: And so this week we are coming at you with one of our most dedicated ACLers we've ever worked with.
• 1:39
  SPEAKER_00: And her name is Rebecca, and she is a remote ACLR graduate, someone I had the pleasure of working with.
• 1:46
  SPEAKER_00: And it's pretty cool.
• 1:47
  SPEAKER_00: So she recently got cleared to return to full competition.
• 1:51
  SPEAKER_00: And she actually had a competition this past weekend that I want to highlight.
• 1:56
  SPEAKER_00: But before we do that, I actually want to take you on a little bit of a journey that Rebecca had with her ACL injury, with her surgery, with her rehab.
• 2:04
  SPEAKER_00: Because I think a lot of you tuning in are always wondering what does it look like with people we work with?
• 2:09
  SPEAKER_00: But also, like, what is the journey?
• 2:12
  SPEAKER_00: Are there ups and downs in the process, or is it just a smooth recovery?
• 2:16
  SPEAKER_00: Short answer, no, not smooth.
• 2:18
  SPEAKER_00: And you'll see with Rebecca's story, even that there were a lot of road bumps along the way.
• 2:23
  SPEAKER_00: And our goal is to just show and share exactly how these things look like in the process, especially for those of you who feel very isolated and who might be hitting issues not only in the early parts, but maybe in the mid and late stages where you're not kind of getting back to the things, especially if you're sitting maybe around like nine months or 12 months.
• 2:43
  SPEAKER_00: Just know, like, you know, there can still be roadblocks along the way, but what does that plan look like and what do the adjustments look like?
• 2:51
  SPEAKER_00: And then how much work are we putting in to get to that point we want to?
• 2:56
  SPEAKER_00: So here's our aim to just cover our A Sailor Rebecca because she absolutely did a remarkable job just staying in the grind of it and being able to communicate and being able to work super hard.
• 3:09
  SPEAKER_00: So let's dive into her background.
• 3:11
  SPEAKER_00: Her initial injury was actually a takedown injury at a BJJ tournament.
• 3:15
  SPEAKER_00: For those of you who don't know what BJJ is, it's Brazilian jujitsu.
• 3:20
  SPEAKER_00: And so she was at a tournament and she wasn't really sure if it was a contact or a planting foot injury when attempting an outside trip to an opponent.
• 3:30
  SPEAKER_00: And this took place in July of 2021.
• 3:33
  SPEAKER_00: The next day she had an ortho visit and the diagnosis of an MCL sprain.
• 3:39
  SPEAKER_00: She tried to return back to BJJ and returning to sport and kept feeling instability.
• 3:44
  SPEAKER_00: She went to an ortho in early November and asked for an MRI.
• 3:48
  SPEAKER_00: Turns out she had an ACL tear, lateral meniscus tear, and a possible medial meniscus tear.
• 3:54
  SPEAKER_00: So that's a pretty long time between the injury itself, which was July 10th, and then November for her to get a consult of what's going on with her knee.
• 4:04
  SPEAKER_00: So she had some months pass by where it was like, oh, it was an MCL sprain versus an actual, like, oh, ACL tear that she was dealing with.
• 4:11
  SPEAKER_00: And so good on her for going in and being like, I don't think this is what it is.
• 4:15
  SPEAKER_00: Let's get an MRI to see.
• 4:17
  SPEAKER_00: And so what ended up happening, she did and had surgery on November 22 of 2021.
• 4:25
  SPEAKER_00: She had a quad tendon autographed, a lateral meniscus root repair, and a small medial meniscus repair.
• 4:32
  SPEAKER_00: So a lot that had to be done here.
• 4:34
  SPEAKER_00: She got an autograph from that quad tendon, that lateral meniscus root repairs are no joke here, and then the meniscus repair as well.
• 4:43
  SPEAKER_00: So usually with these types of situations, you are non-weight bearing for a hot minute.
• 4:47
  SPEAKER_00: So the restriction she had was zero to 90 degrees of flexion range of motion for the first four weeks.
