Philly.com Sports Doc
POSTED: Tuesday, May 14, 2013, 6:00 AM
Justin Shaginaw MPT, ATC
Baltimore Ravens linebacker Ray Lewis speaks during an NFL Super Bowl XLVII football news conference on Wednesday, Jan. 30, 2013, in New Orleans. Lewis denied a report linking him to a company that purports to make performance-enhancers. The Ravens face the San Francisco 49ers in the Super Bowl on Sunday. (AP Photo/Patrick Semansky)
We all marvel in the extraordinary recovery of athletes following injury.
Ray Lewis returned to play less than 3 months following tricep repair surgery. Adrian Peterson nearly broke the single season NFL rushing record less than a year after ACL reconstruction. Kyle Lowry played point guard for Villanova less than 4 months following his own ACL reconstruction.
How is this possible? Do these gifted athletes just work harder during rehab? Do their bodies heal faster than the rest of us?
Or could it be the fear of most sports fans in the 21st century? Could these be using performance enhancing agents to speed up their recovery? Let’s discuss the factors and controversies that contribute to a speedy recovery in more detail.
Ray Lewis and his tricep. Ray injured his tricep on October 14th, 2012. He had surgery three days later and played in his first game on January 6th, 2013. That’s less than 3 months after injury—an unheard of turnaround time. There are many factors contributing to his extraordinary recovery.
First and foremost, Ray took a great risk at returning that soon. His chance of re-tear was very high as the surgical repair takes at least 3-4 months to be even close to being strong enough to withstand the forces involved in football. I’m sure that his rehab was rigorous in regaining the strength needed to block and tackle in the NFL. One would think his age would be a detriment to a speedy recovery, but it doesn’t seem to have been a factor.
The big question: did the deer antler spray help? There is little scientific evidence that IGF-1 (insulin-like growth factor) has any performance enhancing or injury recovery benefit. And IGF-1 is not affected when delivered through a spray. In Ray Lewis’ case, he probably beat the odds of re-injury by playing as early as he did vs. having an amazing recovery aided by performance enhancing supplements.
Adrian Peterson. He is still the talk of the town when it comes to returning from ACL surgery. In his first season back, he nearly sets the NFL rushing record.
Adrian’s first game back was 9 months after his ACL surgery. Although his level of play was astonishing— many players never quite get back to their pre-injury level—the time frame that he returned to play in is within the normal range of 9-12 months. Was there anything more than hard work and determination that contributed to his recovery? A good surgeon and rehab staff helps. But probably more than anything is what makes him such an amazing athlete is the same thing that gave him such a remarkable recovery… great DNA. There are no rumors or whispers about deer spray or any other performance enhancing substances with Peterson, just old fashioned hard work.
When we look for an unbelievably quick recovery from ACL rehabilitation, we don’t need to look any further than the Main Line and former Villanova basketball star Kyle Lowry. Kyle tore his ACL the summer before his freshman year at Villanova. He had surgery on September 17th and played in his first collegiate game on December 31st. That’s just 3 ½ months after ACL reconstruction! Not only did he return to play so quickly, but he had a great season and was named to the Big East All-Rookie team as well as being tabbed Philadelphia Big Five Rookie of the Year. Kyle has gone on to have a successful NBA career without any inkling of a previous ACL injury.
In Lowry’s case, his recovery can be based almost exclusively on his genetics as even performance enhancing substances couldn’t have produced such as a rapid return to basketball.
Genetics, hard work, or performance enhancement? How do these athletes return so quickly? Even though in Ray Lewis’ case there are questions regarding hormone usage, all the deer antler spray in the world won’t get players back on the court and field as quickly as these players returned. These players get back to sports on the accelerated track due to their genetic makeup, excellent surgeons and rehab staff, hard work, and willingness to play in a time frame that puts them at higher risk for re-injury.
Philly.com Sports Doc
The evolution of ACL injuries
POSTED: Tuesday, April 9, 2013, 5:55 AM
Justin Shaginaw and Arthur Bartolozzi
We all have heard someone talk about their ‘trick knee’ they hurt in high school football, or the stories of players losing their college scholarship due to a knee injury. So how does Adrian Peterson return in less than a year and just miss the NFL rushing record? Let's look back and see how we've gotten from there to here—from career-ending setbacks to near-record setting comebacks.
An online search reveals little specifics when looking for career ending knee injuries. This may be because the injury kept players from ever having a recognizable career. Joe Namath was one of a few players to have a successful career in early days of ACL injuries. Namath had a brace made especially for him that allowed him to continue to play without surgery. Back then, surgery was almost always career ending due to the procedure itself and the poor rehabilitation afterwards.
It wasn't until the 1970s when Temple physician Dr. Joe Torg first discussed the Lachman's test for assessing an ACL injury. In the 1980s the MRI helped us to diagnose an ACL tear. Around this same time, arthroscopy was first used for knee injuries. Since then there has been an evolution in both the surgery itself and the subsequent rehabilitation.
Surgery has gone from using a button outside the skin as an anchor for the ACL graft to bioabsorbable screws for anatomical reconstruction. Rehabilitation has also progressed from being casted for 6 weeks to riding a stationary bike the next day following surgery. These advances in surgery and rehab are what allow exceptional athletes the opportunity to return to same level of play in such a short period of time.
But players like Adrian Peterson are the exception and not the norm. In reality it takes a year or more to fully recover from ACL surgery. And even Peterson has not fully recovered as evidenced by some physical measurements and teammates' reports. Now when players suffer career ending injuries it is not solely due to the ACL, but multiple ligament injuries or articular cartilage damage.
New surgical and rehabilitation techniques are allowing players to return to pre-injury levels of competition—but only through months of hard work. In the past, surgery ended careers. Now it allows extraordinary athletes to return in such short periods of time, and average athletes to eventually return to the sports they love.
Justin Shaginaw, MPT, ATC is an assistant athletic trainer for the U.S. Men’s National Soccer Team. Arthur Bartolozzi, MD, is Director of Sport Medicine at Aria 3B Orthopaedic Institute