Latest / The ACL Athlete Podcast / 280 | Further Out and Still Not There: Why Your ACL Recovery Is Taking Longer Than You Expected

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280 | Further Out and Still Not There: Why Your ACL Recovery Is Taking Longer Than You Expected · 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, team?
• 1:01
  SPEAKER_00: And today we are going to keep this short.
• 1:05
  SPEAKER_00: I promise you.
• 1:06
  SPEAKER_00: Shorter than what I have been doing.
• 1:08
  SPEAKER_00: I know the episodes have been longer and longer.
• 1:11
  SPEAKER_00: And so I'm going to try and keep this nice and short for you.
• 1:14
  SPEAKER_00: So I'm going to challenge myself to not go on tangents and to just speak the thing that I am here to speak to you guys about.
• 1:21
  SPEAKER_00: So today's episode is one of those I've been wanting to record for a while because I hear it constantly.
• 1:27
  SPEAKER_00: And I mean constantly.
• 1:29
  SPEAKER_00: And we see it constantly from athletes we work with and from people who reach out to us all the time.
• 1:36
  SPEAKER_00: Maybe you're six months out, maybe you're nine months out, maybe you've already crossed the one year mark.
• 1:44
  SPEAKER_00: And something just doesn't feel right.
• 1:47
  SPEAKER_00: Not because anything is medically wrong, but because everyone around you, your surgeon, your PT, your family, your friends, maybe it's teammates, seems to think you should be fine by now.
• 2:00
  SPEAKER_00: You should be close to it, especially based on time, you should be almost back.
• 2:05
  SPEAKER_00: And you've even used the reference, oh, I'll be back at the nine to 12 month range, because that gets thrown around a lot in ACL world.
• 2:13
  SPEAKER_00: And here's the thing you might be at one of these time points and you don't feel close.
• 2:19
  SPEAKER_00: You don't feel almost back to it.
• 2:22
  SPEAKER_00: You feel like you've still got a long road ahead of you.
• 2:25
  SPEAKER_00: And you might be the person who's like, I'm looking down this tunnel and I don't really see any light.
• 2:32
  SPEAKER_00: And it's this kind of quiet, nagging feeling that maybe you are the problem in this situation.
• 2:39
  SPEAKER_00: Maybe you're not doing enough.
• 2:40
  SPEAKER_00: Maybe everyone else's recoveries are on this like clean nine to 12 month track, and you are somehow the exception.
• 2:48
  SPEAKER_00: So I'm talking directly to you today because that feeling, that sense that something is wrong with you or that you're falling behind, which inevitably every ACL athlete is going to feel.
• 3:01
  SPEAKER_00: But I guarantee you, most of you feeling this and listening to this episode have had this run across your mind.
• 3:09
  SPEAKER_00: No one listening to this is saying, I'm well ahead of time, I'm gonna graduate, and I'm gonna be good to go.
• 3:14
  SPEAKER_00: And that's if you are, then good for you.
• 3:16
  SPEAKER_00: But that's maybe 1% of you.
• 3:18
  SPEAKER_00: The rest of us is going to be essentially in this nonlinear trajectory.
• 3:28
  SPEAKER_00: And you are the one who are constantly on yourself about falling behind, not on the right quote unquote timeline, if you will.
• 3:35
  SPEAKER_00: And it's one of the most common things we hear.
• 3:38
  SPEAKER_00: And it almost never is the full picture.
• 3:41
  SPEAKER_00: So I'm gonna get into it today because I think it's important to really anchor this to you guys.
• 3:47
  SPEAKER_00: And maybe you're, you know, the person that's even two or three months out and it feels this way.
• 3:51
  SPEAKER_00: And that makes sense.
• 3:52
  SPEAKER_00: You're early on in the process, so we're not here to say that this doesn't count towards you as well, but especially as you've been in it, you've been in the thick of it for not just a few weeks, not a few months, but six months, y'all.
• 4:05
  SPEAKER_00: Six months, that's half a year.
• 4:07
  SPEAKER_00: That's a long time.
• 4:07
  SPEAKER_00: You can do a lot of things in six months.
• 4:10
  SPEAKER_00: Maybe it's nine months, maybe it's a year, maybe you know, you're listening to this and you're a year and a half, two years out.
• 4:16
  SPEAKER_00: You could be 10 years out.
