At this stage, Manton was unaware that she had just ruptured her ACL. In the days and weeks afterwards, she did not experience much pain, just soreness and tenderness. She worked on getting the swelling down in her knee and thought she had not done much damage.
Manton, a nurse, thought it was a little excessive when a physician suggested she go for an MRI, but she took the advice anyway. “Even the morning I was going for the MRI I felt like a bit of a fraud, that I didn’t have a genuine injury. I thought the MRI was a bit excessive, but I went and had it done.”
Sure enough, the rupture was discovered. A visit to Moran ensued and then surgery. Manton underwent the surgery at the end of March and is in the third month of her rehabilitation programme. She is not alone or even in an exclusive group of sportspeople who have ruptured their ACLs – many athletes have done it and there have been a lot of high profile cases.
The question, discussed in serious tones on sidelines and debated in dressing rooms after matches, is are ACL injuries becoming more common? There is no definitive answer, says Moran, because there is no concrete data from yesteryear from which we can use to draw a comparison.
“If you go back 20 or 30 years you have a situation where the MRI scan was only coming into its own. If you go back about 40 years and you got a rotational injury to a knee and players had any sense of giving, it was assumed to be cartilage. I still see patients today in their 50s and 60s who have ruptured their ACL and don’t know it.”
a physiotherapist and head of performance rehabilitation at the Sports Surgery Clinic, says ACL injuries are more common among those who play field sports, because the movements required are riskier to the knee.
“A runner can [injure their ACL], but it is all about risk. The high-risk positions are single leg landing and single leg change of direction. So, cyclists, swimmers and track and field athletes are moving straight ahead; I can’t remember the last person I saw doing their ACL like that.”
There will always be a certain amount of ACL injuries which are contact – they cannot be prevented – but non-contact injuries, which have to do with the way an athlete moves, can be reduced through improving movement and lower body strength.
Manton is very passionate about injury prevention and it is something she says she will push for when she finishes her recovery. “Obviously going through this myself, I wouldn’t want anyone else going through it and if we can try prevent it I think we should. We need to start working on it now rather than later.”
ACL rehabilitation can take anywhere between six to 12 months, but King is quick to warn that there is no one-size-fits-all scenario for returning to sport. Your return should be guided by how well you move, not how many months you have been in rehabilitation, he says.
Manton has a very positive outlook on her injury. She is progressing well in her rehabilitation programme, which she does five to six days a week with her husband, who is also recovering from an ACL injury.
“The programme really helped me in that I am progressing very well, but it also helps keep your mental health in check, knowing that you are doing all you can to get back to the game you love.”
King’s advice to those who may be dejected because they are injured is that “every injury is an opportunity” to come back a better athlete then you were before.
“If you ruptured your ACL and it wasn’t a direct hit to the knee, that is clearly a sign that athletically speaking or from a movement competency point of view, you weren’t really moving as well as you could.
“Obviously no one wants to take six to 12 months out to try to improve their movement, but it is an opportunity to come back stronger and fitter.”
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