How to Rate Recruits with ACL Injuries?

[Outside Shot]

I'm curious what some thoughts are regarding how to rank recruits once they suffer ACL injuries? It might sound cold-hearted, but many are never quite the same player afterwards, while some do regain form. I ask because there are some highly regarded players in this class that are still highly ranked, yet have suffered ACLs. We really don't know what they will be like post-ACL. I think it is hard to separate that from their current ranking. To me, a true eval has to factor that in. Curious what others think.

 

[HuskyNan]

I'm curious what some thoughts are regarding how to rank recruits once they suffer ACL injuries? It might sound cold-hearted, but many are never quite the same player afterwards, while some do regain form. I ask because there are some highly regarded players in this class that are still highly ranked, yet have suffered ACLs. We really don't know what they will be like post-ACL. I think it is hard to separate that from their current ranking. To me, a true eval has to factor that in. Curious what others think.

We UConn fans saw Sue Bird tear her ACL in her freshman year and then go on to lead her team to two national championships. We've also seen Shea Ralph tear her ACL 4 or 5 times then become an NCAA Tournament MVP. While these are admittedly unusual examples, they do illustrate that an ACL tear doesn't necessarily mean that a player can't go on to develop into an outstanding one.

 

[UCONNfan1]

Additionally, one can generally look at players like Kalana Greene - who was quite the athlete before her ACL, but after it, realized she needed to become a "smarter" basketball player and not rely so much on her athleticism because it wasn't quite the same after her injury.

I've read some kids actually say they are stronger and better after an ACL because it forces them to work their muscles differently to be come stronger in their lower body and to change the way they approach fitness, etc. It did make Kalana Greene a better "basketball" player, but not a better athlete...

 

[alexrgct]

HoopGurlz used this rationale to keep Morgan Tuck at #16 for much of junior and senior seasons. But then she seemed none the worse for it. Really depends on the player.

 

[Outside Shot]

It's just impossible to predict. I also think of Michala Johnson's struggles. Doty has been a warrior in the face of great challenges. Just not sure how to factor it in to a recruit's rating.

 

[MilfordHusky]

Good question. It's a little like Tommy John surgery for baseball pitchers. Some are great for years afterward. Others don't make it back. The range of outcomes is vast, but the potential for full recovery is there. Sue Bird's career would be Exhibit A for that.

 

[winlots]

I'm curious what some thoughts are regarding how to rank recruits once they suffer ACL injuries? It might sound cold-hearted, but many are never quite the same player afterwards, while some do regain form. I ask because there are some highly regarded players in this class that are still highly ranked, yet have suffered ACLs. We really don't know what they will be like post-ACL. I think it is hard to separate that from their current ranking. To me, a true eval has to factor that in. Curious what others think.

OUTS: terrific thread idea....potential to promote some thoughtful response.....invites implicitly AND even explicity input from others....seemingly very sincere question/issue......a little different sort of theme, etc....all good, and a rare tip o' the cap to ye, Lad.

Just back from a stellar anniversary night out. Counting the "Whirlwind 25-year Courtship," ( and I count every arduous year), my wife says we're up to 44 now....sure as hell feels like all of 45 to me.

I see some great posts already on here, so I'll respond in the context of what they had to say, below.

 

[winlots]

We UConn fans saw Sue Bird tear her ACL in her freshman year and then go on to lead her team to two national championships. We've also seen Shea Ralph tear her ACL 4 or 5 times then become an NCAA Tournament MVP. While these are admittedly unusual examples, they do illustrate that an ACL tear doesn't necessarily mean that a player can't go on to develop into an outstanding one.

HUSK: very solid point and supportive facts.

(Surely the team achievements noted are "unusual" examples of comebacks.....but i have NO idea of the statistical data re such comebacks re kids in less outstanding programs. Anybody?? Were these successes illustrative of ACL issues or of the pre-eminence of the UCONN program? )

 

[winlots]

Additionally, one can generally look at players like Kalana Greene - who was quite the athlete before her ACL, but after it, realized she needed to become a "smarter" basketball player and not rely so much on her athleticism because it wasn't quite the same after her injury.

I've read some kids actually say they are stronger and better after an ACL because it forces them to work their muscles differently to be come stronger in their lower body and to change the way they approach fitness, etc. It did make Kalana Greene a better "basketball" player, but not a better athlete...

UCONN: good andVERY important distinction (player vs. athlete)....and good post.

 

[winlots]

HoopGurlz used this rationale to keep Morgan Tuck at #16 for much of junior and senior seasons. But then she seemed none the worse for it. Really depends on the player.

ALEX- yup, right on target as usual. Would go so far as to say re Tuck, WAY beyond "none the worse for it"......like # 5 or so vs 16/? What think?
?

 

[winlots]

It's just impossible to predict. I also think of Michala Johnson's struggles. Doty has been a warrior in the face of great challenges. Just not sure how to factor it in to a recruit's rating.

