Analyzing ACL injuries and the effects they have on the NFL


In the fast pace NFL world, injuries are a normal occurrence. Of all the possible injuries an NFL player can have, there are two that seem to happen more than any other. Concussions and ACL injuries.

ACL injuries seem like a new thing these days due to the frequency in which they seem to happen. The Detroit Lions have dealt with ACL injuries as of late. Stephen Tulloch most recently and memorably tore his ACL celebrating a sack on Aaron Rodgers. According to these stat from the ACL Recovery Club, ACL injuries have been tearing through the NFL the last two years, like the plague

But what is an ACL injury? How does it affect athletes? These are questions I had to find answers to. I decided to get in touch with Holland Hospital and Shoreline Orthopedics to get to the bottom of this ACL business. They were kind enough to put me in contact with Dr. Bruce A. Stewart who was more than willing to help.

Without further ado, here is my interview with Dr. Stewart:

DJC: In layman’s terms, what is an ACL tear?

Dr. Stewart: “ACL stands for anterior cruciate ligament.  The ACL is a strong rope-like structure located deep in the center of the knee that connects the thigh bone (femur) to the shin bone (tibia).  The ACL helps to control rotation in the lower leg and it stops the lower leg from sliding forward and twisting/pivoting inward on the upper leg.  When the ACL tears, people can live a pretty normal life and can walk in a straight line and do low impact activities.  However, most athletes are unable to return to cutting, pivoting, or twisting sports like football, basketball, and soccer without an ACL because when they go to cut and change direction the knee will buckle and give way.”

DJC: What is the general ACL recovery time for athletes?

Dr. Stewart: In general, after an ACL tear, you need to wait until the swelling has gone down from the injury and the range of motion and strength are normal before proceeding with surgery.  This averages 2-4 weeks from the time of injury until surgery.  After surgery, the earliest I will clear an athlete to get back to sports is 6 months, but for most athletes, that is too soon.  The ligament has a much higher chance of retearing during the first year after surgery.  I advise athletes that it is much safer to wait until 9-12 months than to try to get back at 6 months.  Many athletes feel like they are ready to get back after 3 or 4 months, but the graft has not fully matured by that point and overall balance and core strength and single leg jumping and landing strength is not good enough to safely return.”

Dec 22, 2013; Cincinnati, OH, USA; Minnesota Vikings running back Adrian Peterson (28) runs the ball in the first quarter of the game against the Cincinnati Bengals at Paul Brown Stadium. Mandatory Credit: Trevor Ruszkowksi-USA TODAY Sports

“Adrian Peterson was an exception rather than the norm, but everyone expects to be Adrian Peterson.  He returned to play about 8 months after surgery and had a great season, but that is not typical.  For every Adrian Peterson story, there are more Derrick Rose or Jerry Rice type stories where people either take over a year to get back or try to come back too soon and re-injure the knee. ”

DJC: Can one ACL injury lead to a future ACL injury?

Dr. Stewart: “Yes, it is possible to retear the graft.  However, the chance of doing this drops significantly after the first year from 10-20% down to under 10%.  Athletes who have torn their ACL in one knee are actually much more likely to tear their ACL in their OTHER knee as well compared to athletes who have never torn their ACL.”

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  • DJC: Can an ACL injury lead to any other serious injuries?

    Dr Stewart: “Yes. ACL tears are frequently associated with other ligament or cartilage injuries to the knee.  People who have torn their ACL are more likely than others to have problems with their meniscus cartilage (a shock absorbing cartilage in the knee). ”

    DJC: Can an ACL injury cause any permanent damage?

    Dr. Stewart: “Yes. Regardless of whether or not surgery is performed, anyone who tears their ACL is at higher risk of developing arthritis in the knee in the future than someone who has never had an ACL tear. “

    DJC: Out of 10 athletes with an ACL injury, how many are likely to re-injure their ACL?

    Dr. Stewart:  “1 or 2 out of 10 in the high school, college, and professional world.  In people outside of this level of competition, the risk of retear drops to 5% because they are not taking the same degree of risk.”

    “A study from the American Journal of Sports Medicine that followed NFL running backs and wide receivers after ACL tears found that more than 20% of players never returned to a NFL game. The average time for players to return to playing in a game after injury and surgery was just over a year.  When they looked at power ratings (a measure of performance that takes the total yards in a season divided by 10, plus touchdowns multiplied by 6.) they found that there was a significant decline in player performance in the athletes that were able to return to play when compared to a similar group of uninjured athletes (control group) over the same time frame.”

    May 22, 2013; Santa Clara, CA, USA; San Francisco 49ers running back Marcus Lattimore heads towards the locker room during organized team activities at the 49ers training complex. Mandatory Credit: Kelley L Cox-USA TODAY Sports

     With the NFL Draft beginning this evening, one popular scenario for the Detroit Lions is the team taking Georgia running back Todd Gurley with the 23rd pick. When I look at Gurley, I see a talented player they could indeed turn out to be the “once in a generation player” that many feel he could be.

    I also see Marcus Lattimore. The former South Carolina standout was thought to be a future star in the NFL until he tore his ACL his sophomore year. Upon his return to football in his junior year, he once again suffered a debilitating knee injury. This time it was far more serious as Lattimore tore his ACL, MCL and PCL.

    At one point Lattimore was thought to be a 1st round draft choice. He wound up going to the San Francisco 49ers in the 4th round of the 2013 NFL Draft. In his time in the NFL, he never played a down of football and in November of 2014 he announced his retirement from the NFL.

    This is what an ACL injury can do to an athlete. It’s a serious injury that can end careers before they start. Having said all of this, if you were the Detroit Lions would you take Todd Gurley with the 23rd pick?

    What do you think? Leave your comments below and be sure to follow me on Twitter @Lionmike26

    Special thanks to Dr. Bruce A. Stewart and Shoreline orthopedics for your kindness and answers.

    Next: Ultimate Lions NFL Draft Preview

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