Claire Boughton
Sports Editor
Terrell Davis.
Danny Manning.
Pierluigi Casiraghi.
Whether a running back for the Denver Broncos, an NBA hopeful out of the University of Kansas, an import striker with Chelsea or a Keene State College athlete, no one is immune to the infamous “career-ending” ACL tear.
For the names above, their ACL tears, unfortunately, lived up to the daunting reputation the injury had created. However, nowadays more and more athletes are able to return to the sports they love after they endure the same injury that ended careers in the past.
But what does the recovery process actually involve?
Keene State sophomore and men’s soccer midfielder Declan Pietro-Coughlin is someone who knows the process all too well. Coughlin tore his ACL on October 25, 2019, in a home contest against UMass-Boston. Coughlin had recently recovered from a hamstring injury before returning to the field, only to go down once again after a handful of games back.
“I came back too soon,” said Coughlin when recalling that game. “I was running and my leg just gave out… I felt a crack and then, when I was on the ground, I had no pain because everything, the nerves and things, had been torn apart.”
Coughlin was carried off the field by several teammates and was laid down by the bench where he was then looked at by the athletic trainer. After being looked at, and once the game had wrapped up, Coughlin was told it was likely an ACL tear.
But what had happened to cause it?
Program coordinator for the athletic training education program and professor in the exercise science department Dr. Wanda Swiger explained what the ACL is and how athletes tend to damage or tear it.
“The ACL stands for anterior cruciate ligament and it’s one of the main ligaments that is in your knee,” explained Swiger. “It basically prevents excessive anterior movement of your lower leg on your thigh bone, your tibia to your femur.”
Injuries to an athlete’s ACL happen most commonly in one of two ways. One way is from an external force that makes the ligament stretch well past its capabilities. This can be compared to a rubber band snapping if it is pulled on with too much force.
“When an ACL tears in a direct contact situation… you have some sort of external force that hits the knee,” said Swiger. “And when that happens the ACL usually tries to do its job; it will stretch to a point, and after that point, if the force is strong enough, it will basically tear the ligament in some fashion.”
Another common way that athletes can tear their ACL is that the ligament gets put under great stress, whether it be from a sudden stop or change in directions. This is what is called a non-contact mechanism.
“In essence, what happens is that the person, whether it’s a dancer or a soccer player it doesn’t matter, does some type of a motion that puts them into a valgus position that strains or stretches that ACL beyond its point.”
After the tear happens, the recovery process begins.
For Coughlin, the first step in the process was to go in for reconstructive surgery on the ligament in his knee.
“There are three fairly common procedures [for fixing a torn ACL],” explained Swiger when asked about the different forms of surgery someone can undergo. “One is using the person’s own patellar tendon, so they take the middle one-third of the patella tendon and they take a little piece of bone from the patella, a little piece of bone from the tibia… then through arthroscopic surgery, they drill a hole, take out the old ACL, tunnel through the new patellar tendon [and] attach it with screws.”
Swiger talked about how the patella tendon route was the most common procedure seen for fixing ACL tears, however, the other two procedures are somewhat similar. There is also a hamstring-tendon graft. That is where they take a section of the athlete’s hamstring tendon and thread it through the same created hole as described above and that tendon then becomes the replacement for the ACL. The third procedure, which Swiger explained is usually only done if one of the two procedures previously explained was done and failed, involves using the contraside ACL or a cadaver.
“We’re usually using something within the person’s own body to replace the torn ACL because it can’t be sewn back together,” said Swiger.
As for Coughlin, he isn’t sure what route the surgeons picked when it came to his surgery.
“I trusted them, I didn’t want to know,” Coughlin laughed when asked about his own surgery.
Coughlin made it clear he knew exactly what it felt like after the surgery, however.
“The first three days are really tough,” said Coughlin. “You have a lot of pain, but then, after those three days, I started rehab and I was really excited about that.”
Rehabilitation can be done by athletic trainers if the patient is an athlete or it can be done by a physical therapist. According to Swiger, normally within the first couple of days post-operation the only worries are wound care and making sure the athlete is icing and keeping the leg elevated and compressed.
“What we know about the ACL and how it heals is that early motion is key,” explained Swiger. “Typically someone is already doing some type of range of motion exercise right off the bat.”
Swiger also explained that most people are put into a hinged brace that protects the knee and may be on crutches for a day or two after the surgery.
“[Athletic trainers and physical therapists] want people walking as soon as possible because it actually helps,” said Swiger. “You have these little receptors in the bottom of your feet and so the earlier you can get someone walking the quicker they can actually get rid of the swelling.”
Coughlin was interviewed on February 10, putting him 15 weeks into the ACL tear recovery process. As for his soccer season next year, he is hoping to be back on the field by July so he can participate in the preseason.
“Just stay positive,” said Coughlin, giving a piece of advice for anyone dealing with an ACL tear. “Before I go to bed I think about the day I’ll be back on the field, scoring a goal. That’s what keeps me going.”
Claire Boughton can be contacted
at cboughton@kscequinox.com
