What to Expect After a Torn ACL
Kendall Wallace was playing pickup basketball on August 31, 2010 in Las Vegas. Nothing was out of the ordinary.
During a random play, he received a high pass from a teammate. He jumped up and caught the pass, and as he landed, he immediately put the ball on the floor and darted left.
"It was a move I've made a million times," Wallace said.
Only, his right knee wasn't ready for the cut this time. It collapsed inward and Wallace fell to the court. He wasn't necessarily in pain, but he knew something wasn't right.
Turns out, Wallace tore the anterior cruciate ligament (ACL) in his right knee. It's a common sports injury, particularly in basketball where there is so much cutting. Female basketball players are especially prone to the injury.
The ACL is a ligament that attaches the femur to the tibia through the knee. It's one of four main ligaments in the knee, and helps give the knee stability that is crucial for basketball players. When you have ACL surgery, a lengthy rehabilitation process follows and basketball is out of the question for several months.
We interviewed one male and one female college basketball player -- Wallace of UNLV and Whitney Hand of Oklahoma -- who have recently recovered from ACL injuries. While Wallace had a simple ACL tear and no other damage, Hand injured her knee even more in a 2009 game, tearing her ACL, MCL, meniscus and lots of cartilage.
We asked the two to take us through the process from start to finish, from the injury itself to the first game back. The hope is that this provides insight into ACL tears for young players who might experience it, through the eyes of those who have already gone through it.
Whitney Hand, a 6-foot-1 guard, was a sophomore at Oklahoma and the reigning Big 12 Conference freshman of the year. On November 27, 2009, she was playing her fifth game of the season, against San Diego State at the Paradise Jam tournament in the U.S. Virgin Islands.
"The court was slick, so I made my shoes super sticky before the game," Hand recalled. "I was sprinting down the court, and the ball got loose behind me. So I planted and turned. My shoe stuck to the ground when I turned, and my knee dislocated. I tore everything."
It was similar to the way Kendall Wallace was hurt in his pickup game. Wallace, a 6-foot-4 sharpshooter, was doing a sudden change of direction just like Hand when his ACL gave out.
The difference? Wallace didn't feel much pain.
"I felt it give, and I felt a little snap, and then it was just burning," Wallace said. "It felt like it was on fire for 20 seconds. I didn't feel any pain after that. I felt like I could walk it off and play, but I didn't because I knew something was up with it."
Hand, meanwhile, did a lot more damage than just a torn ACL. She was in a lot of pain immediately.
"When you just tear the ACL, the nerves sever and it doesn't really hurt," Hand said. "I also had a large bone bruise on my tibia that's still there. That caused tons of swelling and I really couldn't walk."
Hand and Wallace did have one thing in common, unfortunately: It was the last time they would be playing basketball for a while.
Since Hand was in the Virgin Islands, she waited until the team returned to Oklahoma before getting an MRI to determine the extent of the injury. Her knee was still really swollen, but an MRI was done about three days later and it confirmed the extensive ligament damage in her knee.
Wallace, meanwhile, had UNLV trainers and doctors look at his knee immediately, and an MRI was scheduled for the next day.
"I had all the doctors and trainers look at it," Wallace said. "They were pulling on my leg to see if something was there. They did that test and said they were 98 percent sure that I tore my ACL. So I knew before I went in to get my MRI. (The MRI) was just confirmation."
The news was devastating for both players. A long journey awaited them.
Due to the severity of Hand's injury, she had to wait for the swelling to go down before getting her knee repaired. She didn't have surgery for three more weeks.
While going under the knife can be a stressful experience, all the waiting made Hand annoyed more than anything.
"I was wanting to get it over with," Hand said. "I was ready to attack it. I was sick of waiting around not being able to do anything. I was ready to get the process started."
Wallace, meanwhile, spent a little time after the injury doing strengthening exercises to get the knee ready for the surgery. He went under the knife 17 days after injuring the knee.
ACL reconstructive surgery involves using a replacement graft from a different part of your body, or from a cadaver. Three grafts are more common than others: a hamstring graft, a patellar tendon graft or a cadaver graft. The new graft is put in place of the torn ligament.
