Mark McFarland Professor Mahaffey English 1102-100 28 January 2013

Road to Recovery Proposal Exigence Injuries in sports have always been an issue, but there seems to be more and more star players going down each and every season. Every sport has made many new updates in the equipment used because of the major injuries that have happened in the past. Football has provided new helmets and pads that are much more protective of the body. Baseball has provided the players with new helmets, because being hit by a pitch can be very life threatening. Basketball has come out with new shoes, ankle braces, and knee braces for players to wear in order to prevent injury. Injuries are very important and harmful occurrences to all aspects of a team. If the player is hurt, then they could be out for the season or maybe even for the rest of their career. Most professional athletes are counting on their health, because it is their job to go out and play each and every night. The coach could essentially lose his job if the team cannot function without a certain player lost to injury. Inquiry How can technology improve treatment and recovery of injured athletes? How will a player come back quicker and stronger than before the injury? I would like to know a lot more about how the therapy part works after a player is injured. The technology in

todays society is drastically changing, and I feel that injuries will be overcome in a much quicker manner in the future. Therapists and Trainers will gain a deep understanding of the injuries and with better technology and treatment, I think an injured athlete can recover much quicker. I think the trainers and therapist do an amazing job with all injuries, but I think there is always room for improvement. I know a lot about sports and how certain injuries can occur, because I have been there and injured myself many times. I have been through the physical therapy and recovery part of an injury and it is not an easy task to overcome. Method I would like to research a couple of my key questions on the internet such as what type of improvement could be made to treat an injured player. I would also like to conduct an interview with the physical therapist I attended after one of my injuries. If I could possibly interview an athlete that has been through a major injury and has went through the recovery process, that would probably give me more information than any website. I feel like an interview with a therapist or player would give me the most information, because theyve been there and know a lot about how the body works. I would really like to get different opinions from trainers of different sports to have a comparison of the types of injuries and the process of recovering. I am really looking forward to finding out as much as I can about my topic, because it is definitely something I am interested in and would like to end up pursuing for a future occupation.

Annotated Bibliography Reference Citation 1: Lin, Jerry. "Recovering From An ACL Injury." ACSM Fit Society Page (2012): 4. SPORTDiscus Evaluation: The first article I found would be a very biased opinion on how Doctor Jerry Lin feels about recovering from an ACL injury. I am sure other doctors would agree with a lot of what he says, but other doctors might disagree with certain parts of his article. The article gives the reader a good inside look on how one would go about recovering from an extremely painful injury in the ACL. Gist: The ACL is a ligament that mainly functions to provide knee stability... (Lin). The ACL is starting to become one of the worst injuries in all sports, because just a slight movement can result in the ACL (Anterior Cruciate Ligament) to completely tear or stretch. the ACL receives very little blood and thus has poor healing capacities (Lin). This injury causes many athletes to miss entire seasons and thus not return in the same shape as before. with Full Text. Web. 17 Feb. 2013.

Reference Citation 2: Manske, Robert C., and B.J. Lehecka. "Evidence -- Based Medicine/Practice In Sports Physical Therapy." International Journal Of Sports Physical Therapy 7.5 (2012): 461-

473. SPORTDiscus with Full Text. Web. 17 Feb. 2013. Evaluation:

This source is also a biased article focusing on how evidence-based medicine will advance and help our society in the future. Evidence-based medicine will be one of the main contributors to the rehabilitation of athletes based on what Manske and Lehecka mention. The article is full of statistics and scientific evidence, but I see the article being very one-sided towards the medicine part of recovering and not as much the physical activity on the injury to strengthen the muscle. Gist: The percentage of Level I studies published in the prestigious Journal of Bone and Joint Surgery has slowly increased from 4% to 21% between the years of 1975 and 2005 (Manske and Lahecka). The study shows that medicine is the leading contributor to athletes recovering from an injury, which shows the article is biased towards medicine. The article is also referring to evidence-based practice somewhat and shows that a combination of both will help sports physical therapists in the future.

Reference Citation 3: Ritter, Malcolm. "Rehab May Be Better For ACL Tears; Study Shows Surgery After Injury Doesnt Improve Outcome." San Jose Mercury News (CA) 22 July 2010:

Associated Press. NewsBank. Web. 13 Mar. 2013. Evaluation: This source is a non-biased source, showing a study of patients with a torn ACL and whether or not they needed surgery. The study looks at the injury two ways, with surgery and without surgery. Depending on the severity and what the patient plans to do after the

