Green Bay Packers Jake Ryan Injury Discussion

The injury bug bites again. This time Green Bay Packers linebacker Jake Ryan has torn in ACL in his right knee for the second time in his football career. He initially tore his ACL back in college when he was at the University of Michigan.

According to reports it was a non-contact injury. He was going to make a tackle and his ACL tore.

There have been a rash of ACL injuries this past week and there hasn’t even been an NFL Preseason game yet.

ACL Injuries are not uncommon. They are usually accompanied with a “pop” when the tear initial occurs and then the knee becomes incredibly unstable. ACL injuries can occur in the following ways:

• A direct blow to the knee that causes the knee to hyperextend
• Turning about your knee when your foot is planted
• Attempting to change direction quickly (a quick change in slowing down and speeding up)
• Landing awkwardly after jumping

Often times what can accompany an ACL tear is damage to the medial meniscus and the medial collateral ligament.

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Anatomy Review:

The Anterior Cruciate Ligament (ACL) is a small fibrous band that connects the femur to the tibia. The main function of the ACL is to prevent anterior translation of the tibia about the femur. It also prevents hyperextension of the knee beyond the knee being straight and excessive internal rotation of the tibia.

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Rehabilitation Outlook:

Unless you are as genetically gifted as Adrian Peterson, ACL recovery typically falls between 9-12 months. It’s first about restoring your ability to return to daily activity function and then returning to physical fitness preparation and then return to sport, which can lead to recovery taking 12-15 months of complete recovery. We’re going to highlight some points in the initial phases of care.

Initial phases of rehabilitation are going to focus on strengthening the quadriceps and strengthening the hip primarily through very “low-tech” exercises such as squeezing your quadriceps and straight leg raises in a multitude of directions.

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I understand why the exercises above are a part of care. But in terms of rehabbing active people and professional athletes, even the basic and simple exercises can be progressed. It is not just adding a 5 pound ankle weight to their leg or having them do a third set of 10 repetitions.

Training the single leg in the simple exercises can be just as important as increasing the weight or number of sets and repetitions in an exercise. The single leg training will force your body to train the stabilizing function of muscles that you don’t traditionally think of.

There are simple exercises and other closed-chain exercises you can use to strengthen the hip that are more engaging to the hip muscles and may help transition you more effectively into the next phase of rehab such as:

• Side bridge/Side plank

• Quadruped hip airplane (with rotation)
• Supine Bridges

• Quadruped birddog

Where I come into play is at the initial phase of care. Helping to restore knee flexion range of motion is really important. With being immobilize in a brace for several weeks after surgery, the muscles of the knee can become stiff and shortened, so working on the muscles directly is one way to help influence knee range of motion.

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Season Outlook:

For Jake Ryan his season is over. When he tore his ACL the first time at Michigan in 2013, he was able to return later that year in October to play. It wasn’t disclosed if it was partial or complete ACL tear. It’s unlikely he’s returning this year. It hasn’t been reported if it was a partial or complete tear of his ACL, but it’s expected he will be back for training camp next year. Anytime you have an ACL tear in the same knee previously the rehabilitation may take it bit longer.

There’s already been a rash of ACL Injuries and the first preseason game has not started. You can essentially assume every year there are going to several ACL injuries and it’s real unfortunate. Aside from a direct blow to the knee, the athletes are bigger, stronger, and faster each and every year with advances in training and nutrition. But anatomy is not evolving, the joints and ligaments of the body can only handle so much tension and compressive force before the threshold is reached. You are hopeful for an effective and efficient recovery process so that they can be on the field for training camp next year.

As I was writing this article, two more players tore their ACL. Two of them happen to play for the Tennessee Titans.

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Disclaimer: I don’t own any of these pictures. They belong to the NFL and the Green Bay Packers and Tennessee Titans. All credit goes to the photographers, ESPN, Sports Illustrated, USA Today.