• 4:18
  SPEAKER_00: I don't know, whatever ACL kind of timeline that you have been on, but you are kind of further out from this surgery and this injury.
• 4:26
  SPEAKER_00: I want to talk about this today because I think it's super important for us to really get some detail behind this and break this down.
• 4:35
  SPEAKER_00: And here's where I want to start the nine to 12 month number.
• 4:39
  SPEAKER_00: We've all heard it.
• 4:40
  SPEAKER_00: You've heard me throwing it around, and it is something that we try to use as a healthy expectation of this process.
• 4:47
  SPEAKER_00: You've maybe heard your surgeon use it.
• 4:50
  SPEAKER_00: Maybe they say six months, maybe they say eight months, maybe they say nine months.
• 4:54
  SPEAKER_00: We hear the whole spectrum, y'all.
• 4:56
  SPEAKER_00: And then we hear surgeons who also say a year mark, right?
• 4:59
  SPEAKER_00: And that's all healthy framing, right?
• 5:01
  SPEAKER_00: We need to give some sort of expectation because one of your first questions is going to be, well, when can I get back to X?
• 5:07
  SPEAKER_00: When can I do this?
• 5:09
  SPEAKER_00: And usually that nine to 12 month mark gives us enough of a proxy to say, okay, we know the research shows that re-injury rates go down after the nine-month mark based on what we see, and that that allows that ligament to heal from a biology standpoint to turn into at least the tensile integrity or resistance that we need to be able to do its job, like the native ACL.
• 5:32
  SPEAKER_00: Now it'll keep growing and it'll keep healing and it'll keep turning from a tendon to a ligament past the nine-month mark, but at least we get to a certain threshold where it can withstand the stresses we need it to, typically.
• 5:45
  SPEAKER_00: Now, it's talked about the nine to 12-month mark by probably your PT.
• 5:50
  SPEAKER_00: I hope that they're at least using that as a reference.
• 5:53
  SPEAKER_00: You probably Googled it and seed, you probably put it into AI and seen it, and on some level, it became the target, the finish line, and the thing you were supposed to hit.
• 6:05
  SPEAKER_00: But here's what nobody is telling you.
• 6:08
  SPEAKER_00: That number is a framework, but it is not a guarantee, y'all.
• 6:12
  SPEAKER_00: It is an average built from the research populations that I've shared.
• 6:16
  SPEAKER_00: It was never designed around your specific injury, your specific surgery, your specific graph, your specific life and circumstances, or the quality of care you've had access to, or a lack thereof.
• 6:29
  SPEAKER_00: It was never a promise.
• 6:31
  SPEAKER_00: It was just a starting point that somehow got treated like a rule.
• 6:35
  SPEAKER_00: And you'll hear all the ACL influencers on social media who say the same thing, right?
• 6:41
  SPEAKER_00: And I think that it is just from a timeline standpoint, if we could just gravitate towards like, okay, what is a healthy range?
• 6:50
  SPEAKER_00: We do say that nine to twelve month range.
• 6:53
  SPEAKER_00: The thing is, is that when you hit 10 months and you still feel like you're 10 months away, let's say even six months away, it does not mean you failed the recovery.
• 7:04
  SPEAKER_00: It might just mean the timeline was never accurate for you to begin with.
• 7:09
  SPEAKER_00: And that distinction matters a lot, y'all.
• 7:12
  SPEAKER_00: And so let's talk about why.
• 7:15
  SPEAKER_00: Because I think when you understand the real reasons people are still in this process far beyond 12 months, it stops feeling like a personal failure and starts to feel like what it actually is.
• 7:28
  SPEAKER_00: A very, very, very, very complicated injury with a lot of variables that nobody sat down and explained to you.
• 7:36
  SPEAKER_00: And this is something just kind of pulling back the curtain, if you will.
• 7:41
  SPEAKER_00: Y'all, I have talked to so many ACL athletes, like thousands and thousands and thousands of ACL athletes at this point.
• 7:48
  SPEAKER_00: This has been my obsession, this has been my world, this is what I've dedicated my craft to.
• 7:53
  SPEAKER_00: So when you're listening to this, I promise you, I am bringing in the collective amount of conversations that I have across the spectrum of ACL world.
• 8:02
  SPEAKER_00: And there will be more that will evolve with this, but I am bringing this to you guys because we're in it, we're seeing it.
• 8:09
  SPEAKER_00: I'm working with these athletes, our team is working with these athletes.