rehabilitation would show doctors if they necessarily need surgery or not. The article gives the reader a good look into the surgery phase of the ACL injury. Gist: Maybe we will be surprised that a lot of people actually do not need an ACL reconstruction (Ritter). Most athletes are quick to agree to the surgery for the reconstruction of the ligament for the simple fact that they could possibly recover quicker. This article is covering the why part of a patient and whether or not they need surgery. If a major athlete were to have this type of injury and plan on getting back in the game, doctors would most likely recommend surgery and then rehabilitation. Others may prefer to just simply enter rehab and recover that way. It really just depends on the patient and their level of physical activity. Reference Citation 4: Kruse, LM, B Gray, and RW Wright. "Rehabilitation After Anterior Cruciate Ligament Reconstruction: A Systematic Review." Journal Of Bone & Joint Surgery, American Volume 94.19 (2012): 1737-1748. CINAHL Plus with Full Text. Web. 14 Mar. 2013. Evaluation: The source being used is an article giving insight to rehabilitation and how to incorporate rehab into the recovery process. It goes into detail on the results from Postoperative Bracing, Accelerated Strengthening, Home-Based Rehabilitation and Neuromuscular Training. Through this article I get a whole new prospective on Physical Rehabilitation. Gist: Successful anterior cruciate ligament (ACL) reconstruction requires physical

rehabilitation to help patients return to an active lifestyle (Kruse). I really like this article since it focuses on the physical part of rebuilding and strengthening the knee. It talks a lot about the different types of ways athletes can rebuild the anterior cruciate ligament and then how the athlete can support the knee after rehabilitation using bracing. Throughout the essay, evidence based medicine is mentioned along with physical rehabbing. Reference Citation 5: Tate, Parker. Personal Interview. 17 Feb. 2013. Evaluation: I am interviewing Parker Tate, a Physical Therapist Assistant at a gym in my hometown. He has been through a lot of the schooling for a Physical Therapist and I feel that he is a very credible source. I am having to hold an interview via email because he is in a masters program and I cant meet with him in person. Gist: The interview is one of the more important parts to my research component for the simple fact I am getting an actual Physical Therapist opinion on his ideas. Parker is the therapist I went to after pulling my groin last year and is a new face to the physical therapy program coming straight out of school. I have talked to him many times and he always seems to have an understanding of what he does in the Physical Therapy field. I would really like to see how his answers compare or contrast to my secondary resources.

Synthesis Although most of the sources I found turn to the physical treatment of an injury for rehabilitation, Robert Manske and B.J. Lehecka thinks that evidence-based medicine

is the essential component to recovering from a major injury. A simple ankle sprain or twist of the ankle is a very common injury in todays world although it is not quite serious. The easiest way to treat that type of injury would be to rest the ankle, ice for a certain amount of time, compress the injury with some type of tight bandage, and the elevate the ankle above the height of the leg for blood flow. It is not common for somebody with a sprained ankle to go to the doctor so most people have the general understanding of how to treat it, however an ACL (anterior cruciate ligament) injury is very serious and needs treatment as soon as possible. Major injuries on the other hand such as an ACL tear cannot be treated without a doctor or therapist care. My first reference citation was based solely on the ACL injury which has become one of the worst and most common injuries by athletes. My sources vary somewhat between the injury and the different opinions of the authors. Manske and Lehecka talk about the medicine side of rehabilitation which in my opinion can help tremendously with the pain, but not as much on the recovery side. Then, the article Kruse wrote talks about the physical conditioning and therapy part of rehabilitation instead of medicine. I agree more with Kruse, because I feel like conditioning and working the muscles and joints around the injury helps to a full recovery much faster than would medicine. I agree with Maske and Lehecka in the fact that medicine will definitely be a future reference for an injury, but I do not think you can recover fully without some type of physical activity. Although EBM has been a buzzword for some time now, many sports physical therapists are still not completely sure of how to integrate EBM into daily clinical practice (Maske and Lehecka). Many physical therapists have not yet understood the evidence-based medicine side of therapy, but later into the future I believe most all physical therapists will incorporate medicine in

their workplace somehow. Maske and Lahecka also talk about the EMP (Evidence-Based Practice) side of therapy which is the physical conditioning or practicing. All of the sources I found are all related to the opinions on the correct way to recover from a major sports injury. Doctor Jerry Lin talks about how to continue physical activity after tearing an ACL in his article. Also, Lin talks about resting, icing, compression, and finally elevating the knee. ACL is a major injury and takes an extended amount of time to recover from. Derrick Rose and Adrian Peterson are two star professional athletes that both tore their ACL. Peterson recovered from the injury much faster than did Rose so I believe it depends on the therapy and how the person feels about the recovery process. All of the sources I found are all interrelated and all describe physical conditioning along with one source that talks about medicine. Every source I used, including my interview talks about rehabilitation through physical activity such as therapy, and evidence based medicine. I agree with the RICE recovery and I feel that helps tremendously in simple injuries as well as major injuries in the long run. It really just all depends on the person as to how fast they will recover and when they will be ready to return to their sport.

ROAD TO RECOVERY
ACL INJURY BACKGROUND:
There are four major ligaments located in the knee. The most important being the anterior cruciate ligament (ACL). An injury to the ACL is essentially over-stretching or a partial/complete tearing of the ligament. The ACL is a very important ligament located beneath the patella. The ligament is actually a fibrous tissue connecting the femur to the tibia and fibula portion of the leg. An injury to the ACL can sideline athletes for a certain period of time depending on their rehabilitation process. The ligament gives the lower part of the leg mobility.
Lindsey Vonn is a professional skier who tore her ACL in an event this past winter. She came down awkwardly after a jump in the course and the knee collapsed. She is currently recovering and hopes to return to the sport for next season.