• 4:54
  SPEAKER_00: She was non-weight bearing for six weeks, so she could not, she had to be on crutches for six weeks.
• 5:00
  SPEAKER_00: And then no squatting past 90 degrees until four months and may add open kinetic chain exercises at four months.
• 5:07
  SPEAKER_00: So basically something like a knee extension, uh, which we kind of worked around because we wanted to build up her quad.
• 5:13
  SPEAKER_00: So we were able to kind of kick that in a little bit early.
• 5:16
  SPEAKER_00: But training prior to that ACL injury, she was training eight to 10 hours per week pre-injury, five to six BJJ classes, three to five fitness conditioning with kettlebells and kickboxing.
• 5:28
  SPEAKER_00: And ideally, she was wanting to now go and watch two to three BJJ classes per week and then potentially do anywhere from five to six workout sessions per week.
• 5:38
  SPEAKER_00: So her schedule kind of shifted from doing BJJ solely and some fitness conditioning to being able to still go to BJJ classes, but also being able to uh do and focus on her rehab and other workout-based movements.
• 5:54
  SPEAKER_00: Her goals that she had was to return to competition in BJJ and podium.
• 5:59
  SPEAKER_00: Those were her main goals.
• 6:01
  SPEAKER_00: And so one of the things I want to talk about here is just kind of her timeline.
• 6:05
  SPEAKER_00: So obviously, now it's March of 2023.
• 6:08
  SPEAKER_00: So one of the things I want to talk about is how did 2022 look for her?
• 6:12
  SPEAKER_00: And what was that whole process and journey?
• 6:15
  SPEAKER_00: So we'll talk a little bit about the timeline, but more so about the roadblocks that she kind of dealt with along the way.
• 6:22
  SPEAKER_00: It wasn't just this smooth, like, okay, she hit this restore uh block with us and then rebuild and then return, and then she was back.
• 6:30
  SPEAKER_00: It was more so of like, okay, the early phases had its challenges, mid-stages had its challenges, and even the late stages had its challenges.
• 6:39
  SPEAKER_00: So we didn't connect initially until a month, two months after her having surgery, and wanting more specific ACL-specific guidance and help because she just felt like she wasn't really getting that necessarily from where she was at.
• 6:52
  SPEAKER_00: And she wanted someone who is a little bit more focused on this area, especially given you know the re-injury rates, as well as like just needing more of a dialed-in program and guidance.
• 7:04
  SPEAKER_00: So we worked together, and in the early stages, what we ended up focusing on, which you guys know of, is the quiet knee and rebuilding some strength and some other positions.
• 7:14
  SPEAKER_00: And the biggest things that we had challenges with were actually knee extension range.
• 7:18
  SPEAKER_00: How many of you are probably shaking your head at this point?
• 7:21
  SPEAKER_00: Yep, that's me.
• 7:22
  SPEAKER_00: Knee extension can be really tough to get back, depending on the surgery, how your body responds.
• 7:28
  SPEAKER_00: And it could be troublesome even in the mid to late stages if we don't work on it.
• 7:32
  SPEAKER_00: And so knee extension was a big, tough issue with Rebecca early on, and even into the mid-stages.
• 7:39
  SPEAKER_00: And so for her, we worked a lot on that.
• 7:42
  SPEAKER_00: And then the other thing was also getting her flexion range back.
• 7:45
  SPEAKER_00: So trying to get that heel towards your butt, and especially with a sport like BJJ, we need to make sure we're comfortable being able to sit onto our heels and get into that deep knee flexion because a lot of times you're going to be in that position where you need it.
• 7:58
  SPEAKER_00: Into the mid-stages, two of the things that we dealt a good bit with was still that extension and still working on the heel to butt.
• 8:06
  SPEAKER_00: And then some other things that actually came into the mid-stages was pateller catching.
• 8:10
  SPEAKER_00: So her patella would kind of clunk at this certain position of her extension.
• 8:15
  SPEAKER_00: And then we had to work on that and then donor sight issues.
