Torn ACLs now are a scourge of several sports

Braden River High School running back Raymond Thomas’ recovery from a torn anterior cruciate ligament didn’t happen overnight, and he wasn’t the first to go through the process in Manatee County.

In fact, he was one of three Braden River football players to tear his ACL in the span of six months.

Junior defensive lineman Zach Brown tore an ACL on Nov. 6, while junior wide receiver Juwaan Jenkins did the same thing during offseason 7-on-7 activities earlier this year.

There are plenty of other ACL injuries across the Manatee County football landscape and in other sports.

Bayshore softball pitching star Miriam Schmoll tore the ACL in her left knee in 2015. Surgery and rehab brought her back to the diamond, where she led the Bruins to the program’s first state championship appearance this year.

“After surgery it was difficult. I was on crutches for about three weeks, and it was extremely hard just doing normal things,” Schmoll told the Bradenton Herald last August. “It definitely built up the mental side of me, and I am hungry to get back to where I was at. It’s also opened up my eyes to how precious the game is and how I’ve got to hold onto it tightly.”

So where did Schmoll or the other high school stars go for a torn ACL?

Most end up at Coastal Orthopedics, which has several offices throughout Manatee County.

“I think we do all of the ones that happen in this county,” Lamar said.

Lamar has a personal history with torn ACLs. As a college football player at Davidson (N.C.), Lamar missed his sophomore season while recovering from it.

“It was devastating,” said Lamar about the injury he suffered more than 20 years ago. “It’s hard to watch your teammates go out there and play (without you). ... I think the mental aspect is critical.”

Two other Coastal Orthopedics doctors, Arthur Valadie and Steven Schafer, perform surgeries, too.

Schafer’s daughter, Jessica, played soccer at Manatee High last year and he said several of her high school teammates tore their ACLs at one point in their careers.

History lesson

Like any advances in medicine, the more time that has passed figuring out how to fix something, the more efficient the process has become. Tommy John surgery isn’t the end of a baseball pitcher’s career. Neither is a rotator cuff injury.

Both used to be.

The same is true with ACL tears.

In the beginning, the biggest issue was not realizing the severity of the injury or the nature of the injury. Lamar said it was often referred to as a trick knee, because after the initial swelling goes down, the knee looks normal and athletes can run straight ahead.

“As soon as you try and change directions or cut and twist, the knee would give out,” Lamar said.

Once the injury started being diagnosed, doctors and surgeons started figuring out how to treat it. Surgery became the standard response in the 1980s.

And surgery on high school, college or pro athletes involves grafting the patellar tendon or hamstring tendons onto the ACL. The patellar tendon graft is the more popular option.

“That’s been the gold standard graft for a very long time and remains the gold standard graft,” Lamar said.

The recovery time depends on the athlete, but it is approximately six to eight months.

Females at greater risk

Lots of research has shown female athletes tear their ACLs at a rate of at least five times more than male athletes, Lamar said.

“Often times it has to do with strength, balance, landing and takeoff patterns, hormonal changes and basically the size of the knee and proportionality of the knee,” he said. “There’s a number of reasons.”

Soccer and basketball are the biggest team sport culprits because of how many quick cuts are made while running during play, but no sport offers immunity from an ACL tear.

“There’s lots of different theories on why girls have more risk than guys per hour spent,” Schafer said.

While females are at a higher risk of tearing their ACLs, the rehab process for the first two phases aren’t any different to what male athletes endure. The last phase, which prepares athletes for a return to play, differs depending on the sport that particular athlete plays. The idea is to have the athletes performing drills that replicates the movements they most often utilize for their specific sport. For example, quick cut drills are prevalent in that return to play phase for football players coming back from a torn ACL.

Places to go

Coastal Orthopedics is a leading place to rehab a torn ACL, with offices located in West Bradenton, East Manatee off State Road 64 and in Lakewood Ranch.

Sarasota Orthopedics is an option, too, and it’s where Dr. Johnny Gibbs, who performed Braden River’s star tailback Raymond Thomas’ ACL surgery, is at.

Add in several other smaller practices, and there’s no shortage of choices when it comes to getting an ACL surgically repaired and rehabbed.

Outside of those, high school athletes rely on the likes of Braden River’s Chris Gadah, Manatee’s Chris Peters, Southeast’s John Karl and the rest of the county’s athletic trainers. Most of the county’s trainers are affiliated with Agility Physical Therapy and Sports Performance.

There’s plenty of physical therapy places to rehab with, too.

But to get fully healed, it takes time, self-belief and patience.

Just like Thomas did to return to the Pirates backfield in time for a Kickoff Classic and a monstrous first regular season game against Bayshore.

This story was originally published September 6, 2016 at 8:00 PM with the headline "Torn ACLs now are a scourge of several sports."