ACL Reconstruction Follow Up
In August, I did some reporting on ACL (Anterior Cruciate Ligament of the knee) tears. Reuters reported recently, in a study of Australians followed for over three years following their reconstructions, that "half of people who played sports competitively or just for fun don't perform as well as they used to." When narrowed down to those who played competitively pre-injury, only 91 of 196 returned to their competitive sport.
While this is a single study, and review of many give a more representative picture, suffice it to say that tearing an ACL can be a serious injury. Also recently reported was poor results in Division 1 athletes who had ACL reconstruction using allograft tissue, that used from the tissue bank from another donor. In fact, the failure rate approached 50%. So, if you find your self in this quagmire, the better educated you are, the more you are able to help the surgeon make the best decision for the correct way to proceed in your specific case, the higher likelihood you'll have to return to the sport you love.
Concussions Off the Bike
Who among us hasn't been on a group bike ride where there hasn't been a crash of some sort? If you were lucky, it was just a little road rash. If not, a portion of the injury could be a head injury. And this is true for helmeted cyclists as well. Not infrequently a concussion will occur and this has the potential for being a more serious injury than we may have previously thought. The October 10, 2011 Sports Illustrated has an article on the NHL which discusses the head injury to it's "most important star" Sidney Crosby. They are rededicating themselves to player protection, and we should too.
But haven't we always had the culture of endurance over safety? Haven't we seen the films of the last 400m of IM Hawaii where Paula Newby-Fraser, the Queen of Kona is weaving down Hualalai Street like some kind of drunk when Karen Smyers sprints by? Or Chris Legh, or Wendy Ingraham and Sian Welch, as they weave uncontrollably toward the finish line? Maybe they've crossed a line of a different sort! In the mid 2000's, I had the slowest bike time of all 1700 competitors in Hawaii when I stopped to help a biker on the down hill from Hawi whose front wheel had hit one of the plastic highway road reflectors at just the wrong angle. POW! Instantaneous crash, broken helmet, closed head injury, you can guess the rest as we waited for rescue help together. In short, once a concussion is recognized, that athlete's day is done - they should not be allowed to resume their sport, triathlon included.
Research is showing that healing of injured brain tissue requires sufficient nutrients and rest. If this isn't allowed to occur, then the potential for increased injury increases. Previously, injury severity scales left a great deal of interpretation to the examiner when deciding how serious the concussion really was. Now, especially in NCAA sports, if a player suffers a concussion of any magnitude, he or she is out of the game. No questions asked.
So, as an athlete, how do you determine if your bike mate's had a concussion after that crash? Well, you're probably not a neurologist, but starting with an "index of suspicion," at least considering that it's possible helps. Was there a loss of consciousness, confusion, head or neck ache, blurred vision or anxiety? In an athletic contest like football, the athlete would be asked, "Who Scored last?" or "Where are we playing today?" Finally if the suspicion continues, the player would be checked for balance and coordination. Now, I'm not saying that every time somebody in your bike group goes down that you start this cascade. But what I am saying is, that as a friend of somebody who's had an accident and my not realize that they've suffered a head injury - and are not making the best of decisions - you need to take charge. Nice the injured rider into calling it a day, just because, and give them a ride home. Likely, a trip to the local ER just to be on the safe side would also work Then, maybe after all that, it gets to be Miller Time.
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