• 8:18
  SPEAKER_00: So she had a quad tendon, and we started to realize there was some issues that she that was arising from the lack of extension and also the donor sight-related discomfort.
• 8:29
  SPEAKER_00: And so over time we progressed and worked on this.
• 8:33
  SPEAKER_00: She stayed super consistent and eventually we got there.
• 8:37
  SPEAKER_00: We got there, which is huge.
• 8:39
  SPEAKER_00: And that's the biggest piece here is staying consistent and laying down those bricks as we talk about and keep working on those because if we just focus on those for a short period of time, in these situations, especially with range of motion, we're typically not going to get it.
• 8:54
  SPEAKER_00: But this is where we got to chip away slowly our daily bricks, one after another.
• 8:59
  SPEAKER_00: And eventually this hopefully lays into place.
• 9:02
  SPEAKER_00: And if not, then that's where there needs to be assessments to see all right, is there something else going on?
• 9:07
  SPEAKER_00: Otherwise, we continue to just keep working on it.
• 9:10
  SPEAKER_00: And so then she does her early and mid-stages.
• 9:13
  SPEAKER_00: And then some of the roadblocks that we dealt with that was interesting, was actually in her later stages.
• 9:18
  SPEAKER_00: So eight to nine months post-op, she started getting this like weird clunking in August.
• 9:23
  SPEAKER_00: And we kind of worked around it, tried to make sure that the knee was okay, still working on progressing on some strength and just keeping an eye on the clunking.
• 9:32
  SPEAKER_00: That reduced down a little bit.
• 9:34
  SPEAKER_00: And then the next month, which would have been September of 2022, she got a grumpy knee, woke up, swollen, hard to extend, and even walk on the knee.
• 9:45
  SPEAKER_00: And you're like, man, all right, if she's at like nine to ten months and this is what she's dealing with, um, yeah, it happens.
• 9:51
  SPEAKER_00: It happens more than you guys think.
• 9:53
  SPEAKER_00: And it doesn't mean that it's okay, but it does mean that something aggravated the knee, and we got to make sure that we adapt the program to make sure we get back on track.
• 10:03
  SPEAKER_00: And so one of the things that she said that I wanted to note here is I'm a bit worried about it since it's a decent amount of pain walking on it right now.
• 10:11
  SPEAKER_00: And this is totally normal, especially when your expectation is all right, I hope I'm in the clear once I'm in those late stages to be able to make sure I don't have these like flare-ups or issues when in reality it still can happen.
• 10:25
  SPEAKER_00: And there's plenty of ACLers we work with where they might have pushed too hot out of the gate, or maybe just something came up in the late stages, and the knee can kind of just act up and get grumpy.
• 10:36
  SPEAKER_00: And so what we did was we calmed it down, we focused on regressing a little bit with programming, we put in some stuff that felt good, and we slowly built it back up.
• 10:46
  SPEAKER_00: And so that was the big goal was more so to know, okay, this isn't time to freak out.
• 10:51
  SPEAKER_00: There's nothing wrong.
• 10:52
  SPEAKER_00: We've been progressing as we have been and has been totally fine.
• 10:56
  SPEAKER_00: And so then we just got to put some pieces in play and adapt to programming to make sure we feel good.
• 11:01
  SPEAKER_00: We're still working on strength and the goals that we have, but also not pushing into that aggravation or making the knee more grumpy.
• 11:10
  SPEAKER_00: So we just want to restore those baselines that we had.
• 11:13
  SPEAKER_00: And so we did, and over time that improved.
• 11:16
  SPEAKER_00: And then over a little over a month later, we had already gotten back to that baseline.
• 11:21
  SPEAKER_00: It actually happened again.
• 11:22
  SPEAKER_00: So she got her extension back, was back to normal baseline numbers, and it happened again.
• 11:28
  SPEAKER_00: This time there wasn't anything previous to it that aggravated it.
• 11:32
  SPEAKER_00: It just happened, and instead of stopping, we adapted again.
