The “DL” Report: NFL Week 3

With the NFL Week 4 about to begin tonight with Minnesota Vikings playing the St. Louis Rams there are plenty of injuries news and notes in regards to this game here:

Dalvin Cook – Running Back


Marcus Peters – Cornerback


Aqib Talib – Cornerback


The only one out of those three I would expect to play is going to be running back Dalvin Cook for the Minnesota Vikings. But other major injuries occurred. There were a few more anterior cruciate ligament (ACL) tears this week. I wanted to highlight on the initial phase of rehabilitation that occurs with ACL Rehabilitation.

Down went San Francisco 49ers Quarterback Jimmy G.

Down went Miami Dolphins Defensive End William Hayes

Down went Cleveland Browns Linebacker James Burgess

The ACL Injury count this season is in the mid 30’s already and it is the start of Week 4 in the NFL. It is something that is going to happen every year and while you do your best every off-season to prevent injuries, they are inevitably going to happen. You don’t just focus on injury prevention in the off-season but also athletic performance and treatment in the off-season too.

Anatomy Review:


The Anterior Cruciate Ligament is one of the four ligaments that holds the tibia to the femur. It attaches to prevent the tibia from moving forward in comparison to the femur.

It is also designed to prevent medial rotation (inward rotation) of the tibia about the femur. It’s a primary band of connective tissue that contributes to the overall stability of the knee.

Many ACL injuries are due to non-contact injuries, where the individual is going to make a quick change in direction, their foot is planted, they rotate about their foot and pop goes the ACL. If there is a traumatic event, most of the time it is due to a force that hyperextends the knee causing it to tear (i.e. Willis McGahee at University of Miami).

Surgery is the option to repair the ACL. Often times they will recreate the ACL from the hamstring tendon or the patellar ligament.

Rehabilitation Review: Phase 1 Review:

I want to talk about the immediate care following surgery of an ACL Tear. Because you can get right into rehabilitation the next day when it comes to ACL recovery. The goal in Phase 1 in recovery is by the end of the first week that I can get you to weight-bearing on your crutches for a tolerable amount of time and hopefully getting your knee to bend past 90 degrees. If those things do not happen it is not the end of the world and there could completing factors that impede that progress, but that is our goal in that first week of treatment.

Treatment over the first week is designed to:

  • minimize pain and inflammation around the knee
    • the use of electrical stimulation and massage will assist with that
  • maintain active range of motion in ankle
  • restore passive range of motion in knee and hip
  • restore movement in the patella
  • electrical stimulation will be used to assist in developing strength
  • introduce knee strength (eccentric and concentric) and knee control (towards the end of the week)
    • Partial Squats

    •  Hamstring Curl to 90

A lot of the treatment is in this first week will take a lot of time each day. It’s not because an athlete is weak but because there’s pain with surgery and it’s often a slower process, something not all athletes are appreciative of because they are always going 100 mph.

Season Outlook:

ACL tears typically fall under the category of “season-ending” injuries. What you have to further determine if there was any other knee structure damage that occurred. Whether it was the medial collateral ligament (MCL), the medial meniscus, the lateral meniscus, the lateral collateral ligament (LCL), or any vascular or nerve structures damaged as well. It hasn’t been reported that any of the most recent string of ACL tears resulted in further damage to the knee itself, which is a good sign.

With that said the hope is that all three players will be able to return to the field late in the summer next year towards the end of training camp to hopes of playing next year.

Disclaimer: I don’t own these pictures. They belong to the NFL, Getty Images, Associated Press, Bartleby and Grey’s Anatomy. I use them from Google.

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