OUT : agreed here. Seems to me to be extraordinarily difficult to factor in.....must be all degrees of injury, all degrees of surgical intervention competence/success, etc.
That's why I asked earlier if anyone had any crude data on the "combacks" from ACLs regardless of program excellence.

 

[Outside Shot]

winlots-congrats on the milestone and many more. Sure is nice to have great teammate in life.

There are a lot of variables that affect recovery. How much damage in addition to ACL? Meniscus? MCL? Etc. What is rehab situation?
Maybe a player's body type factors in?

 

[UcMiami]

I think one of the major issues with ACL (and really any other serious injuries is the quality of health care and rehab that the athlete gets. When the injuries happen in college, the care and rehab is typically absolutely state of the art, and the results should be as good as possible. For HS athletes it is a whole other story with a wide range of care available. While not an athlete, I experience that varying care on very similar injuries and the results were widely divergent.
Specific to ACL injuries, the rehab is probably more significant than the actual operation and that gets into both the training of the caregiver and the attitude and dedication of the athlete.
And some of it is genes and just dumb luck. CD had great care but one of her major setbacks was just a total rejection of one of her replacement ligaments.
With a player like Tuck, because the injury happened early in her HS career, she had two full years of HS recovery to prove that her situation was as good as it could get. With athletes that have their injuries later in HS careers, it is a much bigger guessing game as to how they will respond in their college careers. I think most rankings try to reflect medical issues, but with injuries that happen late in HS, many of the ratings have already been 'fixed' and do not get updated again.

 

[OneTrickPony]

I often wonder how much variation there is in ACL tears...for instance, do the doctors have a much better idea of the potential for recovery by looking at the actual situation than we get from hearing the term...and to what degree.

They were talking on the radio yesterday about Marcus Lattimore, the South Carolina running back that suffered a greusome knee displacement...both anteriors and the medials completely torn. The speculation centers around how much collateral nerve and circulatory system damage he's suffered. He may wind up with a "dead foot."

Is there a nerve and circulatory element in simple ACL injuries, as well?

 

[stamfordhusky]

Is there a nerve and circulatory element in simple ACL injuries, as well?

There may be. In addition to a clean ACL tear, which is the "best" type, an athlete may also have to deal with:

- Other torn ligmaments, most typically the MCL
- Torn meniscus, which slows down rehab and sometimes can affect recovery for a long time (even forever)
- Nerve damage
- Dislocated kneecap (which goes along with multiple torn ligaments)
- Broken bone(s)

Put several of these together and an athlete may never get back to 100%. Also, as mentioned, the body type etc of some female players make a recurrence significantly more likely for certain players.

 

[rjp172]

The point made about when during an athlete's career they tear an acl determining the final outcome seems very valid. You hear of players tearing an acl and never being the same, but you also see players at top universities and the pro level make full recoveries. For ND Peters tore her acl midway through her freshman season in the BE. She re-tore the same acl at the beginning of the next season around the same time Mallory tore hers. Both sat out that season and came back during the next season although Peters had yet another surgery on the same knee. Mallory picked up where she left off or at least seemed to because she was never dependent on shear raw athleticism. Peters looked the worse for wear that half the season and she and her coaches were talking about how she'll never be the same still into her 3rd year. By the time BE season came along she was looking like the player they had hoped. Awarded all BE honors, DPY and played a vital role in the national runner up run. Her last season went off without a hitch, repeated the awards and looks to be settling in on a pro career. Once she came back in the middle of what should have been her junior year (2nd eligibility wise) she never missed a game.

 

[OneTrickPony]

There may be. In addition to a clean ACL tear, which is the "best" type, an athlete may also have to deal with:

- Other torn ligmaments, most typically the MCL
- Torn meniscus, which slows down rehab and sometimes can affect recovery for a long time (even forever)
- Nerve damage
- Dislocated kneecap (which goes along with multiple torn ligaments)
- Broken bone(s)

Put several of these together and an athlete may never get back to 100%. Also, as mentioned, the body type etc of some female players make a recurrence significantly more likely for certain players.

I suspected as much...I've had the meniscus on the inside of my right knee shaved down to the quick and that knee always gets sore even though my movement isn't impaired. During that operation, they actually purposely strained or tore (don't really remember) my medial ligament to gain access. The doctor told me that injury, by itself, is really nothing and they do it all the time...the anteriors are much worse.

 

[UcMiami]

I suspected as much...I've had the meniscus on the inside of my right knee shaved down to the quick and that knee always gets sore even though my movement isn't impaired. During that operation, they actually purposely strained or tore (don't really remember) my medial ligament to gain access. The doctor told me that injury, by itself, is really nothing and they do it all the time...the anteriors are much worse.

