Adrian Peterson leads way in ACL recovery in NFL
3:39a.m. EST December 7, 2012
Prehab and rehab
Surgeons typically don't reconstruct ACLs until a week or two after the injury. That interim is for the prehab.
"The best thing to do before surgery is to get as much swelling out of the joint as possible to get their range of motion back," said Anna Hartman, a physical therapist and Director of Physical Performance Therapy at Phoenix-based Athletes' Performance, a training/rehab center for elite athletes.
"The more range of motion they go into surgery with and the less swelling … the better the outcomes they have."
That means ice and elevation, massage and manipulation of the knee and exercising muscles of the hip that shut down after a leg injury. Hartman also has her patients work on range of motion in a pool with his or her body unweighted.
After surgery, Hartman said the doctors typically have the athletes stay home for 2-3 days. The knee is in an immobilizer (a type of brace that can be adjusted to allow for varying degrees of knee bending), and the athlete is on crutches.
After that, the rehab moves into full swing. Hartman said athletes usually are off crutches in two weeks, although the immobilizer will stay on for about four weeks.
From five weeks to 16 weeks, she said, the athlete does exercises to strengthen the muscles of the hip, thigh and calves. "Typically around 12 weeks, we'll clear them to start running straight ahead," she said.
The cutting and running come between 4-6 months.
"Six months, usually, the doctor will clear them to return to sports-specific activities," Hartman said.
She added, "I won't allow somebody to cut until they've shown me they have good strength and hip stability and are tolerating things well."
The emphasis is on the quality, not the quickness, of the recovery.
"In the early 2000s, there were a lot of people pushing -- without any science -- returning in like 2-4 months," Harner said. "Many of these athletes weren't ready. They didn't have the muscle power. They didn't have the balance. ... Their knee would fatigue, and they'd blow the graft out again.
Now, the rehab is more carefully monitored, Harner said: "We're now looking at what is the function of the knee and the leg and the lower extremity. Can they do a shuttle drill (changes of direction around cones)? Can they do one-legged hops and can they run on a treadmill for 15 minutes and then stand on a single leg without having it wobble?"
Peterson rehabbed at the Vikings complex and near his Houston home, at Memorial Hermann Sports Medicine Institute, where he worked with physical therapist Russ Paine.
"The things you guys don't see is how much I work and grind and fought through different situations to get back," Peterson said. "Mentally, I was able to push through when I was tired and didn't want to do anything. I definitely give credit to the things I put into my off-season."
The patella tendon is still sore after games, but it's a small price to pay for Peterson to return to the form that makes a 2,000-yard season possible to him.