A torn anterior cruciate ligament (ACL) can change your entire life in the blink of an eye. One minute, you’re a healthy and fit person who is driven and focused on competing physically with others. The next thing you know, your brain is flooded with thoughts of laziness, pessimism, and fear.
It’s just a knee injury, so it couldn’t possibly affect your brain, right?
The reality is depression and anxiety are commonly reported by patients with ACL injuries. But the worst feeling is post-traumatic stress disorder (PTSD), which is more commonly associated with wartime soldiers or survivors of terrorist attacks and other outrageous criminal behavior. But anyone can be traumatized, and studies show ACL injury is heavily linked to PTSD.
In fact, a majority of ACL patients (at least 75% each) reported experiencing symptoms of trauma, like avoidance, intrusion, and hyperarousal. Patients in the age range of 15-21 experienced heightened symptoms, and female patients experienced greater trauma than their male counterparts. I didn’t need a study to tell me that, as I lived through the trauma and am affected by the PTSD personally.
Let’s explore how this seemingly innocuous injury can be the cause of so much pain and anguish in our lives.
Prevalence of ACL Tears
Your ACL is a small ligament that runs diagonally across the middle of your knees and provides rotational stability while keeping your tibia from sliding in front of your femur. When this ligament is torn, it’s like snapping a stretched rubber band. You’ll hear a signature popping sound, and many report pain and swelling within the first few hours of the injury.
But what you can’t ignore is how difficult it suddenly is to walk without that ligament intact. It’s estimated that approximately 200,000 ACL injuries occur each year, and about half of them require surgery to repair.
Athletes most commonly suffer from a torn ACL because of the physical stress their bodies are constantly under while training and competing. Females are most likely to be injured, especially while playing soccer, basketball, and softball. Knee injuries are among the most common serious injuries in high school sports, accounting for about 60%.
And things don’t get better at the professional level, as instances of ACL tears increased over the last decade in the NFL and NBA. Even worse, one in five male football players who underwent ACL reconstruction surgery ends up retearing it. This makes it one of the most common sports-related injuries, and that’s just one physically demanding job.
Unfortunately, a torn ACL often involves other injuries, both physical and psychological.
The Trauma of a Torn ACL
An ACL injury in itself can have long-lasting and even permanent physical damage involved. But it typically happens in physically demanding jobs, and that means that suffering from an ACL rupture could end your career. That’s just the start of a traumatic journey that should be appreciated because more than your legs depend on those torn ligaments.
Injured athletes are sidelined and can no longer train, practice, and compete with the team. You go from being an integral part of the team and showcasing your physical prowess to only being there in spirit. It can lead to you losing a sense of self, causing degraded mental health and leading you down a dark path.
Your teammates may not help either. Although you may still have a level of camaraderie, they know that you’re no longer aiming at the same target. You may not be on the team forever, and you’ll lose a lot of your connections. It’s possible you can even be bullied, as former teammates consider you broken.
For some people, the inability to compete can cause an inability to make a living. You may have defined yourself as an athlete or soldier and now need to find a new lifestyle and career. This is a major life change that ranks up there with the most traumatic events of your life, including the death of a loved one or divorce.
There’s no shame in admitting you’re traumatized and recognizing the other detrimental effects of an ACL injury.
The psychological effects of an ACL injury are the main factors determining whether an athlete returns to the sport (or how they recover if leaving). There are three main negative feelings you may feel that are signs of the trauma experienced.
An ACL injury can lead to a change in overall mood, which is an early sign of mental health problems. Patients with ACL injury have shown signs of depression, as endogenous opiates are no longer released into the body. This can impact your feeling of self-worth and lead to sudden bouts of depression, anxiety, and anger.
It’s vital that you seek therapy, counseling, and practice self-healing techniques to regulate your emotions. Just because you have a thought does not define you, and you’re allowed to feel emotions. It’s how you ultimately treat yourself and others while acting on these emotions that will define your character.
The most common clinical issue experienced by ACL patients is kinesiophobia, which is the fear of reinjury. In the initial years following an ACL reconstruction, patients may be overly careful and aware of their knees in hopes of protecting themselves from further injury. Although they may be physically healthy, their fears could lead to an inability to perform like they used to.
A higher level of fear makes it less likely to return to the field, and that can quickly snowball into isolation.
The final major negative effect you’ll experience is a lack of optimism. Negative emotions and self-doubt will cloud your mind, and you’ll find ways to justify turning inward and avoiding life in the name of protecting yourself. You may also fight depression due to the loss of your self-identity.
While it’s natural to feel these thoughts, don’t let them overwhelm you. Coping strategies can help you adhere to the rehabilitation process and get your life back on track.
Recovering from a traumatic knee injury requires a holistic approach that accounts for both the physical and psychological effects. It can end your career and derail your life, and you shouldn’t discount the negative mental health impacts of an ACL injury.
But you don’t need to do it alone. A supportive team can help speed up your recovery time and secure a better quality of life. I’ve been through it myself, and you’re more than welcome to reach out with any questions or concerns you may have.