• 11:36
  SPEAKER_00: This time it went away in five days, and we eased back into her programming a bit faster because she was able to return back to that baseline faster.
• 11:46
  SPEAKER_00: And then now we are sitting, so that was September, October, and now we're sitting in November, November 22nd.
• 11:53
  SPEAKER_00: Her grumpy knee again kicks in.
• 11:55
  SPEAKER_00: And this time it went away in three days.
• 11:59
  SPEAKER_00: So the big take-home here isn't that we were just doing something to aggravate it because really we were tracking the programming, we were tracking symptoms, we were tracking her progressions with testing and also with her strength measurements, and things were going just fine.
• 12:15
  SPEAKER_00: The thing is, like sometimes the knee can be unpredictable, and this is where we have to make sure we have an adaptable program and we can pivot whenever we need to.
• 12:24
  SPEAKER_00: And so when this last grumpy knee episode happened in November and it went away in three days, this was so key.
• 12:32
  SPEAKER_00: And the big take-home here is that Rebecca didn't freak out.
• 12:36
  SPEAKER_00: We communicated and she knew that this was something that we had managed in the past.
• 12:40
  SPEAKER_00: It felt familiar.
• 12:41
  SPEAKER_00: And so, what I usually tell people is that pretend you're driving on this road, you're trying to get to this destination.
• 12:48
  SPEAKER_00: And what we have to do is potentially take a detour.
• 12:51
  SPEAKER_00: The detour can either be long or it could be very short.
• 12:55
  SPEAKER_00: Now, in some situations, we tend to make it long just because you know we might shut down or we might stop doing everything.
• 13:02
  SPEAKER_00: And it can actually drag out the detour and get off-road a lot a lot longer than we want to.
• 13:08
  SPEAKER_00: Or we can use these principles that we come back to and communicate and adjust the programming, and we could take a small detour.
• 13:17
  SPEAKER_00: It might just be getting off the interstate to be able to get some gas and get right back on.
• 13:21
  SPEAKER_00: And that's kind of how we frame this.
• 13:23
  SPEAKER_00: That was the goal is to make sure that we just take that small detour.
• 13:26
  SPEAKER_00: We gave Rebecca the self-management tools to know, okay, let's not freak out.
• 13:31
  SPEAKER_00: This is something that we've seen before and we know what your knee responds best to.
• 13:35
  SPEAKER_00: And so we put those pieces in play, and it went away in three days versus us dragging this out for weeks and weeks and weeks and it being this consistent problem or constant problem over time we were dealing with.
• 13:48
  SPEAKER_00: And that was actually the last time we had to deal with it.
• 13:50
  SPEAKER_00: And so it's something that happens in this process.
• 13:53
  SPEAKER_00: I can't tell you why.
• 13:54
  SPEAKER_00: She can't tell you why.
• 13:56
  SPEAKER_00: I don't think anyone can tell you why, but it happens.
• 13:58
  SPEAKER_00: And that's the transparency I want to show in working with our athletes is that there's not always going to be a rhyme and a reason.
• 14:06
  SPEAKER_00: Sure, we would love to deduce that from the testing or from the training or from daily life activities, but you're dealing with the human body and you're dealing with something that isn't always as easy to just, you know, reduce and simplify to this is what it was.
• 14:22
  SPEAKER_00: And sometimes we just need to make sure we set and stick to our principles and adapt things as we need to and know that things are going to be okay, and that's what's going to be key.
• 14:33
  SPEAKER_00: And more often than not, usually we get right back onto the interstate and we get right back on the path.
• 14:39
  SPEAKER_00: And a message I want to point out is a message that she sent three weeks before that actually happened.
• 14:45
  SPEAKER_00: And this is just more so of like keeping the goals in mind and what you're aiming for.
• 14:49
  SPEAKER_00: And she said, Yes, I recently saw that there's a local BJJ tournament scheduled for late March of 2023.
