What can you take from this?
Most of you probably saw the Kansas City Chiefs win the Super Bowl on February 2. You may even remember a few months ago in Week 7 of this season, Pat Mahomes was taken off the field with a well publicized knee injury. What you probably didn’t hear about is the amount of time, energy, and rehabilitation it takes to come back from that type of injury and how truly remarkable it was for him to return just 4 weeks after it happened and furthermore; play another 10 games and win it all!
As an athletic trainer and an authority on rehabilitation for athletes of all shape, size and sport, I have had the opportunity to work with many people with this same injury. Let’s first take a look at what the kneecap (patella to all of us in the medical world) is and how it actually dislocates.
The kneecap is a sesamoid bone, meaning that it is actually embedded in a tendon. In this case, that tendon belongs to our quadriceps muscle (that big thigh muscle in the front of your leg). If you straighten your leg all the way out and totally relax all those muscles you can physically wiggle your knee cap side to side. (Gross right?) The knee cap acts like a pulley providing a smooth surface for the quad tendon to slide over, reducing friction and increasing the muscles ability to transmit force. As the quad tendon stretches, contracts, and relaxes, the knee cap moves with it. Because of this movement, there are supporting smaller tissues that help keep the kneecap in place as it slides up and down and prevents any lateral or sideways type of movement. Up and down, good. Sideways, bad.
Fun Fact: you’re actually not born with a kneecap, it grows over time somewhere between the ages of 2 and 6.
When you dislocate the knee cap, it typically moves to the outside of the knee due to a really strong force pushing it that direction. So imagine the normal look of your kneecap directly in the center of your knee. Now imagine looking down and seeing it on the outside of your knee! Ouch! When this happens all those supporting tissues that keep it moving straight get damaged and the kneecap is now very unstable. Almost to the point that the smallest amount of pressure can cause it to dislocate quite easily.
During the rehab process you will need time for those damaged tissues to heal. You will also need extensive amounts of strengthening of all the muscles around the knee joint itself to stabilize the knee again. For any of you reading this who have gone to the gym to get stronger and/or lose weight you understand the amount of time it takes before you start seeing those changes you are working for. Now imagine you are a football player who needs to be able to run, jump, dodge, juke and jive and absorb a hit from a 240 lbs linebacker in a split second.
For Mahomes his rehabilitation schedule probably looked something like this:
2 – 3 times per day (yes, per day) he would meet with his medical team which likely includes athletic trainers like myself, physical therapists, and team physicians to address any swelling and pain, followed by light strengthening (mostly non weight bearing at first) to get those damaged tissues and muscles activating correctly again. After all, pain and swelling causes a lot of those muscles to shut down.
Once pain and swelling are under control, he would start a more moderate exercise regimen and slowly build up his tolerance to heavier loads of strengthening. Eventually he would start a more active approach to his rehab in which he would perform light running or jumping activities. This leads into incorporating sport specific training that would include movements and activities specific to his position as quarterback. However, if you have ever watched him play you know he is not the typical quarterback… he’s a pretty nimble and mobile guy. This adds yet another aspect to his rehab process – getting back that thing that makes him such a threat.
The typical process for this takes at a minimum 6 weeks! He did it in nearly half that! This speaks very highly to his team’s dedication as well as his own to get better and get back on the field. Granted, he has access to this multiple times per day as well as things like water rehab, advanced equipment and a highly specialized team of experts.
How can all this relate to you?
Put quite simply, getting over this injury or any injury takes a lot of time and dedication to getting well. Most people that enter into a rehab process will see their therapist 1-3 times per week. Mahomes and most high level athletes likely do that in a single day. For Mahomes, his job is to get back to 100% and back on the field. Everyday people like us – have jobs, families, responsibilities and would struggle to see their rehab specialist everyday, let alone 2-3 times a day. In order to help with this, most rehab professionals will and should give you a specific list of exercises to do on a daily basis to compliment what they do when you’re face to face. This “home exercise program” is highly beneficial to your healing process and when it’s not being done your progress can become stagnant. After all, you can’t go to the gym once a week and expect to see results.
Also, healing of any bone, muscle, joint, or back problem takes time. Usually more than we expect and to the tune of months at a time, so people will too often look for the quick fixes. I.e. – braces, medication, surgery; however, the science and research overwhelmingly says the most effective way to get back in the game is via exercise and rehabilitation with a qualified physical therapist or athletic trainer. The quick fixes may provide some temporary relief; however, they do not address the source of the problem.
Physical therapists and athletic trainers have specialty education and are the authorities in helping you heal from any musculoskeletal injuries whether its due to a sport, auto accident, work accident, or just the wear and tear of the day to day. If your goal is to get out of pain and back to that activity you love, there is no better way than through exercise and physical rehabilitation.
by: Daniel Tribby, B.S., ATC, CNP, ITAT