Whatever It Takes Documentary

Jan 29, 2020

On Friday, January 23rd, the documentary, “What Ever Takes”, aired for the first time highlighting the rehabilitation journey of the Edmonton Oilers own Connor McDavid.
 
wit1.png
 
In a short summary, Connor experienced a season-ending knee injury in April 6th, 2019, which, if managed with surgery would’ve required a 10-month rehabilitation prognosis and missing most of the following season. After seeking multiple opinions, Connor decided not to perform the surgery and carried through an intensive rehabilitation program, allowing him to play in the start of following season, just 7-months later!
 
The final injury report included a fully torn posterior cruciate ligament, torn medial and lateral menisci, fully torn the popliteus muscle, torn posterior capsule and a tibial plateau fracture (Figure 1)
 
wit2.png
 

The 2 main takebacks from the documentary are: 1) rehab isn’t easy but can have several benefits and 2) knee surgery isn’t always necessary to get back to sport.

Connor McDavid, who is widely considered to be the best hockey player in the world, expresses his stress and frustrations throughout the documentary explaining the lengthy and tedious process of exercising up to 10 hours a day, seven days a week at certain points in his journey. These emotions are commonly experienced by athletes and non-athletes alike and can be the most challenging part of rehab. Physically, our bodies are very good at adapting to new stressors. With time and effort, our muscles, bones, ligaments, etc. can become stronger and withstand the demands of daily life and sport. What has recently become much more apparent and poses an even greater challenge is overcoming psychological barriers. A recent systematic review and meta-analysis showed only 53% of people who undergo an anterior cruciate ligament (ACL) reconstructive surgery return to their previous level of sport (1). In this study, the 2 greatest factors limiting the return to competitive sport was older age and fear of re-injury. Good knee function and quadricep strength are also predictors of returning to sport (2, 3), but many people overlook the psychological toughness required to endure a long rehab journey.

This documentary also highlights that it is possible to manage a knee ligament injury without surgery. There is emerging evidence that both ACL and PCL injuries can be managed without surgery and allow for people to return to their pre-injury level of sport (4, 5). This is due to many factors, one of the major reasons being that there are cases where a torn ligament has the potential to spontaneously heal, just like in Connors case. Multiple magnetic resonance imaging (MRI) studies have demonstrated that partially and fully torn ACL’s can reattach with time and conservative (non-surgical) care (5, 6) (Figure 2).

wit3.png

This is in no way undermining the importance of surgery! Conservative management can be very effective, but surgery can often be indicated when considering several factors like age, extent of the injury, social support networks, resources, goals and so on. For example, Connor McDavid had a very serious injury, most of whom would’ve elected for surgery if they experienced the same one. He also had the benefit of virtually unlimited resources, access to state-of-the-art recovery technology and a superhero-like rehab team to help him get to where he is now. The pathway chosen should be a decision made between the injured person and their healthcare practitioner when considering their goals and what it best for them.

Regardless of which pathway you choose, some form of rehab is always beneficial to a person’s function. Whether or not surgery is warranted, a well-designed rehab program should always be implemented prior to returning to sport to improve your physical function and prevent re-injury. At least 5-weeks of rehab after and ACL injury but before surgery (aka “prehab”) has shown to improve knee function 2-years later compared to those who didn’t do any pre-hab (7, 8). And when comparing people who have injured their ACL’s, a great rehab program resulted in similar knee function regardless of whether or not surgery was done (9).

In summary, 1) rehab can be very challenging and requires you not only to work hard at your exercise program, but to be considerate of you mental well-being throughout the process. 2) Surgery isn’t always necessary, do what’s best for you and your goals. 3) Having a strong social support system and a healthcare practitioner (like a physio ????), that has your best interest in mind it a great place to start! To book in for an appointment, call 780-458-8505.

 

References

1)     Ross, C. A., Clifford, A., & Louw, Q. A. (2017). Factors informing fear of reinjury after anterior cruciate ligament reconstruction. Physiotherapy theory and practice33(2), 103-114.

2)     Buckthorpe, M., La Rosa, G., & Della Villa, F. (2019). Restoring knee extensor strength after anterior cruciate ligament reconstruction: a clinical commentary. International journal of sports physical therapy14(1), 159.