• 14:55
  SPEAKER_00: And it has me pretty motivated to potentially shoot for that as a goal to get back to competing.
• 15:00
  SPEAKER_00: That'd be 16 months post-op.
• 15:03
  SPEAKER_00: So this is pretty cool from a time standpoint because as we round out this episode here soon, uh, this will kind of shine and show, okay, wow, the future pacing of it and the aim of her goals.
• 15:16
  SPEAKER_00: And so let's fast forward to her criteria and getting past recently.
• 15:22
  SPEAKER_00: So on March 10th, she did some strength testing, which was freaking awesome.
• 15:26
  SPEAKER_00: She hit uh 3.9 on her uninvolved side for her quadriceps peak torque to body weight.
• 15:32
  SPEAKER_00: So typically our goal is 3.0 of torque to body weight for our athletes.
• 15:38
  SPEAKER_00: And she hit this as a 3.9 on her uninvolved side and 3.7 on her involved side.
• 15:46
  SPEAKER_00: That is absolutely killer.
• 15:48
  SPEAKER_00: And then when we looked at the hamstring quadrant ratio, it was two thirds, which was a target we always aim for.
• 15:54
  SPEAKER_00: Her drop jump reactive strength index was above a 2.3.
• 15:58
  SPEAKER_00: We looked at her 505 and penultimate foot contact quality, those all look super solid from that quantitative and qualitative standpoint.
• 16:08
  SPEAKER_00: And then her ACL RSI, which is something that measures psychological readiness, we want this above a 70.
• 16:15
  SPEAKER_00: And she was at a 96, and the highest you could score is 100.
• 16:19
  SPEAKER_00: And sometimes when we get 100s, we're just like, did you really fill this out?
• 16:23
  SPEAKER_00: But when you hit a 96 or, you know, above that range that we're looking for, there's some honesty that you can tell, okay, what was it that might have been short on those four points?
• 16:34
  SPEAKER_00: And whenever you're returning a sport, very rarely do you ever really check a hundred because you still need to kind of do your sport to be able to really hit that hundred mark.
• 16:44
  SPEAKER_00: And then there's the sport-specific work and progressions we worked on.
• 16:47
  SPEAKER_00: So there's a control to chaos continuum, which is basically thinking about being in a closed environment to an open environment of your sport.
• 16:55
  SPEAKER_00: And then you have non-contact to contact-based drilling, you have volume and intensity progressions, and then you have the difficulty of the opponents that you're going to face as well.
• 17:04
  SPEAKER_00: This all being specifically tailored to BJJ and making sure that she was getting very familiar with the sport and not only feeling physically and mentally ready, but also making sure the sport-specific drills were also supplementing that.
• 17:20
  SPEAKER_00: And now the real reason why you guys are here the ACL win.
• 17:24
  SPEAKER_00: So this past weekend, she competed in a tournament.
• 17:27
  SPEAKER_00: And here's what she posted in our ACL athlete community.
• 17:30
  SPEAKER_00: My ACL injury was in July of 2021 at a jujitsu tournament, and surgery was in November of 2021.
• 17:38
  SPEAKER_00: It was a long rehab journey with 14 months of coaching from a Dr.
• 17:42
  SPEAKER_00: Ravi to not just get back to baseline, but way stronger than I was before.
• 17:47
  SPEAKER_00: The end goal for me throughout this entire journey was returning back to jujitsu competition.
• 17:53
  SPEAKER_00: And today I was able to accomplish that.
• 20:00
  SPEAKER_00: I competed in a local tournament against one other female opponent in Gee and no Gee divisions and moved up a weight division since it's a struggle to find women my rank and size in a largely male dominated sport.
• 20:14
  SPEAKER_00: I lost my first Gee match by points, but after shaking that anxiety off, I was able to come back and win my second by points and third with a submission choke.
• 20:23
  SPEAKER_00: Badass.
• 20:24
  SPEAKER_00: My no-gi matches, I went out and dominated with two wins against a points match and then arm bar submission.