"I knew what I was getting in to," Wallace said. "My trainer showed me a surgery on the computer. Once you go in there, you lay down, and once you get that anesthesia in you, it's over. You wake up in the recovery room."
Both Hand and Wallace spent the first couple of days after surgery laying in bed. Hand was in pain for about three days after the surgery.
After the rest, both Hand and Wallace used crutches for about two weeks. Hand was fortunate that Oklahoma was on winter break, so she didn't have to limp to class. School just started for Wallace and he was marching all over UNLV on crutches.
"I was probably on crutches for two weeks, then I had this knee brace they gave me," Wallace said. "I wasn't able to bend my knee so I had this knee brace on and I walked around campus with that."
Both Hand and Wallace started rehabilitation about four days after surgery. Both were fortunate to have the resources that a Division I athletic program offers to get their athletes back in competition.
Hand said the first thing her program worked on was strengthening the quadriceps muscle, which had weakened severely over the past month. Wallace's program initially focused on range of motion, so his leg would have just as much mobility as it did before the injury.
The two rehabbed between five and seven days every week, often alone in the trainer's room while their teammates were practicing and playing on the court. It was lonely, and the work got repetitive.
"They tried to make it fun, but it's the same exercises over and over," Hand said. "There's not too much different stuff they can do."
Added Wallace: "To make progress, you're going to have to go through some pain. Your leg is just torn up after that surgery. It's a lot of hard work. You've got to go in there every day expecting to work hard and push through everything. It's a battle, no doubt about it."
The two spent months building strength, coordination, balance and range of motion in their knee. After four months, both were allowed to do straight-ahead running.
"On a treadmill," Wallace said. "We tried it on a gym floor and it was still painful at that point. I had to keep running on the regular floor to get used to it, and eventually the pain started to go away."
Hand was allowed to make cuts about five months after surgery. Wallace waited until about six months. By this time, both were fitted with a bulky brace that would help stabilize a knee that was still trying to gain the strength and coordination needed to play basketball. They were told to wear the brace while playing basketball for a full year after the injury.
Hand was cleared to play (or "released") about six months after tearing her ACL. Her first action was a pickup game in the summer of 2010. She was extremely nervous.
"I pretty much told the person I was guarding that they were going to get an open layup if they cut real hard," Hand said. "I wasn't playing to cut."
Wallace returned by the end of UNLV's 2010-11 season and practiced with the team as it prepared for the Mountain West and NCAA tournaments in March. He had already chosen to red-shirt so he didn't play in any games.
"I was tentative on it, but I was ready to get back out there with my teammates and compete again," Wallace said. "I was a little out of shape, but that all comes with having to sit around for six months."
Hand soon had another setback--cartilage damage in the same knee that resulted in another surgery and more rehab. Her first real game back was January 2, 2011 against TCU--411 days after her initial injury. Most layoffs are like Wallace's and last around 6-9 months.
While Wallace feels he's 100 percent healed and his knee is stronger than ever, Hand's knee injury was severe enough that she says she will never be the same.
"I'm a different player," Hand said. "I may not be as fast, but I think the mental aspect of the game, getting to watch for a year and gain that perspective, allows you to grow in different ways as a player. I think it makes you tougher, and it makes you take steps in different directions, and it maybe broadens your versatility as a player."
Both players stress that the recovery process from an ACL injury demands a level head. There will be good days and bad days--the key is to not get too high or too low.
"I remember having days where I felt like I could conquer the world and go play a 40-minute game, and days where I couldn't even complete one exercise," Hand said. "I had a roller coaster of a rehab. I think the more consistent you can stay mentally--attacking one day at a time and just remembering that you are progressing no matter how you feel--the better."
Wallace has similar advice for younger players who might tear their ACL: Stay focused and work hard at getting your knee strong again. It's the best way to get your basketball career back on track.
"Look at it as a positive. It's unfortunate that it happens, but you have to look at the good things that can come out of it," Wallace said. "You have to see the light at the end of the tunnel and keep working hard toward it."