Be Your Best: Dissecting the impact of ACL injuries on high school athletes

(Dr. Brian Sokalsky, DO, is at the helm of Jersey Shore Sports Medicine in Ocean City and is a board certified family physician with special training in sports medicine. Once per month, Glory Days Magazine publisher Dave O’Sullivan talks with Dr. Sokalsky about various sports injuries, treatments and prevention methods.) The ACL. You hear about it a lot, but what exactly is an ACL injury, and what are realistic expectations for a high school athlete to come back from one? Our last cover story featured Holy Spirit basketball player C.J. Barnes, who made an impressive recovery from a torn anterior cruciate ligament in his right knee to make it back to the hardwood in just six months. Dr. Sokalsky said that time frame for recovery is rare, but it does happen. He points to Minnesota Vikings running back Adrian Peterson, who made a relatively speedy recovery and went on to win several NFL rushing titles following an ACL tear. “The ACL is the main stabilizing ligament in the knee. It particularly stabilizes the knee for rotation. I think as we all add sports it becomes bigger and bigger. As kids are playing sports at a younger age, and playing at a higher intensity at a younger age, we’re just seeing the injury more because we have more kids playing sports,” Sokalsky said. “It’s a very severe injury, so that’s why when it happens it’s not like an ankle sprain where you can bounce back in a couple of weeks. This is a surgical injury that generally takes up to a year to recover from.” Sokalsky said there are varying degrees of a torn ACL. There can be a small tear in the middle of the ligament, a larger tear, or it can tear away from the bone. There are also other factors that might determine how quickly an athlete can return to action, such as genetics and how intense their rehab program is. Brian Sokalsky is a doctor specializing in sports medicine. His office is located in Ocean City. To contact Dr. Sokalsky, call 609-545-8553 “It doesn’t really matter where it tears. It can tear in the middle or by the bone, but that doesn’t really change things. Once it’s torn, it’s torn and it can’t be put back together. It needs to be replaced,” Sokalsky said. “There are a lot of variables. Sometimes the ACL tears by itself, but often times there are other injuries. You can tear the MCL, the meniscus. One of the big factors is, is it an isolated tear or are there other injuries? Another variable is what rehab is available? The rehab available to a junior in high school is very different than what a professional athlete has available. Working with a therapist every day as opposed to a couple days a week. Additional personal trainers, nutrition. All that plays a role, and part of it is work ethic. And part of it, quite frankly, is the supervising doctor. Some surgeons are more conservative than others, particularly in younger kids.” Sokalsky said there are two ways to repair a torn ACL — by using a ligament from another part of the body, or by using one from a cadaver. “That’ actually a very big topic of discussion —which is better — the two most common options are taking the patella tendon and using that as the ACL, or using some of the hamstring and using that,” Sokalsky said. “There are those who think using your own tissue is better, and there are those who think using a cadaver tissue is better. That is a huge debate among the orthopedic community as to which is better, and right now we don’t really have that answer.” Perhaps the biggest challenge for any athlete who undergoes ACL surgery is not so much the physical rehab — athletes are used to being challenge physically — but the mental side. It can be difficult to get over the fear of injuring the knee again once an athlete is cleared to return. “There absolutely is a psychological aspect. There are two parts to that. The first is the rehab itself. It’s a devastating injury and whatever season you are in you have lost. And depending what part of the season you are in, you could be at risk to lose the next season. You know you have a long, slow rehab ahead of you without being able to play whatever sport it is you are involved in,” Sokalsky said. “The second part is once you do get through that part, is getting the confidence back in your leg. Not worrying every time you take a step if you are going to tear it again. Getting that confidence back is a whole separate psychological part of coming back from the injury.” Sokalsky said, however, that with the medical technology available today, as well as the advances in rehab techniques, it is possible for any athlete to return to 100 percent if they are aggressive in their rehab. “The surgeons have gotten so good and the rehab programs have gotten so good that you can return to 100 percent. Look at some of the pro athletes who have gotten it done,” Sokalsky said. “Adrian Peterson came back and has been the rushing champion twice since his return. In the Super Bowl, Thomas Davis had three ACL tears in the same knee and he is an All-Pro linebacker for the Panthers, so you can come back and there are examples of that.” [adsense]