• 20:31
  SPEAKER_00: I didn't have a huge expectation on myself going in, but came home with double gold.
• 20:36
  SPEAKER_00: Those wins feel pretty amazing after all these months of work.
• 20:40
  SPEAKER_00: When people ask why do we do this?
• 20:42
  SPEAKER_00: Why does the ACL athlete exist?
• 20:44
  SPEAKER_00: This is it.
• 20:45
  SPEAKER_00: This is for the people like Rebecca, where you put in the work, you have had so much time away from the thing you love to do so much.
• 20:54
  SPEAKER_00: And it's not been an easy journey.
• 20:56
  SPEAKER_00: As you guys have seen, there have been tons of roadblocks along the way, and she still put in the work and didn't act like a victim in this process.
• 21:05
  SPEAKER_00: And she was able to come out on the other side, and here she is, winning a tournament with her first competition back.
• 21:12
  SPEAKER_00: And I want to come back to something that's important that I saw with her that I want to highlight.
• 21:18
  SPEAKER_00: And she kept coming back to her why.
• 21:20
  SPEAKER_00: So with some of our check-ins periodically, we'll ask athletes to come back to why are you here?
• 21:25
  SPEAKER_00: Why do you care?
• 21:27
  SPEAKER_00: Why are you doing this?
• 21:28
  SPEAKER_00: What makes you want to like do your ACL rehab?
• 21:31
  SPEAKER_00: What makes you want to do your sport or your activity?
• 21:34
  SPEAKER_00: Why?
• 21:35
  SPEAKER_00: And then dive a little bit deeper.
• 21:37
  SPEAKER_00: And so back in January of 2022, when her and I first started, one of the things that she had mentioned in her why was the way that she was talking to herself and how it was impacting her mindset.
• 21:47
  SPEAKER_00: And one of the things she wanted to correct was making an effort to not call my left knee my bad knee, keeping in perspective the length of this recovery process and trying not to get too down when I struggle with certain exercises, instead, aiming for small incremental improvements.
• 22:05
  SPEAKER_00: That is the small wins in action, and that is how you speak to yourself in action.
• 22:11
  SPEAKER_00: Just key things here, and we always tell our ACLers not to call their ACL side or whatever the side is that has been injured or operated on their bad side.
• 22:20
  SPEAKER_00: You do not want to have these negative connotations towards your knee.
• 22:24
  SPEAKER_00: It is something that you want to refer to as your recovering knee or the operating knee or something a bit more positive, if you will, or literally just call it the left knee or the right knee.
• 22:34
  SPEAKER_00: But something that you want to make sure you restrain from is using it as the bad knee.
• 22:38
  SPEAKER_00: And that terminology is so key.
• 22:41
  SPEAKER_00: And even if we highlight things from the past of uh James Clear's work of identity, identity is so key in creating good habits.
• 22:49
  SPEAKER_00: So if we want to make sure we're building back as best as we can, then even using the bad knee as an example is something we want to not do.
• 22:59
  SPEAKER_00: And she killed it.
• 23:00
  SPEAKER_00: She was the person who actually put that in play.
• 23:03
  SPEAKER_00: She also was aiming for small wins, which are so key in this process.
• 23:07
  SPEAKER_00: And then to fast forward to January of this past year of 2023, this is what she said when she was asked about her why and why she's doing all this to reconnect with it.
• 23:18
  SPEAKER_00: I want to return to BJJ, a competition better and stronger than pre-injury, chase down some world medals in the master's divisions and inspire my daughter and young women in a predominantly male sport.
• 23:30
  SPEAKER_00: I also want full confidence in what I can train to accomplish and adventures I can set out to do without any doubts or thoughts about physical limitations due to my prior knee injury.
• 23:40
  SPEAKER_00: Wow.
• 23:41
  SPEAKER_00: It's just killer.
• 23:42
  SPEAKER_00: It's awesome to hear whenever people really can build in, not only just all right, I'm gonna do the rehab, but when they can actually build in the mindset pieces, it's a big part as to why she has seen the success she has, despite her roadblocks along the way.