• 8:13
  SPEAKER_00: We're mentoring other physical therapists, coaches who are also working with these athletes.
• 8:19
  SPEAKER_00: Like I am very much in this space and very much going to share with you exactly what this is because I think this is so valuable and so important.
• 8:27
  SPEAKER_00: So you guys can get off of your own backs and give yourself a little bit of grace because we all need it in this world and especially in this injury.
• 8:35
  SPEAKER_00: The thing is, is no one sat down and explained to you these variables that complicates this more than just an ACL injury, which is also arguably the hardest recovery to come back from.
• 8:46
  SPEAKER_00: Outside of the crazy stuff like, you know, car wrecks and just chaotic situations and spinal cord injuries.
• 8:52
  SPEAKER_00: If you talk about a musculoskeletal injury that happens to the human body, that happens from sport, this is arguably one of the hardest recoveries.
• 9:00
  SPEAKER_00: And you have one of the biggest targets on your back as soon as you try to get back to what you want to do.
• 9:04
  SPEAKER_00: And it's really hard.
• 9:06
  SPEAKER_00: And so the thing is that when you think about these variables, it could be the injury itself that is adding to it.
• 9:13
  SPEAKER_00: It could have had multiple ligament injuries while you had your ACL injury, not just that, but the MCL, LCL, PCL, you know, other things could have been impacted, the meniscus, the bone bruising.
• 9:25
  SPEAKER_00: The biological timeline is just going to be influenced.
• 9:28
  SPEAKER_00: It's going to be potentially longer.
• 9:30
  SPEAKER_00: Let's say you had a meniscus repair that was complicated and you were six weeks non-weight bearing, locked in a brace.
• 9:36
  SPEAKER_00: You're going to be a little different than the isolated ACL who could put weight the first day.
• 9:40
  SPEAKER_00: And that is not a mindset problem in this.
• 9:42
  SPEAKER_00: This is all about the tissue that has been impacted, right?
• 9:46
  SPEAKER_00: It could be your graph type.
• 9:48
  SPEAKER_00: Certain graphs have longer remodeling timelines than others.
• 9:52
  SPEAKER_00: Allograph, for example, takes longer to mature than an autograph because it is a cadaver graph.
• 9:57
  SPEAKER_00: So then we see the ligamentization takes a little bit longer with allographs.
• 10:02
  SPEAKER_00: Quad tendon, hamstring, patellar tendon, all these have slightly different windows.
• 10:06
  SPEAKER_00: Quad tendon, guess what, y'all?
• 10:09
  SPEAKER_00: It's taking people longer to get their strength back.
• 10:11
  SPEAKER_00: And people's quads shut down way more.
• 10:13
  SPEAKER_00: So if you're listening to this, you've had a quad tendon, and it's something that you've been trying to get your quad strength up, waking the quads up to get them back online, and it's taking longer than expected.
• 10:24
  SPEAKER_00: You know, they're saying you need to be at 80, 90% symmetry at maybe four months post op, and you're not there, it's okay.
• 10:33
  SPEAKER_00: To be honest, like more people are taking way, way longer.
• 10:36
  SPEAKER_00: And if you look at the Schwery paper from 2022, it shows very clearly across all three graph types that quad graphs are taking much longer for people.
• 10:46
  SPEAKER_00: And the thing is, we just have to know that all these graphs are going to be slightly different windows.
• 10:50
  SPEAKER_00: And so the question I have for you is did anyone actually walk you through what that means for your specific recovery?
• 10:57
  SPEAKER_00: Most people I talk to, the answer is no.
• 11:00
  SPEAKER_00: It's just here's the graph type, here's the ACL, here's the rehab.
• 11:05
  SPEAKER_00: No particular protocol to the graph type, it's just this is the rehab that everyone does, no matter the graph type.
• 11:11
  SPEAKER_00: It could be a complication that showed up later: scar tissue, cyclops lesion, something that requires additional intervention and essentially reset part of the clock.
• 11:20
  SPEAKER_00: That happens, and when it does, the nine to 12 month number becomes almost meaningless.
• 11:26
  SPEAKER_00: As in, that's gonna be impacted because we say nine to 12 months.
• 11:29
  SPEAKER_00: If you had a quote unquote perfect journey, minimal setbacks, progressing along, right?
