Nine months of rehabilitation with the Oregon athletic staff all of a sudden meant nothing for Tyler Johnstone. After tearing the anterior cruciate ligament in his right knee on December 30, 2013 in the Valero Alamo Bowl, the redshirt junior was well on his way to what he phrased as “easing” his way into practice as Fall Camp began.
But early on in his first weeks back, Johnstone began to feel a popping noise in that same area when his knee buckled during a non-contact drill. It was later confirmed that the nightmare of enduring not one but two ACL injuries within a nine-month time frame was indeed the case and that Oregon would be without its starting left tackle who hadn’t missed a start in the team’s last 26 games.
“It was tough,” Johnstone said the week following re-tearing his ACL. “It was tough the first time too, back during the Alamo Bowl. It’s kind of the last thing you want to hear from an athletic standpoint. Obviously it’s not fun news.”
From an athlete’s standpoint, as Johnstone echoed, the words “ACL tear” have always been a haunting reality. With statistics such as 400,000 ACL injuries occurring each year on average, making it one of the more common injuries in the US, and studies that point to its increasing presence among young athletes, it would be short-sighted to feel as if these injuries weren’t avoidable.
Yet, Johnstone, who had been cleared by doctors two weeks prior to practice beginning, was now becoming part of another statistic.
According to Mark V. Paterno, PhD, PT, SCS, ATC and his colleagues at the University of Cincinnati Department of Pediatrics, the likelihood of a second injury to the ACL region within the first 12 months of reconstruction is 15 times greater than a previously uninjured knee. Going a step further, his team recently found that the same risk is decreased to six times more likely in the second year following ACL reconstruction.
Does that mean that Johnstone was rushed back too soon? Not necessarily.
“You always need so much time for the graft to heal, which is true,” Paterno said. “There’s always certain parameters around time that it takes for grafts to heal. But, within that notion too, there is some individual nature to within how people heal.”
Adrian Peterson’s MVP performance during the season following tears to his ACL and MCL may have created unrealistic expectations for forthcoming athletes who would undergo reconstructive knee surgery, yet despite that, the rate at which individuals return as soon, if not earlier, than he did has continued.
Now with the standard among physicians pointing to the possibility for an athlete to return to their respective sport in as little as six months, it has Oregon’s Bralon Addison on the verge of being on the field by September. Addison was presumed to be out for the upcoming season after tearing his right ACL during spring practice, however, it has been well noted that his calendar has a circle around the date of the Michigan State game, which would be almost six months since the time that the injury occurred.
“If you surveyed all of the sports medicine physicians in the country, most of them would say that’s a normal range,” Paterno said. “Our data would suggest you’re at the highest risk to get hurt again within the first year. Some would interpret that data to say if you just wait a year you would have less risk.”
According to Paterno, the ACL tear is just like any other major injury though, in that it needs to be evaluated on a case-by-case basis. Factors such as strength, balance and movement pattern – with the most important variables pointing to hip strength and landing mechanics – are more of a guide to how and when an athlete like Addison or Johnstone can get back on the field.
So for Addison, leaving those decisions up to the medical staff, the prospect of playing for the No. 3 ranked Oregon Ducks this year and providing obvious experience at the wide receiver position is adding an extra push to his work ethic regardless if Johnstone received a fate he may be prone to as well.
“It’s definitely devastating for Tyler to go through it again, but I think it only makes me want to rehab harder and get better,” Addison, who logged 61 catches for 890 yards last season, said. “I think if I am not rehabbing with the mindset to get back on the field as quick as possible, I think I’m rehabbing the wrong way.”
Former Stanford basketball player Andy Brown’s story was shaped in almost the exact way Addison hopes to build his. Brown, who received a scholarship to Stanford while at Mater Dei High School in Santa Ana, California, had undergone surgery on his left knee in February and had penned October as his goal to return to the court so he could join the rest of his teammates when practice opened.
Yet for Brown, even though he was cleared by doctors and was given the go to play, his mental capacity was not where it should’ve been. Just 45 minutes into his first practice in a Cardinal uniform Brown tore the same ACL he had undergone surgery on eight months prior.
“I wasn’t by any means comfortable,” Brown said. “I didn’t feel like I was ready. It’s 70 percent mental, 30 percent physical at that point because you get so scared to make a cut or go for a rebound. So what I did was I said ‘screw the mental thing I can go 100 percent’ and I wasn’t ready.”
Brown was then forced to redshirt and start a rehabilitation process that was much longer than the first. He came back this next time with a more refined mentality and had added a substantial amount of strength to which he felt satisfied with. However, those ten months did nothing to avert his knee from suffering the same outcome.
After 18 months spent fully geared towards rehabilitation, Brown had endured three ACL tears on the same knee. With it has come an unparalleled amount of knowledge about the injury and his only advice for those in a position he was in stems from the mistakes he made.
“Listen to the doctors but there is no point in trying to rush back,” Brown, who would suffer a fourth ACL injury that ended his career in 2013, said. “You can be in my position where you work your butt off for six months or so and your getting back into great shape and you come back a couple weeks too early and all of a sudden one play and boom it’s taken away from you.”
Paterno and his colleagues, along with dozens of other medical teams around the country, continue to look into different interventions or exercises that may reduce the chances of re-injury, but as for now the same protocols stick and the same likelihood of re-injury remains.
As for Johnstone, the 6-foot-6, 289-pound lineman is still seeing the positives and looks forward to having a full year to recover, with additional plans of turning his legs into “tree trunks.” On the other hand, Addison still eyes a comeback to the playing field, and whether it is by September 6 or the latter part of the season, the risks of recurring injury will undoubtedly continue to exist.
“It’s a horrible part of the business,” defensive backs coach John Neal said. “We worry about it all the time and think about it all the time and we have to overcome it when it happens.”
Follow Justin Wise on Twitter @JWISE25