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Old 10-09-2012   #332
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Default Re: Brian Cushing torn ACL .. out for season

Originally Posted by Dutchrudder View Post
Owen Daniels has had three torn ACLs in his career. He took a while to come back after the most recent one, but he did recover.

Adrian Peterson tore both an ACL and MCL on Dec. 24, 2011, and he's back to playing now. They say it's almost inhuman for someone to recover from that as quickly as he has though.

Jamaal Charles tore his ACL last year in week 2 and he's back to what appears to be 100%.

Rashad Mendenhall tore his ACL last year just before the playoffs. He didn't start playing much until week 5 of this season, but he looked good in his first game.

Terrell Suggs tore his in May, but expects to be playing for the Ravens in November. Only a 6 month recovery, which is aggressive.

I don't think we need to worry about Cushing coming back next year, he will have 9-10 months before meaningful practices start. He's a warrior, and I'm sure he will train extremely hard and make himself ready to return ASAP. It just won't happen until next year
[Suggs as has already been mentioned was an Achilles rupture]

ACL rupture post surgical repair, return to play recovery and return performance level expectations have been elevated just in the last decade. Six to nine months is an expected return to play for an NFL player. However, there is still great variation in those parameters seen. There have been very few NFL-oriented studies on this injury. There was a 2009 study that concluded that Dlinemen and LBs were most affected with return performance level. Another concluded that those players having 2-4 years NFL experience were more likely to return to previous level as compared to those with more than 4 years. There was the conclusion that wear and tear led to lesser return performance (the better recovery in college players). Variance could be accounted for by other not uncommonly encountered simultaneous injury factors of the MCL, PCL, LCL, meniscus, patellar disease or arthritis. Although examples of high-profile RBs are commonly presented, there are many RBs that never got the chance to achieve high-profile status before their early careers were cut short. Not only have improved surgical techniques made this injury far from hopeless today, but the rehab regimens have probably had even more to do with the success. Being able to build the supportive upper leg muscles to the point that they can themselves lend stabilization to the knee. Many of you may not be aware of this (I know Kubiak would be), but John Elway, after sustaining a complete rupture of his ACL, ended up playing his entire college and NFL career without an ACL in his left knee. He wore a brace. But his secret was that he had absolutely massive upper leg muscles virtually substituting his ACL, and, of course, he was not an RB.

After brilliant careers with Broncos ... - The Denver Post ....READ THE REST

Each is headed for knee replacement surgery, Elway sooner than Davis, but both make light of their physical issues, having conditioned themselves to live with the long- term effects. They made millions playing football and knew the risks.

Said Elway, "Other than the lobotomy, everything else is good."

Not exactly.

Elway initially injured his knee in high school, and surgeons removed his anterior cruciate ligament. By the time he retired, he had had five knee operations, guaranteeing himself a post-career lifetime of problems.

"I knew what I was getting into," he said.

Living with pain

So why put yourself through it? In Elway's case, he had a legacy to fulfill. He was the top-rated player in the country in high school and the No. 1 pick in the 1983 NFL draft. He contemplated retirement in his early 30s, but refused to bow to the pain - and the frustration of playing in Dan Reeves' offense - until he won a Super Bowl.

"Just ask Dan," said Elway, 47. "I have a hard head."

And a bum knee.

"It continues to get worse," he said. "I don't have an ACL and now I don't have any cartilage on the outside. That's the reason I have to watch it. It's starting to go in. If it goes too far, it's going to be tough to put a new knee in. It gets too deformed."

Davis, who has launched a second career as an NFL Network analyst, finds himself in a similar predicament. The doctors have told him it's when, not if, he has knee replacement surgery. At 34, he wants to hold off as long as possible, what with artificial knees having a typical shelf life of 15-20 years.

In the interim, he makes daily concessions to his left knee, on which doctors performed microfracture surgery during his latter years with the Broncos. His right knee, the one he injured in 1999 when Matt Lepsis fell on him during an interception return, is fine, but the left one is getting worse.

He takes aspirin to dull the pain. He sleeps with a pillow between his legs to ease the discomfort.

"I feel like I'm 50," said Davis, who in 1998 became the fourth player in NFL history to run for 2,000 yards in a season. "I wouldn't change (my career) for the world, but it's tough. I was like everybody else. Most people say, 'It's not going to happen to me. I'm not going to have to deal with that."'

For those of you interested, here is an abstract of the most recent July 2010 study reviewing ACL injury in NFL players:

Return to Play After Anterior Cruciate Ligament Reconstruction in National Football League Athletes

Background: Rupture of the anterior cruciate ligament (ACL) is a common and potentially career-threatening injury in the National Football League (NFL). The return to play (RTP) percentage and the factors affecting RTP after ACL reconstruction in NFL players are not well defined.

Purpose: To determine the actual rate of return to professional football play in the NFL after ACL reconstruction surgery and to determine what factors can predict ability to RTP. We hypothesize that the RTP percentage in this unique patient population will differ from previously reported populations.

Study Design: Case series; Level of evidence, 4.

Methods: Forty-nine NFL athletes who had undergone primary ACL reconstruction at our institution were followed to determine their RTP percentages and factors predicting RTP.

Results: Sixty-three percent (31 of 49) of NFL athletes returned to NFL game play at an average of 10.8 months after surgery. Age at time of surgery, position, and the type and number of procedures were not significantly different between those who did and did not return to play. The average number of games before surgery was 51 for those who did return to play and 28 for those who did not (P = .039). The odds ratio favoring RTP was 5.5 (P = .016) for those players who had more than 4 years of NFL experience before surgery. The average NFL draft round was 3.4 for the group who returned to play and 6.4 for those who did not (P < .001). The odds ratio favoring RTP was 12.2 (P < .001) for those players drafted in the first 4 rounds of the NFL draft compared with those drafted after the fourth round.

Conclusions: The RTP rates after ACL reconstruction in NFL football players are lower than previously perceived. More experienced and established athletes are more likely to return to competition at the same level after this procedure than those with less professional experience. Being selected in the first 4 rounds of the NFL draft was highly predictive of RTP.
This post is simply to present that Cushing has a very good chance of returning to play, and very possibly eventually to pre-injury level..........but nothing in ACL tear is entirely predictable. What we do know is that Cushing will put in elite-level effort in his rehab to give him the best chance to return to Reliant as the elite player we will recognize.
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