• 11:36
  SPEAKER_00: And if you haven't had necessarily the most linear process, which is not most people, that it's gonna probably take a little bit more time.
• 11:47
  SPEAKER_00: It could be also the rehab quality.
• 11:50
  SPEAKER_00: And I'll be real here.
• 11:52
  SPEAKER_00: This is something that you guys know how I feel about this, but this is probably the most common one.
• 11:57
  SPEAKER_00: If I had to pick one out of all these situations that influences the timeline the most, the majority of athletes who come to us further out in this process were not getting bad rehab because their PT was a bad person.
• 12:10
  SPEAKER_00: They were just getting generic, protocol-driven, time-based care in a system that does not give clinicians the time or resources to truly individualize this process.
• 12:22
  SPEAKER_00: There is a real gap there, and athletes pay the price for it.
• 12:26
  SPEAKER_00: And this is what is so hard about this is because our system is not designed for ACL injuries and surgeries.
• 12:33
  SPEAKER_00: It's just not.
• 12:34
  SPEAKER_00: It's okay for the low back pain that recovers in four to eight weeks or the ankle sprain, but for a nine, twelve plus month recovery, you know, insurance or other medical systems, it's volume-driven and you don't get the individualization that you need, and it makes it really hard.
• 12:51
  SPEAKER_00: And then there is life because life does not pause for your ACL injury or your surgery or your rehab.
• 12:59
  SPEAKER_00: A stressful semester, a new baby, a job that has you traveling or on your feet for 12 hours a day, a season of just trying to survive.
• 13:08
  SPEAKER_00: You couldn't do everything your recovery needed, and that has extended the timeline.
• 13:13
  SPEAKER_00: That is not weakness, it's just the reality.
• 13:15
  SPEAKER_00: We have people who get really sick, or they have kids who get really sick and then they get sick and they have to take care of the whole house.
• 13:22
  SPEAKER_00: We have people who have to travel for work and they're on their feet for, you know, 12 hours for potential, you know, shifts in the ER.
• 13:30
  SPEAKER_00: You name it, we have worked with so many different occupations and different people in different life phases that it is not easy to just predict, oh, everyone's just gonna have a smooth nine to 12 month recovery because life is just gonna be on pause.
• 13:44
  SPEAKER_00: It's just gonna keep going.
• 13:46
  SPEAKER_00: And so that's going to influence potentially how many road bumps you have in this, especially in the seasonal life you're in.
• 13:52
  SPEAKER_00: And for a lot of people, it is not just one of these things, it is a combination of two or three, maybe 10 of them stacked up on top of each other.
• 14:03
  SPEAKER_00: And when that happens, the nonlinear part of this injury becomes very, very real.
• 14:09
  SPEAKER_00: And I want to ground this in something real because I think sometimes you hear this is normal and it feels abstract.
• 14:16
  SPEAKER_00: So let me tell you about a few athletes we're working with right now, so that way you can get a reference for this.
• 14:22
  SPEAKER_00: We have a PhD candidate, busy with school, been at this for over two years before, had some complexities along the way, and he joined with us recently.
• 14:31
  SPEAKER_00: He wants to get back to basketball, but he has not been back.
• 14:34
  SPEAKER_00: Not because he quit, not because he stopped caring about it, but because he had never had the right guidance.
• 14:39
  SPEAKER_00: And somewhere along the way, the months turned into years without real measurable progress.
• 14:44
  SPEAKER_00: And you guys all know this.
• 14:46
  SPEAKER_00: Time passes by quick.
• 14:48
  SPEAKER_00: And then eventually it's like, oh, I was gonna get to that at month six, and then it's month nine, right?
• 14:53
  SPEAKER_00: Two years into this, and we're essentially starting from scratch, building a foundation that should have been built in the first six months.
• 15:00
  SPEAKER_00: But there were some challenges along the way, and we're hoping that we can do that with him now that we have a plan in place.
• 15:06
  SPEAKER_00: He has started with us and we're excited to get this going.
• 15:09
  SPEAKER_00: We have a rock climber, 10 months post op, significant strength deficits, and get this.
• 15:13
  SPEAKER_00: He has never been once tested.
• 15:17
  SPEAKER_00: Was working with like a trusted PT, if you will, but never had the objective measures of quadricep strength, hamstring strength, any of that.
• 15:25
  SPEAKER_00: No limb strength symmetry assessment.