• 23:56
  SPEAKER_00: The other thing that I will highlight about her is that she continued to do some coaching and drilling in her sport as soon as she could.
• 24:04
  SPEAKER_00: She wanted to keep her involvement in it, which allows her to stay sharp.
• 24:07
  SPEAKER_00: It also allows her to stay involved in the process and not miss the sport nearly as much because she's still staying present with it.
• 24:14
  SPEAKER_00: So that's also key.
• 24:15
  SPEAKER_00: So don't feel like you have to completely shut down and be involved as much as you can, especially if there's a community around it or a team around it.
• 24:25
  SPEAKER_00: See if you could just stay involved with the process as much as it feels healthy to do so.
• 24:30
  SPEAKER_00: And then as a physical therapist and as a coach coaching her, a few things I do want to touch on.
• 24:36
  SPEAKER_00: Her compliance was insanely great.
• 24:39
  SPEAKER_00: She always showed up, even if it wasn't the best day or workout, or she was feeling sick.
• 24:45
  SPEAKER_00: Um, we would communicate about it or we would adjust things, even when the knee was being grumpy.
• 24:50
  SPEAKER_00: She would communicate and let us know.
• 24:52
  SPEAKER_00: She would do what she could, and we adapted things.
• 24:55
  SPEAKER_00: And that does bleed into that communication piece, which is my second point.
• 24:59
  SPEAKER_00: Always communicating, always checking in as we need to, and was always open about how things were going, any feedback, and allowing us to just really adapt the program and keep the needle moving.
• 25:12
  SPEAKER_00: It was a huge game changer in this process.
• 25:15
  SPEAKER_00: And as I have said in the past, our three-step process anchors using, planning, supporting, repeat.
• 25:22
  SPEAKER_00: Testing, planning, supporting, repeat.
• 25:24
  SPEAKER_00: And we do this with all of our athletes.
• 25:27
  SPEAKER_00: And this is the absolute key to having a really successful ACL rehab and getting back to your sport.
• 25:33
  SPEAKER_00: And when we our team discusses the athletes who get to this other side of ACL rehab to return to sport, to just kind of being back to themselves and the ones who don't.
• 25:44
  SPEAKER_00: And it's the ones who really do show up, who put in the work, who provide the feedback, who communicate, they always do.
• 25:53
  SPEAKER_00: More often than not, 10 out of 10 times, they will.
• 25:56
  SPEAKER_00: And that's the thing that I want to highlight here is that if you feel like you're struggling, and if you're someone in this process that is not getting what they need, first it kind of comes back to the big points of like, all right, do you know where you are?
• 26:09
  SPEAKER_00: What does the plan look like to help get you to the next checkpoint and to your goals?
• 26:13
  SPEAKER_00: And are you truly being supported on that?
• 26:15
  SPEAKER_00: That's what's really important to evaluate and have an honest conversation with yourself and with anyone involved in the process of okay, how does this look?
• 26:24
  SPEAKER_00: And this is the thing that I probably see with communicating with other ACLers is that there's usually a glaring hole in one of these pieces.
• 26:32
  SPEAKER_00: Your plan and support could be awesome, but if you don't have testing, then that's a big issue.
• 26:36
  SPEAKER_00: You could have testing and support, but if the plan isn't reflecting what you need to build towards, that's a problem.
• 26:42
  SPEAKER_00: And then testing and planning, that's awesome, but you really need that guidance or the guardrails and GPS to make sure that you're making the progress and adapting the program as you go.
• 26:53
  SPEAKER_00: I think that if Rebecca was just on some templated program and that hiccup happened, you know, month eight, 10, and 11, and there was no adjustments being made, then who knows how long that would have lingered or what would have been the outcome of those things.
• 27:08
  SPEAKER_00: But because we were communicating and guiding, then we were able to adapt the program to be able to course correct and make sure that we keep building.