3)     Herrington, L., Ghulam, H., & Comfort, P. (2018). Quadriceps Strength and Functional Performance After Anterior Cruciate Ligament Reconstruction in Professional Soccer players at Time of Return to Sport. Journal of strength and conditioning research.

4)     Agolley, D., Gabr, A., Benjamin-Laing, H., & Haddad, F. S. (2017). Successful return to sports in athletes following non-operative management of acute isolated posterior cruciate ligament injuries: medium-term follow-up. The bone & joint journal99(6), 774-778

5)     Madelaine, A., Fournier, G., Sappey-Marinier, E., Madelaine, T., Seil, R., Lefevre, N., ... & Society, F. A. (2018). Conservative management of anterior cruciate ligament injury in paediatric population: about 53 patients. Orthopaedics & Traumatology: Surgery & Research104(8), S169-S173.Ihara, H., & Kawano, T. (2017). Influence of age on healing capacity of acute tears of the anterior cruciate ligament based on magnetic resonance imaging assessment. Journal of computer assisted tomography41(2), 206.

6)     Costa-Paz, M., Ayerza, M. A., Tanoira, I., Astoul, J., & Muscolo, D. L. (2012). Spontaneous healing in complete ACL ruptures: a clinical and MRI study. Clinical Orthopaedics and Related Research®470(4), 979-985.

7)     Eitzen, I., Moksnes, H., Snyder-Mackler, L., & Risberg, M. A. (2010). A progressive 5-week exercise therapy program leads to significant improvement in knee function early after anterior cruciate ligament injury. journal of orthopaedic & sports physical therapy40(11), 705-721.

8)     Failla, M. J., Logerstedt, D. S., Grindem, H., Axe, M. J., Risberg, M. A., Engebretsen, L., ... & Snyder-Mackler, L. (2016). Does extended preoperative rehabilitation influence outcomes 2 years after ACL reconstruction? A comparative effectiveness study between the MOON and Delaware-Oslo ACL cohorts. The American journal of sports medicine44(10), 2608-2614.

9)     Wellsandt, E., Failla, M. J., Axe, M. J., & Snyder-Mackler, L. (2018). Does anterior cruciate ligament reconstruction improve functional and radiographic outcomes over nonoperative management 5 Years after injury?. The American journal of sports medicine46(9), 2103-2112.



Please add your bio info through your member profile page, or through your dashboard.