• 15:28
  SPEAKER_00: Nobody ever sat him down and showed him where he actually stood relative to where he needs to be for his particular case.
• 15:36
  SPEAKER_00: No benchmarks, no roadmap.
• 15:38
  SPEAKER_00: He was just kind of going, just doing exercises, hoping he would get there, going based on feel.
• 15:43
  SPEAKER_00: We have an athlete who is going through two-stage ACL revision.
• 15:47
  SPEAKER_00: This is her fourth ACL surgery, who has a complicated autoimmune history layered on top of that already.
• 15:54
  SPEAKER_00: So it's a complex surgery with complex, you know, just body, you know, and fighting things.
• 16:01
  SPEAKER_00: And her road is genuinely long.
• 16:03
  SPEAKER_00: She knows it.
• 16:04
  SPEAKER_00: We've talked through it.
• 16:05
  SPEAKER_00: It was long before us and connecting, and it's going to be long after, and we've talked through this, but at least she knows what that road actually looks like now and what the plan is.
• 16:14
  SPEAKER_00: That clarity alone changes things.
• 16:17
  SPEAKER_00: And then we have the competitive ultimate frisbee athlete, two years out, quad symmetry sitting at 63%, two years out, still dealing with graph site from their quad tendon complications, still trying, but stalling out because the programming and guidance just wasn't there.
• 16:34
  SPEAKER_00: And meanwhile, he has already missed tournaments, events he had circled on his calendar, trips with his teammates, moments you can't get back, the cost of prolonged recovery is not just physical, it's relational and emotional in ways that are really, really hard to quantify.
• 18:56
  SPEAKER_00: We have a 45-year-old skier who tore both ACL skiing and is someone who has been in this recovery process for a long period of time, well over a year, and they've torn both their ACLs and it hasn't been straightforward.
• 19:13
  SPEAKER_00: They got one ACL torn, got the surgery done, and then on the other ACL tear, when that came to the right timing, they had that done three months later to get to a stable place.
• 19:24
  SPEAKER_00: And yeah, you can imagine that this person is having a very, very long process.
• 19:28
  SPEAKER_00: So their nine to 12 month recovery has been compounded by a lot.
• 19:32
  SPEAKER_00: Oh, and also there has been some other mom pieces that have layered into this that have made this process a bit more complex.
• 19:41
  SPEAKER_00: And so, as you can see, this is just a handful of people we are working with to give you an example, all remotely, never met them in person.
• 19:49
  SPEAKER_00: But the thing is that they've all had a very complicated path.
• 19:54
  SPEAKER_00: And they have complex histories, they are not coming in at month one.
• 19:59
  SPEAKER_00: We have people coming in at month one, and guess what?
• 20:01
  SPEAKER_00: We get to set the foundation and we get to minimize as much wasted time as possible.
• 20:07
  SPEAKER_00: Whether they're going to in-person PT and they're wanting to work with us, or whether they just want to switch over to us, we can make it work and it's fun to be able to do that.
• 20:16
  SPEAKER_00: But I would say that is typically the minority because sometimes people don't realize they have not the right guidance, or they're just kind of spinning their wheels, or the expertise of the PT was in the first eight to 12 weeks, and then it was just a matter of feeling a bit lost.
• 20:35
  SPEAKER_00: It's like your post-op rehab was kind of limiting you, and then once you get to normal daily life, you're kind of further into it.
• 20:43
  SPEAKER_00: The specificity of it kind of went away because life was no longer limited.
• 20:47
  SPEAKER_00: It was just now you don't feel strong, you don't feel like you're moving towards anything.
• 20:51
  SPEAKER_00: There was no roadmap for you.
• 20:53
  SPEAKER_00: And so this is the challenge that we have in a lot of this is that people can come in early, but a lot of times they come in a lot later.
• 21:01
  SPEAKER_00: And so this is something that is very, very common in this process.
• 21:06
  SPEAKER_00: And while you might think that this is just the minority here, majority of the time, these are the people who we're seeing all the time.
• 21:15
  SPEAKER_00: And when you talk to most ACLers, they're probably rarely where they quote unquote should be in this timeline, if you will.
• 21:24
  SPEAKER_00: And so here's what I want to land.
• 21:26
  SPEAKER_00: The first thing is this if you're further out and still not there, just know that you're not broken.
• 21:31
  SPEAKER_00: This is not something that you should put blame on yourself.
