Frequently Asked Questions
What is the anterior cruciate ligament?
The anterior cruciate ligament (ACL) is one of two ligaments that are
inside the knee. This ligament is frequently injured in sports. When
the ACL is torn, the knee will often be unstable and it will be
impossible to play sports that involve cutting, running, and jumping.
Surgical and rehabilitation advances have made the ACL injury less of
a threat to athletic careers than it used to be. The ACL can now be
anatomically reconstructed with a graft, and many players return to
their previous level of competition following this surgery. ACL
reconstruction is still a major surgery that requires extensive
rehabilitation supervised by a qualified physical therapist or
certified athletic trainer. In uncomplicated cases and depending on
the sport, athletes can expect to return to full sports participation
in approximately 6 to 9 months following ACL reconstruction.
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What is an athletic trainer?
An athletic
trainer is a professional who is highly trained in the science and
art of athletic injury management. Athletic trainers have a minimum
of a bachelor's degree and have completed rigorous practical and
academic training in athletic injury prevention, evaluation,
treatment, and rehabilitation. Following successful completion of
appropriate academic coursework and practical experience, a
difficult three-part exam administered by the National Athletic
Trainers' Association Board of Certification must be passed for an
athletic trainer to become certified. Certified athletic trainers
must meet continuing education requirements throughout their careers
to maintain their certification. For more information on athletic
trainers, see
www.nata.org.
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What will happen if I keep playing on an injury?
You can make an injury worse or cause increase in symptoms that make
it impossible to play effectively. In some cases, playing with an
injury will not make that particular injury worse. However, playing
with an injury will significantly increase your risk of injuring
something else. By favoring an injury, other anatomical structures
around the original injury will be under increased stress. Also,
favoring an injury will place other body parts at risk. For example,
Dizzy Dean the Hall of Fame pitcher tore his rotator cuff by
continuing to pitch with a broken toe. Because he could not push off
his injured foot, the load on his shoulder increased to the point of a
career-ending injury.
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When should
I see a doctor?
If a sports injury produces significant swelling or discoloration,
creates prolonged tingling or numbness, creates a prolonged loss of
function or recovers for daily living activities but continues to
limit the ability to play, a doctor should be consulted. RICE (rest,
ice, compression, elevation) is the best initial treatment for mild to
moderate sports injuries and should net continual improvement over
several days. If this fails, you need to be sure that the injury is
not more serious than initially suspected.
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Is it safe
for pre-teens to lift weights?
The National Strength and Conditioning
Association issued a position statement on pre-adolescent resistive
training in 1996. It stated that children can experience strength,
motor, psychosocial, and general health benefits from resistive
training. However, the quality of supervision and design of the
program is more important than the equipment used. It is very
important that children who weight train do so under the close
supervision and instruction of a qualified professional who
understands the physical and psychological development of children.
It is very important for pre-pubescent children with athletic goals
to learn to control their own body weight and fundamental movement
skills. If only one type of resistance training is possible,
body-weight strength exercises such as push-ups and pull-ups should
take priority over weight machines and barbells.
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Will my body be restored to its original function after I have
surgery?
Often this depends on the extent and type of injury. There have been
remarkable strides in orthopedic surgery over the last 25 years,
developing procedures that are "anatomic". That means the surgeon
will, as nearly as possible, "fix" the injured structure to restore
the original anatomical configuration. However, all surgical
procedures will create scar tissue and some structures may need to be
removed or replaced. The ultimate goal for a surgical procedure is to
relieve symptoms and restore anatomy so that function is normal. In
most cases a good comprehensive program of appropriate surgical
treatment and post-operative therapy results in full return to the
pre-injury level of function.
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Do I need
physical therapy?
Musculoskeletal injuries typically respond very well to physical
therapy, and the therapy usually accelerates recovery and the
restoration of function. Athletics require a high-level function.
Therapy to reduce pain, restore motion and strength, and recondition
the body facilitates a timely and safe return to participation.
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What type of pain can expect after orthopedic surgery?
As orthopedic surgery techniques have become
less and less invasive, post-operative pain has decreased in
severity and duration. However, as with most surgery, there is pain
following orthopedic surgery and most surgeons will prescribe a pain
medicine for the first 7-10 days. The amount of post-operative pain
is also dependent on the surgical procedure performed. In most
cases, patients do not need pain medication for more than one week.
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How long
will I be out with a sports injury?
This depends on the type and severity of the injury, but proper care
and treatment can dramatically affect the amount of time lost.
Fortunately, most sports injuries are minor, and when treated properly
with RICE (rest, ice, compression, elevation) initially, heal within a
week or two. Regardless of how mild an injury is thought to be
initially, if it does not consistently improve with RICE over the
first two or three days, a physician or certified athletic trainer
should evaluate it. Moderate sports injuries, determined by
significant swelling, pain, discoloration, or loss of function, should
always be evaluated by a physician. Even if surgery is not required,
physical therapy often is and it may take 3-6 weeks or longer to
return to play after a moderate sprain or strain. Occasionally, sports
injuries are severe enough to require surgery and, depending on the
injury and type of surgery, may require 6 weeks to 9 months of therapy
after surgery to return to play.
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Should I
use ice or heat to treat a sports injury?
Acute injuries (injuries that just occurred) to bone, muscle,
joints, etc. should be treated with ice. It is best to use real ice,
rather than chemical cold packs, contained in a plastic bag or
securely wrapped in a towel. The ice pack should be applied directly
to the injury site, wrapped in place with mild compression, and the
injured part should be elevated above the level of the heart of if
possible. This is described by the acronym RICE (rest, ice,
compression, elevation) for care of acute injuries. Unless the person
is known to be hypersensitive to cold, real ice will not freeze or
injure the skin. Treatment time is 20-30 minutes and can be repeated
after the skin has returned to normal temperature. If a barrier is
used between the ice pack and the body part, treatment time should be
extended.
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