Posted By


Tag Cloud

why active physio workscanadian trailsfernie ultracanada dayankle sprains in athletesfree fort bbqsafe exercises during pregnancyorthopedic surgeonsfirst appointmentfort saskatchewan chamber of commerceultragolf injuriessouth edmontonfasciafun in the fortITU World Grand Final Triathlon Edmontonexercise planexercisegreat white north triathlonpiraformisglute strengtheningimPACT testing10 milerbellerose bike a thonbellerose bike-a-thon10milercovid 19yogarehabilitationcouch to 5knew york marathonmodified return to activitycity chase world championshippine to palmBPPVtriathlonremembrance dayfitnessacupuncturejaw painolympian distance challenge#teamrehabnational triathlon championshipsturkey on the trailsorthoticsshoulder painfort saskatchewanCBC interviewMS Bike Leduc to Camroseexercise challengeregistered massage therapistvirtual carebasketball injurieswrist painstaying fit while pregnantcupping therapycycling racevolunteercross trainingDiastasis Recticoncussion in sportrestcompressionfoam rollerconcussions in sportBFR trainingrunning shoesair relaxst albert road racetext neckbarefoot runningheadachesdiagnostic imagingschoolinjury preventionpatellar tendonitisWPTDskatingcustom fit compression stockingsgait analysiskids fun runcore strengtheningbowen therapyfitness programfitness journeytrapsyegfithalf ironmanscapulaplantar fasciitisparadepricectv edmontonknee replacementironman canada5kmbackpack safetyexplore alberta#activephysioworksrunningdr chanHawrelak ParkMS Bikejames deanultrarunningrunning techniqueflexibilityhikingbowen techniqueSAPECextended health caretrail runningworld championshipsurgent care physiotherapyvertigoGunn theory of IMScity chase canadaRace#eddiedontbendthoracic spine mobilityst. albert road racetaperingtraining planPosturecarpal tunneldry needlingout run rareACLcyclingtechniqueshoulder imagingknee injuryvictoria daylifestyle exposinister 7bikes on broadwaysynchronized skatingultra runningwinter runningrunning injuriesiceMRIyou can ride 2fort saskatchewan trade showconcussion testingheadacheSt. Albert Triathlonhockey injuryGLA:D® Edmontoncupping in st albertavoiding injuryhiking in the mountainsIntramuscular Stimulationexercise programpelvic health physiotherapysoccer injuriespush up programp90xholiday hoursst albert triathlonms bike tour10 miler training plancommunity involvementbest of T8Nyegphysiofirst trimechanical stressvestibular rehabilitationmagrathathlete injuryphysical therapyironmanwounded warriorsbaseline testingwarm handstraining on vacationTeam RehabGLA:D™ knee programinjection therapytournamentsmall business nomineecat-scanyegbikegrand openingkids of steel triathlonaquathonlumbar spine imagingpelvic healthConnor McDavidfoot paincity chase national championshipspin classms bike tour 2019Winter Injury PreventionSwimITU World Triathlon Grand Final Cozumelcervogenic headachesmedical mission to Ecuadorcommunity runglobal edmontoncharitybanff triathlonactive physio works 5kmrental car motor vehicle accidentdeath racepregnancy back painblood flow restriction trainingniagara fallscupping therapy in st albertglute strengthmarathon runningsleepobstacle coursepole walkingultramarathonGLA:D® St. Albertcommunitypiraformis syndromeneck painclavicle fracturecomplete concussion management inc.road rage hockey tournamentarthritis of the spinedraw prizestaperdr shepsgolfer's elbowtreatment for headachesstretchingUrinary IncontinenceultrasoundneedlingOsteoarthritisrotator cuffPFPSdown and dirty obstacle courseconcussion managementpelvic girdle painmarathon traininghip impingmentdirect billingswimmerBest Physiotherapistdizzinesskeep fit, have funreturn to sport5kedmonton oilersHIITst. albert chamber of commerce10kmyardworkprotectPRPmyofascial cupping therapyphysio for golfgolfswimmingituGLA:D™ back programfast trax ultrahip painkidslost souls ultraheel painshockwaveedmonton100 milearthritislateral epicondylitismotor vehicle accidentback painworld triathlon championshipsvolleyball10 mileworkout planITU World Triathlon Grand Final Edmontonhigh intensity interval trainingrunning footwearshockwave therapyeaster mondayshoulderWTS Edmontontraininginjuryseptember 30IT band syndromeHealth Information Actfundraisingpreventing sports injuriesultrarunnermarathonphysiotherapyworld physical therapy daytreatment plantrapezius strengtheningroad racefootballlegacy park family festivalpelvic health physiotherapistcuppingcortisonelow back paintennis elbowtelerehabtreating sports injuriesadventure racingcanada day paradest albert 10 milervirtual rehabcustom fit orthoticsdraw prizegood fridaymuscle tightnesspre-natal fitnessyou can ride tworecoveryms bike tour leduc to camrosedeath race training planDRAworld grand final edmontonsecondary submittingcommunity eventwarm heartankle spraincity chase national championshipscity chaseSCAT 3racingvelocity stage raceyegfitnessSt. Albertcold weather runningfamilymud runACL injuriesstrengthstrength trainingeasterconcussionctv morning livetrail runslip and fallsnutritionstrengtheningsports concussionrotator cuff tearGLA:D®registered massage therapyservus placepelvic floortrade showWestern Stateswhatever it takesankle injuriesIMSrunners kneemassage therapydave proctorshin splintsTMJnational championshipsadaptive cyclingtour de palm springspainRuniron legsplantar faciitisactive physio workshalf marathonMS Bike Tour 20201km kids fun runknee painx-raycorn5km obstacle courseroastwhat to expectfrozen shoulderP-90Xprehab before rehabBikestem cellcancer carefestivalthoracic spineoperation esperanzaphysiotherapy for cancer patientselbow painhockeysports injuryGLA:D™running formclinic closurehip replacementfundraiserDiastasis Rectus Abdominis (DRA)


Archive

What to Expect

We understand that you may have a few questions before visiting our clinics for your initial appointment.

Book an Appointment

Book in for an appointment with one of our qualified Active Physio Works Physiotherapists &
Registered Massage Therapists.

Treatments

We understand each person is different so we offer a variety of techniques that are best suited to your individual needs.