• 21:34
  SPEAKER_00: You did not fail your rehab.
• 21:36
  SPEAKER_00: This injury is genuinely hard.
• 21:38
  SPEAKER_00: You guys know this.
• 21:39
  SPEAKER_00: The process is nonlinear, and for a significant number of people, it takes longer than anyone told them it would, even that nine to 12 month range.
• 21:49
  SPEAKER_00: That is the truth of this, and it's important for you to hear that and know that, especially coming from pulling so many conversations and what we see very, very regularly.
• 22:01
  SPEAKER_00: You cannot compare this to the professional athlete who got back in nine months or six months or eleven months who it was their full-time job.
• 22:10
  SPEAKER_00: You just can't do it because your life is very unlikely similar to that athlete where they're getting paid for this.
• 22:16
  SPEAKER_00: This is their full focus.
• 22:18
  SPEAKER_00: You know, do they have other people to kind of help them with life?
• 22:21
  SPEAKER_00: Probably.
• 22:22
  SPEAKER_00: Um, they have the resources available and supposed to be the top-tier, like, you know, things that they have at their facilities, but they still take time to get there.
• 22:32
  SPEAKER_00: So we shouldn't expect the exact same thing, but you should expect the same level of care, even if you don't have access to all the fancy gadgets and whistles, right?
• 22:41
  SPEAKER_00: You deserve the same guidance, and if not better.
• 22:44
  SPEAKER_00: But I also want to say the second thing here because I think it matters just as much.
• 22:47
  SPEAKER_00: Normalizing this is not the same as accepting being stuck.
• 22:51
  SPEAKER_00: There is a difference between understanding that recovery is complex and nonlinear and just continuing to drift without a plan.
• 23:00
  SPEAKER_00: I'm gonna say that again.
• 23:01
  SPEAKER_00: There's a difference between understanding that recovery is complex and nonlinear and just continuing to drift without a plan.
• 23:10
  SPEAKER_00: And what I see most often in athletes who are far out and still struggling is not a lack of effort.
• 23:18
  SPEAKER_00: It's a lack of the right structure.
• 23:21
  SPEAKER_00: It's a lack of the right guidance, lack of clarity, it's a lack of just not having any direction.
• 23:29
  SPEAKER_00: They were never tested, so they don't actually know where they stand.
• 23:32
  SPEAKER_00: They don't have programming that is individualized and progressing, they don't have a coach who has a clear picture of their injury, their goals, and what it takes to close the gap.
• 23:41
  SPEAKER_00: No expertise in this process, so then they just getting general stuff.
• 23:45
  SPEAKER_00: And they don't have milestones to tell them when you hit this target, you're ready to move forward.
• 23:51
  SPEAKER_00: So, so important.
• 23:52
  SPEAKER_00: And this is not a character flaw, that is a gap in the system that has failed you.
• 23:58
  SPEAKER_00: But once you know that gap exists, you have a choice about what to do with it.
• 24:03
  SPEAKER_00: So if you're Sitting with this episode right now, and it is hitting super close to home.
• 24:08
  SPEAKER_00: I want you to do two things give yourself some grace.
• 24:11
  SPEAKER_00: Genuinely, this is hard, y'all.
• 24:14
  SPEAKER_00: I've been through it twice.
• 24:15
  SPEAKER_00: We've walked hundreds of athletes through this process.
• 24:18
  SPEAKER_00: Our team is currently working with so many ACLs.
• 24:20
  SPEAKER_00: We're working with mentees who are trying to navigate people through this.
• 24:25
  SPEAKER_00: It's hard.
• 24:26
  SPEAKER_00: It's hard.
• 24:26
  SPEAKER_00: There's a reason why re-injury aids suck.
• 24:29
  SPEAKER_00: And the thing is that it's not an easy solution.
• 24:32
  SPEAKER_00: It was always going to be hard.
• 24:34
  SPEAKER_00: And the fact that you are still here, still working, still trying to get back to what you love, that is what matters here.
• 24:40
  SPEAKER_00: And then the other thing is get honest with yourself about what you actually have in place.
• 24:45
  SPEAKER_00: And I think most people don't do this.
• 24:50
  SPEAKER_00: And if you're listening to this right now, I encourage you to just take a second and pause and just think about these questions I'm about to ask you.
• 24:59
  SPEAKER_00: And audit your process.
• 25:01
  SPEAKER_00: Audit where you are.
