ACL Prevention

 

As sports medicine professionals, we are always looking for a way to prevent injuries.  Working with coaches, we work to help our athletes train in ways to both avoid and minimize the impact of injuries.

Strength training, flexibility, and skills acquisition are all tools in the prevention tool chest. More recent techniques such as chaos training and training based on a variety of individualized metrics have made a difference. But there are still almost a quarter of a million ACL injuries per year in this country. 

Studies tell us that for every male that has an ACL injury, 8 females have one. That data can be argued, dissected, and defied, but the bottom line is still that more girls have ACL tears than boys.

I have two friends, Dr. Tim Hewett and Dr. Amy Arundale, who have dedicated their careers to injury prevention, particularly for the ACL.  Both have PhD’s in biomechanics and both have focused exhaustive studies on preventing ACL injuries.

Dr. Hewett created the original Cincinnati Jump Program, which did have some impact on ACL injury incidence, but even he admits that we have all had limited success in the prevention arena.

Dr. Arundale, who works for the NBA’s Washington Wizards, is most certainly considered one of the foremost authorities on preventing ACL injuries but she tore her own ACL, playing Australian Rules Football. 

I’m going to bring this story to a personal level.  Last year, I worked with a young athlete as she rehabbed her knee after ACL surgery.  It was nine grueling months of work. Along the way, we worked diligently on both legs, putting a lot of emphasis on preventing an injury to her other knee.

She got the benefit of everything that I know about ACL prevention--and I have dedicated a large part of my career to understanding the ACL. She returned to basketball in the fall and had no problem with the knee that she had surgery on—it performed at a very high level. Yet, you know the rest of the story.  A few weeks ago, she tore the ACL in her other knee.

So the bottom line is that we just don’t know how to truly prevent ACL injuries.  We can lessen the risk but we can’t stop it. That is frustrating for me.

Because of that frustration, I have engaged several of the leading authorities in the country in an ongoing discussion about what else we might do. One of the common denominators appears to be a narrowed intercondylar notch (you probably need your orthopedist or physical therapist to explain that one).  There isn’t a practical solution for that one.

What don’t we know?  The effect of the menstrual cycle on ACL injuries.  We know that adequate sleep is important but what role does fatigue play?  And how do you deal with that?

Are there training techniques that we just don’t understand yet? We know that how the foot interacts with the ground is important but how best to intervene?

What we do know and which I’ll preach for the rest of my life—it is essential that young kids play and run and move their bodies. Especially girls. And begin sports training by the time puberty hits. Not just playing a sport, but training for that sport.

I’ll admit that we don’t know what we don’t know right now—but we’re looking, searching for every ingredient to the ACL prevention our athletes so desperately need.  

Senior Leadership

 

Senior leadership.  Teams talk about it all the time. But what is it?  And how do you know it when you see it?

Every team needs leaders. I’m involved with a lot of leadership development activities, so I have a lot of opinions about what it takes to be a leader. I also know that there are different kinds of leaders. 

When you think of a leader, what do you think of?  Do you think of the rah-rah leader, the one that is the loudest?  Or do you think about the silent type—the one that forges ahead and leads purely by example?

Effective leadership can be a combination of many things. If we always look for the same thing in our leaders, we are likely to be disappointed.  I will herein declare that everyone is a leader. It might be on your team, your job, your community, or your family. I will also declare that anyone can be a better leader.  Anyone can grow their leadership skillset.

So, what kind of leadership skills do you have?  Maybe put another way, what are your strengths and weaknesses as a leader?

I believe that all effective leadership is “servant leadership.” What that means to me can best be described in quotes and cliches.

“Leaders eat last.” Author and inspirational speaker Simon Sinek even has a book titled Leaders Eat Last.  Effective leaders make sure that others are taken care of before they take care of themselves. Effective leaders put others first.

My Dad always told me “don’t ask anybody to do anything you’re not willing to do yourself.” He started telling me that when I was quite young and it was a lesson well learned—I’ve tried to follow that principle my entire life.  If you want to be a good leader, you never let anyone work harder than you.

Effective leaders display integrity.  Dwight D. Eisenhower has been quoted as saying “the supreme quality for leadership is unquestionably integrity.  Without it, no real success is possible.”

Maya Angelou famously said “people don’t care what you know until they know that you care.” You have to truly care about those that you hope to lead.  Nothing else will work.

Effective leaders are good communicators. Maybe not the rah-rah type and maybe silently leading through their actions, but getting their message across, regardless of how they do it.

