Injury Sam Skinner - ongoing ACL recovery (it's fine everyone, Nunez just trialling psychological warfare)

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Nunez

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Righteo, here's a condensed version of what I'm finding with ACLs.

Apologies as it's a bit longer than id hoped.

As always there kind of has to be a disclaimer just to provide a bit of context...

Despite how much effort we put into rehab and injury prevention I think we currently lack the necessary perspective to truly prevent them - which I think is more possible than we realise.

All of this is from my perspective as a Physio trying to solve a set of problems in my clinic. It's not true empirical research, but it's real time clinical findings - ones that seem consistent and repeatable. So please take from this what you want.

First things first - almost no ACL injury is an accident. It may appear that way, but it isn't. An ACL is seriously robust. It shouldn't fail from either landing or twisting particularly seeing as the majority of ACLs are simple, innocuous incidents.

Accidents happen on the footy field as someone can fall across your leg, but the key it seems here is that the quality of your leg mechanics going in to an accident will have a huge say in how well it stands up to the accident itself. Itll either cope and you'll be fine/fine-ish or it won't and you're out for the year.

Either way, this isnt a conversation entirely about strength and conditioning but the QUALITY of your leg mechanics. It's hugely underrated.

From my experience there is one major factor that seems to be present in every ACL I've ever seen.

Stiff ankles.

There are a few other items of note but this'll be a huge post if I go too deep.

The idea seems to be that if you add some stiffness to the joint below, the WHOLE leg has to find a way around it. You'll see a knee that caves in, you'll see a foot that may turn out, you'll see flat arches.

You'll see an ACL open to rupturing.

It's easy to get a sense of this when looking at someone squat.

Here's a pic of an old Indian lady squatting to FULL depth.



Here's a pic of Sam Skinner squatting to FULL depth.



Notice he's in a deep squat but his heels are a few inches off the ground... he's got stiff ankles, or at least he does if this pic is a true representation of how he squats.

If you can't squat to FULL depth with your heels down, feet straight, knees out and without wanting to fall backwards then you are missing something somewhere. The real kicker is that's supposed to feel normal. Thanks to the modern world - seats, heeled shoes, thongs etc we're batting pretty thin in the inherent flexibility stakes. Just instagram #babysquat or #asiansquat for a decent example of what we should all be able to do.

In summary ACLs (and most other knee issues for that matter) aren't a knee issue at all, they're a leg issue - or at least that's what I'm finding. Essentially the knee fails to cope with the way the whole leg is forced to work around restrictions. The moment an ACL goes is the moment it goes, but the mechanics of your leg leading up to that moment potentially set you up to fail.

There's a lot to cover with an ACL but the thing to take away from today s announcement is that Sam Skinner's knee didn't fail by accident. There's tangible, treatable factors that lead to such a terrible outcome. But you have to go hunting for them.

The biggest wrinkles are obviously his surgeries and rehabs which unfortunately are piling up. But for Sam and anyone else whose suffered an ACL you have to get at the original mechanical flaws, not just rehab the injury.

If he has stiff ankles, they have to go. All the strength and conditioning in the world can't buffer that enough. Clearly Sam's a unit as it is.

Anyway, hopefully that reads well enough, as I said earlier Ill have an in-depth post on this later on but it's a start.

Hope that helps.
Hi Sven,

Thought you may find interesting to hear - I am currently undergoing treatment for a neck injury and part of todays session was testing overall mobility. They actually did the tests on my ankles (which are very stiff) and the EP went on to elaborate about the effect of having stiff ankles can have on your body all the way up to your lower back. In particular, the increased risk of knee injuries if you have stiff ankles.

My previous EP didn't discuss with me back in April last year, so it definitely seems like your theory has caught on in the physio world. :)
 

sven_inc

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Hi Sven,

Thought you may find interesting to hear - I am currently undergoing treatment for a neck injury and part of todays session was testing overall mobility. They actually did the tests on my ankles (which are very stiff) and the EP went on to elaborate about the effect of having stiff ankles can have on your body all the way up to your lower back. In particular, the increased risk of knee injuries if you have stiff ankles.

My previous EP didn't discuss with me back in April last year, so it definitely seems like your theory has caught on in the physio world. :)
Thanks for feeling compelled enough to let me know Nunez!

It'll take the industry some time to catch up but with Nic Nats impending return, Naismith, Brodie Smith etc, and all the AFLW's unfortunate ACLs we will get there at some point. I'm hopeful I can be at the forefront!

On a bright note, saw the Sam was overseas doing some training - looks a treat!
 

Fatcat08

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Hi Sven,

Thought you may find interesting to hear - I am currently undergoing treatment for a neck injury and part of todays session was testing overall mobility. They actually did the tests on my ankles (which are very stiff) and the EP went on to elaborate about the effect of having stiff ankles can have on your body all the way up to your lower back. In particular, the increased risk of knee injuries if you have stiff ankles.

My previous EP didn't discuss with me back in April last year, so it definitely seems like your theory has caught on in the physio world. :)
Thanks nunez - deadset nearly fell over when this feed suddenly appeared at the top of the page! Thought the poor kid was going through another one!
 

luthor

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Mods would do us a big favour by changing the title of this thread to Sam Skinner - recovery from ACL. It gives me a hot flush every time it raises its ugly head.

Agreed.

I pood my pants when this thread suddenly popped up out of nowhere.

Poor bugger has been through enough already.
 

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jason pm

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Sam was really good in the reserves today, took some great intercept marks and some decent disposal. He made a few mistakes but you would expect that on the back of so long out of the game.

IMO he has gone ahead of Jack Frost in the KPD pecking order already.
 

Dodongo

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Sam was really good in the reserves today, took some great intercept marks and some decent disposal. He made a few mistakes but you would expect that on the back of so long out of the game.

IMO he has gone ahead of Jack Frost in the KPD pecking order already.
Dodongo thinks he will be playing seniors up forward come round 20. Or down back if we get injuries. It won't be long until he is pushing down the door
 
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