Chances of successfully returning to skateboarding
do increase dramatically the longer you stay in rehab.
– Jeroen Stam
P-Rod's knee injury explained.
Written by Jeroen Stam, edited by Matt Beare
We all heard P-Rod recently suffered from a serious injury to his knee - something called an unhappy/terrible triad (apparently it got this name from the fact that most people with this injury start feeling unhappy), which in a nutshell means taking out 3 of the main structures inside your knee, or in other words absolutely obliterating your knee. This article will go over some of the symptoms and causes of the different parts of his knee injury and then a bit on prevention so hopefully you never undergo the same problem.
This article has been written by none other than Jeroen Stam, aka @skateboardphysio, aka the on-site physio at the last Street League in Rio de Janeiro.
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meniscus.
The meniscus is a structure inside the knee that's constructed to absorb impact and distribute force throughout the leg. Athletes of any sport are more at risk of damaging this part of the knee than non-athletes, and although this will make a lot of skaters cringe, by definition we’re athletes too. The reason why athletes are more at risk is because meniscus tears come from turning and twisting movements; movements that occur in a lot of sports, and they occur a lot in skateboarding too.
The first thing you’ll notice when you have a meniscus tear is pain and swelling of the knee, along with painful catching and locking sensations typically present too. Depending on the location of the tear, meniscus tears can heal on their own without the need for surgery, and most of the time the orthopaedic surgeon or physiotherapist will just try to help you deal with the pain, and prescribe strengthening exercises to rebuild the meniscus.
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meniscus
MCL: medial collateral ligament.
The MCL is a ligament that prevents the knee from collapsing inward or overstretching, which it does with the help of a number of other ligaments and muscles. It isn’t shown well in the picture but the MCL is actually a wide ligament that fans out giving your knee support from many angles, and preventing it from snapping in half when you pop your tricks.
Injury to the MCL is common in all sports and can normally be treated with immobilisation, physiotherapy, and or surgery depending on the damage. Because the MCL is attached to the meniscus it isn’t too uncommon to injure them both at the same time. Complaints from an MCL tear might be pain, swelling, bruising on the inside of your knee, pain when straightening the knee, and/or a feeling of instability.
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MCL
ACL: anterior cruciate ligament.
The final beast in the unhappy triad is the anterior cruciate ligament (ACL). The ACL prevents forward motion of your lower leg and is an important stabilizer of the knee. It’s about as thick as your pinky but it’s able to withstand enormous force – as much as 2000N; I know what you’re thinking and the answer’s yes, that is about the same force of a 1 year old elephant being dropped from 1metre. Shout out to the good homie David Attenborough for providing that sentence. Sadly, unlike the MCL and meniscus, when your ACL is ruptured it doesn’t heal without reconstructive surgery. However, this isn’t always the case and some people can actually get away without having an ACL at all, and even manage to skate without one! Although a brace like the one Chris Joslin wears might be a good idea.
ACL tears can come from a sudden stop or twisting motion of the knee, like landing awkwardly down some stairs. A loud pop or popping sensation in the knee sometimes occurs with ACL tears, along with severe pain, swelling, and a feeling of instability as common symptoms. Another factor that increases the risk of damaging the ACL is knocked knees/knee collapse – when your knees cave inwards. Note that I use the words ‘risk’ and ‘chance’ because not everyone with something like knocked knees is bound to get hurt as there’s also a lot of bad luck involved.
Although there’s no research on the amount of ACL tears in skateboarding, in my subjective opinion they seem to be increasing. It could just seem to be this way because skaters are getting more exposure now with everyone on Instagram, and skateboarding in general getting more popular, or maybe it’s due to everyone stepping up their hammer game. Just think of the El Toro destruction that’s gone down over the last year.
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ACL
prevention.
Working out along with skating itself are both solid ways to reduce the risk of nearly all injuries. Skating on a regular basis (2-3x a week) is an important part of injury prevention as your body adapts specifically to the stresses you put it through, so the more you skate the more your body will be prepared for skating. Increasing your body’s strength and stability will also greatly reduce your chances of getting hurt and these exercises for skateboarding (2-3x a week) are great options to prepare your body even more for skating and give you extra protection around your knees and other joints. Warming up properly before you skate is also an important part of injury prevention along with making sure you recover properly from your sessions.
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getting back on your board.
If you think you might have damaged the parts of your knee mentioned in this article or you’ve got a lot of pain, swelling, instability, or anything else that’s telling you something’s wrong with your knees, you need to go to the hospital or visit a physiotherapist as soon as possible. The faster you have a rehab-plan in place the better. The orthopedic surgeon will tell you what he/she thinks is the best thing to do; undergo surgery or try conservative treatment like physiotherapy. Remember the choice is always yours, make sure you’re well informed and contact a physiotherapist to give you a second opinion to help you with your choice.
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Meniscus tears normally take about 6 weeks to heal and MCL tears about 3 months. The good news is they can both often be resolved through physiotherapy, without the need for surgery.
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ACL rehab, with or without surgery, takes about 9-12 months. It might come as a shock but only about 55% of people who tear their ACL get back to the level they had previous to the injury. But the chances of successfully returning to skateboarding increase dramatically the longer you stay in rehab and the more effort you put in. We physiotherapists also put you through rigorous testing before we let you roll. What I’m trying to say here is that rehab is hard work, but the more work you put in, the more you’ll get out of it. Take the time to heal up properly and you could get back to skating feeling better and fitter than before.
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the mental side of things.
Can you imagine being off your board for up to a year?!?! Or even a few weeks or months? Being out of your comfort zone, not doing what you love or anything at all for that matter, that takes a mental toll. It’s not uncommon that people feel down or fall into depression after getting hurt. Try to find something else to focus on, something that can help keep your mind occupied while recovering. Learn something new, work on preparing your body in other ways for when you get back to skating, or maybe it’s time you return the favour to your mate for all those hours he spent filming you kick your board away. If that doesn’t help, you could always try finding a sports psychologist or a mental coach. The more you trust your own body, the better you’ll feel when getting back on your board.
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Much respect for the ones who completed their rehab successfully. I hope Paul Rodriquez also returns to skateboarding without any problems, although I can imagine he has enough to keep his mind occupied. Still, support the injured! Good luck to P-rod and all the rehabbing skateboarders out there!
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- Jeroen Stam
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