John Maxwell has said “good leaders take more than their share of the blame, and less than their share of the credit.”  It’s funny how that works, but know for sure that those that might follow you will do so with great gusto if they truly know that you appreciate their efforts and tell them so.

OK, then how do you extrapolate all that leadership stuff to a sports team? You do it all. Service. Work ethic. Showing integrity. Caring. Communicating. Encouraging.

Be willing to set yourself apart but always be responsible to yourself and to others.

Not a sports fan?

 

I’m a sports fan. That much is obvious. But I’m more of a fan of sports rather than someone that keeps up with their stats and players and all that. Let me explain.

I can’t tell you much about the teams or the scores and all that. Oh, I do love my Clemson Tigers but I can’t tell you all the players and how they’re doing.  I know that Dabo Swinney is the coach and that George Quarles’ son is the assistant to the offensive coordinator. And that we need a good running back and a DB or two.

I can’t tell you which former Tigers are in the pro’s or the team they are on, other than Trevor Lawrence and Travis Etienne (Jacksonville Jaguars).

I rarely sit and watch an entire game, start to finish.  I’m just not made that way. I found the Super Bowl interesting in bits and the only way I knew who won the World Series was when I got a photo of my friend Sue Falson (a physical therapist with the Dodgers) celebrating with the trophy.

I’m definitely not that sports fan that lives and dies based on the outcome of a game.  I don’t listen to sports shows on the radio and I rarely watch sports on TV.

My wife is the true sports fan in the family.  Any time I get behind the wheel of her van, you can be sure that the radio is on and tuned to one of the sports radio shows.

But I am most definitely a fan of sports participation.

I believe in sports for everyone. My rule as a father was that I didn’t care what sport you played, but you had to play something.  For the most part, my kids are raising their own kids based on the same principle. 

Sports participation, in and of itself, is an incredibly important part of growing up. Youth sports teams are not about making future sports stars—they’re about teaching life lessons.

But you’ve heard that here, time and time again.

“Upon the fields of friendly strife are sown the seeds that, upon other fields, on other days, will bear the fruits of victory.” That quote from General Douglas MacArthur speaks to the opportunity to learn and grow from sports participation.

Did you know that over 90% of female CEO’s in this country played sports in high school? They learned valuable lessons in teamwork, rewarded effort, and reliability that they carried into hugely successful careers.

But here’s my dark moment—it has become incredibly expensive to participate in youth sports these days. Golf and tennis have long been dominated by those blessed by parents with healthy incomes, who can afford the costs of being good.

Soccer, baseball, softball, and volleyball have, unfortunately, joined the ranks of sports that are just downright expensive to participate in. Between travel ball and private coaching, the costs can be enormous.

What’s the solution? I believe that if your youngster develops real athleticism, if they play multiple sports, if they play for the love of the game, then they will be successful.  Maybe not in what you think might be their best sport—given the opportunity, a child will find what they’re really good at.

And I don’t care what anyone tells you—no one can tell at 8 that a child is going to be a great athlete. So, save your money, travel to cool places, give your child diverse opportunities, and let them find their way.

Let Them Find Their Way

 

I’m a sports fan. That much is obvious. But I’m more of a fan of sports rather than someone that keeps up with their stats and players and all that. Let me explain.

I can’t tell you much about the teams or the scores and all that. Oh, I do love my Clemson Tigers but I can’t tell you all the players and how they’re doing.  I know that Dabo Swinney is the coach and that George Quarles’ son is the assistant to the offensive coordinator. And that we need a good running back and a DB or two.

I can’t tell you which former Tigers are in the pro’s or the team they are on, other than Trevor Lawrence and Travis Etienne (Jacksonville Jaguars).

I rarely sit and watch an entire game, start to finish.  I’m just not made that way. I found the Super Bowl interesting in bits and the only way I knew who won the World Series was when I got a photo of my friend Sue Falson (a physical therapist with the Dodgers) celebrating with the trophy.

I’m definitely not that sports fan that lives and dies based on the outcome of a game.  I don’t listen to sports shows on the radio and I rarely watch sports on TV.

My wife is the true sports fan in the family.  Any time I get behind the wheel of her van, you can be sure that the radio is on and tuned to one of the sports radio shows.

But I am most definitely a fan of sports participation.

I believe in sports for everyone. My rule as a father was that I didn’t care what sport you played, but you had to play something.  For the most part, my kids are raising their own kids based on the same principle. 