Ligaments and cartiledge are in effect 'dead' in that they do not have blood supply or nerves except at their attachment points. There is really no difference in one complete tear vs. another. With partial tears it may be possible to cut the torn part back to the blood supply and some of the cartiledge may regenerate but not to full strength, or just remove the torn bit to releave inflamation/pain being caused in surrounding tissue. Generally though, the only way to repair to complete strength is to replace.
The biggest issue as Stamford Husky says is how much other damage has been done - the more different parts of the joint that need to be replaced/repaired, the harder and longer the recovery takes.
When someone talks about a 'clean tear' it really is more related to whether other parts are involved. (And I suspect sometimes whether the whole or only part of the ligament has torn - but as stated above a partial tear doesn't really help for an athlete.)

 

[Wink96]

Seem that there are a myriad of factors which the placement of whitch can result in various conclusions. Take for example Shea and Sue.

 

[slimmer56]

I hate the ACL injuries, especially in the women's game. It has become an epidemic, almost like cancer.
I do think a lot of luck is involved, especially coming back from the 1st ACL.

I am reminded about Katie Collier the Mcdonalds All-American who just beat Luekemia, then went down with an ACL. How much can one girl take. This girl can really play. Her and Heather Corral are now roomates with the Washington Huskies. She is out for the year, but she says Heather and Christy Kingma have really helped her. Heather had 2 ACLs in high school and Christy is coming back from her 1st this year. They both told her it would hurt worse than she imagined, but her knee WOULD come back stronger. My heart goes out to Katie Collier.
By the way, they won their 1st exhibition of the year beating Concordia U. 92-46 last night. Kingma had 15 pts,12 rebs, & 4 stls. The freshman Corral had 9 pts 3 assists 2 stls in 25 minutes.

 

[slimmer56]

I hate the ACL injuries, especially in the women's game. It has become an epidemic, almost like cancer.
I do think a lot of luck is involved, especially coming back from the 1st ACL.

I am reminded about Katie Collier the Mcdonalds All-American who just beat Luekemia, then went down with an ACL. How much can one girl take. This girl can really play. Her and Heather Corral are now roomates with the Washington Huskies. She is out for the year, but she says Heather and Kristi Kingma have really helped her. Heather had 2 ACLs in high school and Kristi is coming back from her 1st this year. They both told her it would hurt worse than she imagined, but her knee WOULD come back stronger. My heart goes out to Katie Collier.
By the way, they won their 1st exhibition of the year beating Concordia U. 92-46 last night. Kingma had 15 pts,12 rebs, & 4 stls. The freshman Corral had 9 pts 3 assists 2 stls in 25 minutes.

 

[Man-Man]

Great thread/topic one I've pondered for years. My belief from being an athlete with surgeries and not rehabbing properly and never regaining total mobility is that proper rehab is a major factor. Rehab lies not only on the therapist administering it but a lot is on the player herself as there is a lot you are required to do on your own, therefore I think results will vary.

I'm so puzzled when I see players come back seeming as if they haven't missed a beat. This past season I watched Rebecca Greenwell who was back from an ACL look amazing playing against high level kids wearing a knee brace. Unfortunately I can only compare her previous play to seeing her at 10 & 11 years old and what I've read. I've also seen another top ranked kid play amazing after rehabbing an ACL injury that had been hidden from the public/media and no one mentioned any drop in her game over the summer.

I've always wondered if kids that have torn their ACL's are prone to repeat or additional tears. I've also wondered if the ACL prevention craze really is effective. I subscribe to doing the rehab exercises periodically even on healthy ACL's for prevention, don't know if it will help but figure it can't hurt.

To answer the question I have been told by several evaluators that a kid suffering an ACL tear or other injury would not drop in rankings or be penalized solely for having an injury and that they will be reevaluated once they recover. During the rehab however another kid can display skills to move her up past the injured player as per her previous evaluation. If you add in the fact that we are all human this could be purely lip service but that's the general rule from what I hear.

 

[Man-Man]

That was good info about Bird never knew she tore hers, I've talked to Ralph she talked about her multiple ACL injuries but thought that was it didn't know she returned as tournament MVP, I actually assumed that she just gave up playing and became a coach never making a comeback. Good stories and rich history with UConns program keep'em coming.

 

[magical2]

I hate the ACL injuries, especially in the women's game. It has become an epidemic, almost like cancer.
I do think a lot of luck is involved, especially coming back from the 1st ACL.

I am reminded about Katie Collier the Mcdonalds All-American who just beat Luekemia, then went down with an ACL. How much can one girl take. This girl can really play. Her and Heather Corral are now roomates with the Washington Huskies. She is out for the year, but she says Heather and Christy Kingma have really helped her. Heather had 2 ACLs in high school and Christy is coming back from her 1st this year. They both told her it would hurt worse than she imagined, but her knee WOULD come back stronger. My heart goes out to Katie Collier.
By the way, they won their 1st exhibition of the year beating Concordia U. 92-46 last night. Kingma had 15 pts,12 rebs, & 4 stls. The freshman Corral had 9 pts 3 assists 2 stls in 25 minutes.

I missed out on Katie going down with an ACL! My heart and prayers go out to her.
Ya gotta being rooting for this kid.
Ira