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You Threw Your Back Out! Now What?

Most of us have experienced that sudden unexpected sharp low back pain and the inability to fully stand up erect afterward. If you haven’t yet, chances are you likely will at some point. Unfortunately, we oftentimes do not expect it to happen as it either occurs with the most obscure unthreatening activities (picking up a […]

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5 Important Factors for Preventing Injury in Tactical Athletes

Baseline Aerobic Capacity At the heart of every tactical job is the need to escape or mitigate danger when it arises. It doesn’t matter the job: military, police, fire. You have to be able to chase down a suspect, escape an explosion, or go into and come out of a fire. All of that will […]

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Not All ACL Injuries Require Surgery: Understanding Your OptionsPictured above is the iconic statue of Mickey Mantle outside of Oklahoma City’s Bricktown Ballpark. Mantle, the legendary New York Yankees outfielder, started his rookie year in 1951. In Game 2 of the World Series that same year, he sustained a right ACL injury that was never reconstructed or repaired. Despite this, Mantle went on to win 3 MVP awards and a Triple Crown in 1956—all without a functional ACL. What does this tell us? Mantle was what we call a “Coper”—someone who can function at a high level despite having a torn ACL. The ACL: Why It Matters The anterior cruciate ligament (ACL) is one of the main stabilizers of the knee joint. Its role is to: Prevent the shin bone (tibia) from sliding forward on the thigh bone (femur) Provide stability for cutting, pivoting, and side-to-side movements ACL tears are common, especially in athletes. One study cites an incidence of 68.6 per 100,000 people. Contact injuries: when another player collides with your knee in a way that ruptures the ligament Non-contact injuries: more common, often from planting and turning, or a hyperextension moment Research suggests up to 75% of ACL ruptures are non-contact. Female athletes are at higher risk due to anatomical, hormonal, and neuromuscular differences. The “Rule of Thirds” After an ACL Tear Recovery after an ACL tear doesn’t look the same for everyone. Experts often use the rule of thirds: One-third can resume normal activities without limitations (copers) One-third require modifications to improve stability One-third need an ACL reconstruction to return to their desired activities Do You Really Need ACL Surgery? The answer depends on your activity goals: Weekend warrior runners: Surgery may or may not be needed, depending on knee stability after rehab. Active parents: If your goal is walking, light exercise, or playing with your kids, you may not need surgery. Competitive athletes: For those who cut, pivot, and jump in high-demand sports, surgery is often required. Why Pre-Hab Matters Pre-habilitation (pre-hab) before surgery—or instead of surgery—is key for better outcomes. Pre-hab focuses on: Reducing swelling Restoring muscle activation and firing Improving movement patterns Setting realistic expectations Many patients find that after pre-hab, they can do everything they want without surgery—meaning they may be a coper. Why See a Physical Therapist First? When an ACL injury happens, your first step should be a consult with a physical therapist. Here’s why: PTs can assess whether you may function without surgery PTs see many post-surgical patients and can recommend trusted orthopedic surgeons if needed PTs can start your recovery immediately, restoring range of motion and function faster PT gives you the best chance at returning to activity—with or without surgery The Bottom Line Not every ACL tear needs surgery. Some people thrive with rehab alone, while others require reconstruction to achieve their goals. Your activity demands, goals, and response to pre-hab should guide the decision. Start with a physical therapist—you’ll get clear guidance, an individualized plan, and a faster path to recovery. References Plutnicki, K. (2014, May 4). Mantle’s Knee Injury Was Just the Start. NY Times Kaplan, Y. Identifying Individuals With an Anterior Cruciate Ligament-Deficient Knee as Copers and Noncopers: A Narrative Literature Review. Journal of Orthopedic and Sports Physical Therapy, 2011; 41(10), 758–766. Boden, B., Sheehan, F., Torg, J., Hewett, T. Non-contact ACL Injuries: Mechanisms and Risk Factors. J Am Acad Orthop Surg, 2010; 18(9): 520–527.

Pictured above is the iconic statue of Mickey Mantle outside of Oklahoma City’s Bricktown Ballpark. Mantle, the legendary New York Yankees outfielder, started his rookie year in 1951. In Game 2 of the World Series that same year, he sustained a right ACL injury that was never reconstructed or repaired. Despite this, Mantle went on […]

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