• 27:19
  SPEAKER_00: And so as we round this episode out, what are some of our big takeaways from this episode?
• 27:24
  SPEAKER_00: One is that no one's journey is going to be perfect.
• 27:27
  SPEAKER_00: It's very unlikely to follow that typical nine-month timeline.
• 27:32
  SPEAKER_00: And especially if you want to come back at your absolute best, better than before.
• 27:37
  SPEAKER_00: Give that nine to 12 month range.
• 27:39
  SPEAKER_00: Sometimes it could take longer, especially if there's more hiccups.
• 27:42
  SPEAKER_00: And also, you know, consider that she was non-weight bearing for six weeks.
• 27:47
  SPEAKER_00: That immediately pushes the timeline a little bit longer, just because six weeks, you're not putting weight on it.
• 27:52
  SPEAKER_00: So for us to assume that we're gonna make up that time is something that I think is a bit of a misnomer in this process that we assume that everyone starts the same at day one, when really everyone's got a different starting point and starting line.
• 28:08
  SPEAKER_00: So I think that is something to evaluate and understand from an expectation and time standpoint.
• 28:15
  SPEAKER_00: The perfect plan doesn't matter if you're not consistent and you don't communicate.
• 28:19
  SPEAKER_00: Those are the keys.
• 28:21
  SPEAKER_00: If we could have two things that we ask people to do really, really well is to be consistent or be compliant and to be able to communicate.
• 28:29
  SPEAKER_00: Be a game changer with a really good physical therapist and coach.
• 28:33
  SPEAKER_00: I promise you you will make progress, and I promise you you will get back to the things you want to do.
• 28:38
  SPEAKER_00: Make sure that you're working with someone who knows ACLs, who will test you, who will individualize a plan for you, and who will support you.
• 28:45
  SPEAKER_00: That's our three non-negotiables at the ACL athlete.
• 28:49
  SPEAKER_00: Test, plan, support, repeat.
• 28:52
  SPEAKER_00: And then lastly, I want to end with this message from Rebecca.
• 28:55
  SPEAKER_00: Keep grinding.
• 28:57
  SPEAKER_00: There's an indescribable sense of accomplishment on the other side of all this work.
• 29:01
  SPEAKER_00: As a two-time ACL or myself, I cannot agree more.
• 29:05
  SPEAKER_00: It's really hard when you're in the meat of it and really trying to get through everything, but I promise you, you will be stronger, you will be better.
• 29:13
  SPEAKER_00: And Rebecca is a great example of this.
• 29:17
  SPEAKER_00: And if you are someone listening to this and you're not getting the support, if you're not clear on direction, then please just reach out to us.
• 29:25
  SPEAKER_00: We'd love to kind of point you in the right direction, happy to help in any way.
• 29:29
  SPEAKER_00: You could always go to our website and send a contact form or whatever means you would like to reach out to us at.
• 29:36
  SPEAKER_00: We would just love to help you.
• 29:37
  SPEAKER_00: And I do hope that this episode and Rebecca's story and every sailor story that we've shared on this podcast is something that just encourages you for you to even take the next step or just know, all right, I'm gonna show up to rehab and put in more effort and really stick to the plan and making sure that I'm being supported in this and just knowing that it's not an endless journey, that there is actually light at the end of the tunnel and that you can get there.
• 30:04
  SPEAKER_00: It's long, don't get me wrong, but you can get there.
• 30:07
  SPEAKER_00: And Rebecca is an example of this.
• 30:10
  SPEAKER_00: So, Rebecca, if you're listening, shout out to you.
• 30:13
  SPEAKER_00: Thank you so much for being such an incredible athlete to work with.
• 30:17
  SPEAKER_00: So proud of you.
• 30:18
  SPEAKER_00: All right, team.
• 30:19
  SPEAKER_00: I'm gonna go before I shed a tear here.
• 30:21
  SPEAKER_00: If you have any questions, you know where I am, you know how to reach me.
• 30:26
  SPEAKER_00: This is your host, Robbie Patel, signing off.