Mayo Researchers: ACL Injuries Need 2 Years To Heal
MINNEAPOLIS (WCCO) -- One of the risks of playing sports is getting hurt.
An injury we hear a lot about these days is a torn ACL. It happens in professional sports and with younger athletes.
The ACL is a ligament that helps stabilize the knee joint. Playing basketball, football, soccer or tennis puts you at highest risk of injury.
About half of those who do get hurt need reconstructive surgery.
It is amazing what the human body in its best form can do. But when an athlete gets hurt and the diagnosis is ruptured ACL, they know they have a long recovery process ahead of them.
Dr. Timothy Hewett, the director of the Mayo Clinic Sports Medicine Research Center, has studied ACL injuries for nearly 30 years.
"When you tear the ACL, it just splays apart. It looks like crab meat almost," Hewett said. "And those mechanoreceptors, that nervous tissue, that sensory system is completely disrupted."
Sixteen-year-old Lizzie Saxen plays soccer and hockey for Apple Valley High School. She tore the ACL in her left knee last June during a soccer game
"The girl was coming at me with a ball because I play defense. And so she kicked it behind me, so I went to stop on … one leg and it kind of just gave out and I fell," Saxen said.
Doctors have traditionally advised ACL patients to wait six to 12 months after surgery before returning to their sport. But researchers at the Mayo Clinic in Rochester shared a different opinion this spring.
"This is actually quite a controversial idea because all these surgeons, physiotherapists, athletic trainers are putting these kids back at six to 12 months, but they're really not ready to go back," Hewett said.
His team at the Mayo Sports Medicine Research Center reviewed years of data on ACL injuries and recoveries. They say there is evidence the body needs two years to fully recover from reconstructive surgery after an ACL tear.
"If you look at the recovery of things like proprioception, sensation of your knee joint, they don't return until about two years after the injury," Hewett said. "So you don't sense the joint as well. You don't control your body as well."
He says by not waiting two years, athletes are returning to their sport before they have regained balance of the knees and hips, and before damaged nerve tissue has healed.
The early return creates a high risk of re-injury.
He acknowledges that waiting two years creates a lot of missed opportunity.
"Nobody wants to do it," Hewett said. "It's based on data, and sometimes people's minds don't quite wrap around data. They wrap around emotion."
Saxen is back at soccer practice just after nine months after reconstructive surgery on her left knee. Six months after her surgery, she was back on the ice playing hockey.
"At the beginning I was definitely like, 'This is going to take a while to get back,'" Saxen said. "And then there was kind of a point where I was like, 'Wow, I feel really good and everything.'"
Dr. Jason Holm is Saxen's orthopedic surgeon at Twin Cities Orthopedics in Burnsville. Her recovery included strength training, balance exercises and extensive testing along the way.
Physical therapists also taught her ways to avoid re-injury.
"We were able to build the strength back up, and sort of learn, 'How do I land? How do I land so that I'm not planting and letting that knee cave in and buckle so the ACL is at risk?'" Holm said.
What does the surgeon think about waiting two years instead of six months to a year? Holm says every patient is different and recovery times can vary widely.
"It does nothing but tell me that, you know, we have a ways to go, and I don't think it needs to be a full two years," Holm said.
He believes the findings of Mayo Clinic researchers are valuable, saying they give surgeons a resource to share with patients so they can understand just how complicated and serious an ACL injury can be.
Doctors say teenage girls are at a higher risk of ACL injuries than boys, and tears often happen with no contact.
Mayo Clinic researchers presented their findings to a large group of orthopedic surgeons this spring, and they say it was well-received. Click here to read the full study.