Sports participation, in and of itself, is an incredibly important part of growing up. Youth sports teams are not about making future sports stars—they’re about teaching life lessons.

But you’ve heard that here, time and time again.

“Upon the fields of friendly strife are sown the seeds that, upon other fields, on other days, will bear the fruits of victory.” That quote from General Douglas MacArthur speaks to the opportunity to learn and grow from sports participation.

Did you know that over 90% of female CEO’s in this country played sports in high school? They learned valuable lessons in teamwork, rewarded effort, and reliability that they carried into hugely successful careers.

But here’s my dark moment—it has become incredibly expensive to participate in youth sports these days. Golf and tennis have long been dominated by those blessed by parents with healthy incomes, who can afford the costs of being good.

Soccer, baseball, softball, and volleyball have, unfortunately, joined the ranks of sports that are just downright expensive to participate in. Between travel ball and private coaching, the costs can be enormous.

What’s the solution? I believe that if your youngster develops real athleticism, if they play multiple sports, if they play for the love of the game, then they will be successful.  Maybe not in what you think might be their best sport—given the opportunity, a child will find what they’re really good at.

And I don’t care what anyone tells you—no one can tell at 8 that a child is going to be a great athlete. So, save your money, travel to cool places, give your child diverse opportunities, and let them find their way.

Ready and Able

 

I’ve gotten soft in my old age. I mean, I’ve always been a pretty emotional guy—It’s just gotten worse.

Forget Marley and Me—I’ll often get all emotional because the underdog wins, or the couple made for each other get together. 

I had an episode recently where a young athlete that I’ve gotten close to injured her knee.  She had already been here for long rehab on one knee, only to injure the other one.  I was off that afternoon but came back to examine her knee.

When I walked into our reception area, where she sat distraught, it was all I could do to keep from crying with her.  Truth be known, I did choke up quite a bit and maybe leaked a little bit of tears.

One of the things about physical therapists and athletic trainers (and occupational therapists and speech therapists too) is that we really care about our patients.  And we get quite close to them as well.

Even a surgeon might see a patient just a handful of times, but in rehab, we may see them three times a week for several weeks.  We have more opportunity to really get to know our patients and our athletes. 

I was working a soccer match recently when one of our players was injured.  This happened just a few feet in front of me, and from his scream, I knew it was bad.

I jumped up and didn’t wait for the referee to signal me onto the field.  I was there within seconds of the injury, assessing the situation, and quickly deciding that he had a serious injury. 

Athletic Trainers and Sports Physical Therapists prepare for that moment.  We hate it and when one of our athletes gets hurt, we hurt too. But we are trained to know what to do, we quickly go in emergency care mode, and do what is necessary to protect the athlete and make almost instantaneous decisions.

For this young soccer player, it was clear what to do—immobilize him and call for an ambulance.  All of our schools have an Emergency Action Plan (EAP) and put that into action once an injury calls for it.

First and foremost, we make sure the athlete is stabilized. We either call 911 or have someone trusted to make the call, making sure that they tell the operator that we have a medical emergency and that we will need transport to the hospital.

When it is an event where we have student trainers, the EAP is automatic.  Everyone knows what to do and everyone has a job.  We send someone to direct the ambulance to the entrance and to where they can park to best do the job. We inform the parents of what is going on.

If the injury requires splinting or special equipment, we’ve got that with us.  All of our folks carry a complete array of things we might need, including an AED. 

We work hard to be prepared, to anticipate every contingency, and to execute the plan that is in the best interest of the injured athlete.  School officials understand and cooperate.  Game officials understand and wait patiently. Fans and parents do what they can—pray and hope for a good outcome.

It’s the worst part of the job and yet it’s the most essential part of the job. We practice regularly to be good at what we do. We want to be ready and able.

For the Teens in the House

 

I know there aren’t many teenagers reading this. It’s mostly old folks like me.

After it’s published in The Daily Times, I share it on social media, but again, the readers are generally older.  That’s OK.

Maybe it trickles down. I hope so.

I know I’ve had a lot of people through the years that told me that they sent it on to their grandkids or saved it for their kids. 

Today is a pass-it-down column. I know my audience but I hope it reaches a younger generation, specifically teenagers and especially teenage athletes.

Don’t settle.  In sports, in relationships, in life.  Ever.  You’re stuck on the bench—don’t accept that as the best you can do. Find out what you can do to get better, to get more playing time. Pay the price and don’t give anything less than your best.

Aim high. My kids and my grandkids will tell you, “can’t never did do nothing.” That quote came from my Dad and I’ve repeated it often. 