• 25:02
  SPEAKER_00: Because I promise you, this could be the difference in getting back to what you want to do in six months and in nine months and in 12 months.
• 25:10
  SPEAKER_00: This time a year from now, you could be in a much different place if you can answer these and you can audit these with honesty and to know if you need to make a change.
• 25:20
  SPEAKER_00: Number one, do you have your strength numbers?
• 25:23
  SPEAKER_00: Do you know specifically how much your quads on both sides are kicking out objectively, your hamstrings on both sides, how they compare to each side and relative to your body weight?
• 25:34
  SPEAKER_00: Do you have a plan that is specific to you?
• 25:37
  SPEAKER_00: When you open up whatever it is, your sheet of paper, you go to PT, you look at this app, is your entire week plan and is there intention behind every single one based on your testing and the targets and benchmarks that you have set up?
• 25:51
  SPEAKER_00: Are you communicated that of what is the next step?
• 25:53
  SPEAKER_00: Do you always know where you're going?
• 25:55
  SPEAKER_00: And do you have someone who can tell you where you are and what comes next?
• 26:00
  SPEAKER_00: And if the answer is no, that is the thing to fix.
• 26:04
  SPEAKER_00: That will take months and months and months off of this hamster wheel that you feel like you're on.
• 26:10
  SPEAKER_00: And it'll also just help you offload this kind of mental hurdles and all the thoughts that are going through your head because someone who knows this process can answer those and they should.
• 26:20
  SPEAKER_00: And so that's the main thing to take from this, y'all is that I want you to audit this process, but I also want you to know that it's just normal if you are listening to this and you are a year out and you still have a long road ahead.
• 26:33
  SPEAKER_00: Guess what?
• 26:34
  SPEAKER_00: There's many more ACLers in this world than there are the people who are finishing at nine months.
• 26:39
  SPEAKER_00: I promise you.
• 26:40
  SPEAKER_00: And this is what my episode is for today.
• 26:43
  SPEAKER_00: I thought it was going to be shorter, and man, I'm gonna have to start doing something different.
• 26:48
  SPEAKER_00: I apologize.
• 26:49
  SPEAKER_00: But you know what?
• 26:50
  SPEAKER_00: I felt really deep within me, like just to share this with so much conviction.
• 26:56
  SPEAKER_00: And if this episode resonated with you, if you've been in this process for longer than you expected and you're starting to wonder if it's always going to feel this way, I want you to know it doesn't have to.
• 27:06
  SPEAKER_00: A longer road is just it's not a dead end, y'all.
• 27:09
  SPEAKER_00: It's not.
• 27:10
  SPEAKER_00: It just means you just need some better navigation, you need some help, you need someone to be able to direct you and guide you.
• 27:16
  SPEAKER_00: I think about your physical therapist and your ACL rehab team should be your GPS.
• 27:22
  SPEAKER_00: You should always know what direction you're going, any detours you take, how long it's gonna take, and every turn along the way, getting you from point A to point B, always, no matter where you are in the process.
• 27:32
  SPEAKER_00: That is our team's main philosophy and goal is like we are gonna be your guides in this no matter what.
• 27:38
  SPEAKER_00: Answer any questions, get you to the right place, make sure that you feel supported and you have a plan and testing through this process.
• 27:46
  SPEAKER_00: And if you want to learn more about how we work with athletes at every stage of this, including these messy, complicated far out versions, I'm gonna have to get our team on this because if they could just kind of vouch for all the cases we have right now, the complexities, but also how far people out are.
• 28:01
  SPEAKER_00: It's crazy.
• 28:02
  SPEAKER_00: And it's people who are coming in at just random points in this process because they've just been fed up.
• 28:08
  SPEAKER_00: And the thing is, is like we want to help you if that is something that you are interested in or you feel convicted to, or if you just need someone to bounce a thought off of.
• 28:17
  SPEAKER_00: We are here to help.
• 28:18
  SPEAKER_00: We'd love to be in your corner.
• 28:20
  SPEAKER_00: We appreciate you guys for being here and supporting this podcast.
• 28:23
  SPEAKER_00: And if there's any questions that you have in general, please reach out.
• 28:27
  SPEAKER_00: We are here to help.
• 28:29
  SPEAKER_00: I'll catch you in the next episode.
• 28:31
  SPEAKER_00: This is your host, Ravi Patel, signing off.