teamCSSM - Camberwell Sports and Spinal Medicine
With the Eagles having snuck into the finals for the 2017 AFL season, there has been a lot of speculation about the possible return of star ruckman Nic Naitanui for a run at the finals. Naitanui has missed the 2017 AFL season following a late season ACL injury in 2016.
There has been a lot of evidence around suggesting that “NicNat” has made good progress with his knee rehabilitation, including this video from a US rehab camp in July, which has fed much of this speculation. Eagles coach Adam Simpson has put this speculation to bed during the week by ruling Naitanui out for the season, however with some players over recent years returning from ACL reconstructions in less than 6 months, many are asking, Why so long?
It is a good question and it is a question that we get a lot in the clinic when dealing with injured athletes at a local level. Whilst I do not pretend to have any inside knowledge of NicNat’s progress, nor would I dare second guess the judgement of the Eagles medical team, I do believe that Naitanui’s situation is a perfect example of the old saying, ‘just because you can, doesn’t mean that you should.’
We know after many years of following the progress of athletes returning from knee reconstructions that the risk of re-injury increases substantially by a premature return to sport. Much of this knowledge was reinforced by a 2016 study that found that athletes who return to high level sport have a four fold increase in re-injury compared to athletes who do not return to sport1. In fact almost 1 in 3 athletes who returned to high level sports sustain a re-injury within 2 years1. An alarming statistic – but what is most interesting is that this re-injury rate decreased by 51% for each month return to sport was delayed up until 9 months after surgery1.
It seems that 9 months is the magical number – so is it a matter of just waiting? The answer is a resounding no! If wishing to return to sport at any level, effective and specific rehab is important. This rehabilitation program works towards regaining symmetry of muscular strength in the muscle groups around the knee. Effectively retraining the nervous system to build co-ordination and proprioception which increases agility, body awareness and reduces the chances of reinjury2. The rehabilitation program is best designed by your treating practitioner, be it an Osteopath or Physiotherapist in consultation with your orthopedic surgeon.
Return to sport should not be attempted until a criteria of sports specific performance goals are achieved. It is likely that this is an area where the West Coast medical team are at with Naitanui. They will have set performance goals for Nic to achieve at the start of the rehabilitation phase and it may be that he is not quite there yet. Good management can reduce re-injury risk by 84% after ACL reconstruction1. It is unlikely that they will release Nic Naitanui to return to play if there is any doubt about his ability to sustain the load. A re-injury now would potentially risk Nic’s ongoing career.
ACL injuries are distressing and the rehabilitation process is a long one. However, a positive outcome is achievable with careful management and patience.
Should you have any queries about a knee injury you have sustained, feel free to contact the team at CSSM.
About the Author.
Travis Bateman is an Osteopath, trail runner, mountain biker, habitual back of the pack finisher and founder of Camberwell Sports & Spinal Medicine. His clinical interest is in movement analysis and its relationship to injury management, pain and sports performance
Published 1st September 2017
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