Dream big, bodacious dreams.  If you don’t dream it, you can’t achieve it. Don’t limit yourself to only what you think you can do. 

I’ll get personal here for a bit. I came from a small town with parents who had to work hard. Don’t get me wrong—I never went hungry and I was never cold from an unheated house. 

But I also didn’t have people around me (other than my mother, and she doesn’t count) that told me that I could make a difference, yet, somehow, I dreamed of changing the world.

Maybe that world is the one you can reach out and touch. Maybe it is the community where you live. Or your state. Or your country.  I’ve been able to change some things, however small and seemingly insignificant, on so many levels. If I hadn’t dreamed it, I couldn’t have done it.

Be kind.  Nothing can truly change the world without it. They say “no good deed goes unpunished,” but I say no good deed goes unrewarded.  Kindness to strangers, kindness to those difficult to be kind to, kindness in every situation—you may not see or feel the reward, and you may not change someone else with your kindness, but your reward comes in the adult you will become. And the positive influence you will have.

Have courage.  Maybe that means speaking in front of a group. Maybe it means asking that special person out on a date. Do it. You won’t regret it.

Make friends with the kid that’s different or maybe the one who doesn’t seem to have friends. You will get more out of that than they will. You will become a better person because of it. And when you’re old and grey, you’ll be glad you did that.

I know that I’m just some old guy but, just like your parents, if you’re paying attention, if you listen more than you talk, and if you’re honest about yourself, you gain some wisdom with all those years. 

So, take it from me—be the best version of you.  That’s it. That’s the whole game.

Ode to Teachers

 

This week is Teacher's Week in Joe's column.  Last week I wrote about Coaches.  Not long ago, I wrote about teachers, coaches, and Scout leaders. 

 Today, it’s the teacher’s turn.

Mrs. Betty Swiney was one of my kindergarten teachers.  She and Mrs. Ross. Do you ever have a name pop up and then you think of a one word memory of that person? When I think about Mrs. Swiney, the word "safe." pops up.  She made us feel safe, most of us doing something outside our own home for the first time.

First grade was Mrs. Turner--she and her husband were great friends of my parents.  Her 6’8” husband and my 5’6” dad until the day they died.  I always thought that I got special treatment because of that but after talking to others many years later, I realized that she made everyone in her class feel that way.

Mrs. Limburg was one that made us want to go to school, even though recess was my personal favorite subject. Other names escape me. Mrs. Johns in 4^th grade was the mother of a classmate. Mrs. Cantrell in the 5^th grade was special and could read our minds.

Schools integrated when I went into the 7th grade and, for the first time, we switched classes.  Mr. Archer was our favorite and years later, we were friends as adults. Both his sons were in my Sunday School class many years later. 

In the 8th grade, the principal, Mr. Rothwell taught us science. His daughter Ann and I grew up together and remain friends, as were our parents. I loved Mr. Rothwell but he wouldn't hold back if I was getting out of line. Mrs. Galyon was our Social Sciences teacher and was definitely old school.  It's interesting that I don't remember her first name but I remember her husband's first name.  It was Stanley.

High school was a mix of football, girlfriend, time with great friends, and a little bit of the academic side.  School was easy for me and I didn’t always focus like I should. I guess “A’s” came too easy for me.

Mrs. Marcus taught both freshman science and sophomore biology.  She was awesome.  Ms. Wattenbarger (sophomore English) was really good but I remember most fondly her student teacher, who had been a track star at UT and had us break down and analyze popular music like The Beatles’ “Revolution” and “Lucy in the Sky with Diamonds.”  Unorthodox, but it clicked with me. I discovered poetry in the most unlikely of places. 

My favorite in high school was Mrs. Smith who taught Chemistry and Physics.  Her daughter Suzie was in my class and, for maybe the first time, somebody recognized that maybe I had a brain after all.

Edward Headlee (later Dr. Headlee and School Superintendent) was our senior English teacher and probably more responsible than anyone else for 40 years of this column.  I can still recite parts of 17^th century Beowulf, spoken in old English.

The path of our life is determined by those teachers. Good teachers teach more than sentence structure and chemical formulas. Good teachers invest their lives in the development of somebody else’s children.  They aren’t paid well and rarely get the accolades or appreciation that they so richly deserve.

So, if you get a chance to look up one of your old teachers, or if you happen to run into them somewhere along the way, tell them. Tell them of what they meant to you. Tell them how your life turned out.

Trust me, it will mean the world to them.