AC L Importance of the ACL:

The ACL is a ligament that mainly functions to provide knee stability... (Lin). The ACL is most commonly injured in a sport that requires an extended amount of planting and pivoting of the leg such as soccer or basketball. This ligament is a key contributor for the knee to function properly and very few people can get up and walk away immediately following the injury. Many studies have concluded that females are far more prone to injure the ACL than males simply because women have a different body structure than men. Athletes worldwide are more commonly injuring the ACL because just a simple or sudden movement to the knee can cause one to collapse and grasp their knee in pain. I know many athletes, both young and old, who are experiencing or have experienced an ACL injury. It is becoming one of the most severe and more well known sports injuries of todays time.

Rehabilitation:
There is no quick recovery after an injury as severe as the tearing of the ACL. Although it is very painful to tear a ligament, this pain is just the beginning of a long and strenuous rehabilitation process. The majority of athletes planning on returning to their respective sport will have surgery almost immediately after tearing the ACL instead of waiting to see if rehabilitation will heal the tear on its own (Ritter). The doctor or physician will give insight on how the recovery process should be performed for that certain athlete, so each person may have a completely different agenda. Surgery helps to reconstruct the ligament much faster than letting it heal over time on its

AC L
own. Surgery repairs the knee, but physical rehabilitation is still a vital key to full recovery. Successful anterior cruciate ligament (ACL) reconstruction requires physical rehabilitation to help patients return without pain hindering the physical activity on to an active lifestyle (Kruse). Several of the sources agreed on the physical aspects of rebuilding and strengthening the knee. Incorporating RICE (resting, icing, compressing, and elevating the knee) everyday will also help with swelling and even recovering faster. Aside from physical activity in rehabilitation, a couple of my sources talk a lot about evidence based medicine. Evidence based medicine could be a key contributor to the physical therapy field. However, many physical therapists have not yet integrated this idea into their work due to it being a new emerging ideal (Manske and Lahecka). It seems that medicine does not really shorten the knee. There is really no better way to recover from an injury than to enter actual physical rehabilitation. During the first couple of weeks after surgery, stretching the knee is the most vital key for rehab. The next couple of weeks the athlete will start into very mild workout exercises such as lunges or squatting and then work into building the strength up by continuing these exercises with a little weight. After about ten weeks walking and jogging is recommended in order to maintain the strength and flexibility. rehabilitation, but it can certainly alleviate the pain during the process. Parker Tate, a physical therapist I interviewed, says medicine is used mostly during the acute phase of recovery for pain so the athlete can enter the initial rehab

AC L Professional Athletes Sustaining an ACL Injury:

Derrick Rose and Adrian Peterson are two star professional athletes, in two completely different sports, both of which tore their ACL while competing. Peterson recovered from his injury much faster than Rose. The injuries were nearly the same, but I think recovery depends on the therapy and how the person feels during rehab. Peterson was very quick to get up and come back which could be a bad thing if he re-injured the ligament. Rose has taken a very cautious approach and is in the midst of returning after approximately a year and says he is not coming back until he feels 100% jumping and moving laterally. Derrick Rose has been quoted as saying Its all about being ready in a sports article. The comparison between the two athletes are tremendous because they are completely different guys in completely different sports with the exact same injury. These are just two examples among many whom have torn this certain ligament. It really just depends on the athlete as to when they feel comfortable to return.
Adrian Peterson is a star NFL running back that tore his ACL in a game against the Washington Redskins a couple of seasons ago. Peterson was quick to recover and won M VP his first season back from the injury. Derrick Rose tore his ACL during the 2012 NBA season after attempting a lay-up. He is steadily recovering from his injury and looks to return to the Bulls lineup as soon as possible.

AC L Future Recovery:
Doctors will always plan the rehabilitation process for the athlete considering the degree of the injury. Physical Therapy will always be incorporated in recovering from any type of injury. The types of machines used by physical therapist contribute a large amount to the recovery process. The continuous passive motion (CPM) machine can be used to move the knee at a slow rate to help increase mobility. There is no better cure than to physically reconstruct the ligament after the surgery. Flexibility and Strengthening Exercises will always be most important throughout recovery time, but I feel that some kind of medicine will take over and heal the ligament much faster. Medicine will be incorporated into the therapy field in the future because of the major advancements in the medical field. Recovery today typically lasts on average around four to six months, but most athletes are not fully to recovered after this amount of time. Some athletes like Derrick Rose can take up to a year to recover. In the future athletes will most likely recover much quicker than today if technology keeps advancing at the rate it is now.
The Anterior cruciate ligament and Posterior cruciate ligament and the two main ligaments within the joint of the knee. The M edial collateral ligam ent and Lateral collateral ligament are located on the edge of the two bones and are not as important as the ACL and PCL.