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‘Once you’ve been through one you really understand the process of what it takes to go through it’ - ACL injuries require physical and mental recovery

How the long road to recovery works from someone with experience tearing an ACL.

Syndication: The Columbus Dispatch Kyle Robertson/Columbus Dispatch via Imagn Content Services, LLC

The Columbus Crew opened the 2021 Major League Soccer season in mid-April with plenty of fanfare. Former Crew legends presented the team owners with the 2020 MLS Cup as the new crest at historic Crew Stadium was revealed to a standing ovation. The match ended without the same excitement in a 0-0 draw against 2020’s Supporters’ Shield winners in the Philadelphia Union.

After the game, as head coach Caleb Porter began his press conference, 19-year-old midfielder Aidan Morris made his way onto the pitch at historic Crew Stadium. Morris suffered an ACL tear three days prior as his knee landed awkwardly on a tackle.

A few minutes passed as Morris stood alone on the field. Only he knows the thoughts going through his head. It could have been time alone to reflect on his performance in the 3-0 MLS Cup Final victory against the Seattle Sounders. It could be thinking about the road to recovery he’s about to travel.

Morris has people around him that have gone on the same journey. Crew fullback Milton Valenzuela missed the entire 2019 season after a preseason ACL injury. The newly-signed Kevin Molino has torn his ACL twice. There’s a third name, who came to Columbus in 2020, who has more experience than they want with ACL injuries. Former National Women’s Soccer League defender, and current Crew TV analyst, Jordan Angeli.

After the MLS opener, against Philadelphia, midfielder Aidan Morris spent time at the corner of the field.
Thomas Costello

Her soccer career included three ACL tears, twice in college and once as a professional. She not only lived the years of mental and physical stress, surgeries and rehabilitation but has since made it a goal of her life to help people going through the intense experience.

During the Champions League match where Morris suffered the injury, Angeli noticed an awkward and strange moment. While backtracking, the referee got into his path. To avoid the referee, Aidan adjusted his stride. It created an awkward situation for the young midfielder. Then when he reached in for a tackle, it was a familiar and painful moment for Angeli.

“It’s hard for me to watch,” said Angeli. “I didn’t really watch the replay too closely because it’s still a tough injury for me to honestly report on because I can feel it happening.”

No injuries are easy to watch. Nobody wants a player on either team to get hurt. For Angeli, ACL injuries are different.

“Once you’ve been through one you really understand the process of what it takes to go through it,” said Angeli. “Unlike other injuries, in just the mental fortitude you have to have to get through the length of it.”

Angeli stressed that every ACL injury is different. Angeli, Morris and anyone else with this injury all go through different trials. There’s no cookie-cutter ACL experience. Angeli tore her ACL three different ways, twice pushing off of her left leg to go right and landing with her leg too straight on a jump and once with a contact-induced tear when an opponent tackled her, earning a yellow card.

Surgery and physical recovery

There is a different route for every ACL tear. Some athletes return within a year and some take longer. It’s a tedious process of fighting back swelling, incremental improvements and mentally working through setbacks.

The road to recovery begins before surgery. In the days before, people must work on reducing swelling and building strength around the knee. This process is important in reducing muscle atrophy, or the wasting away of muscles. Then comes the surgery, which Angeli gives a word of warning.

“I wouldn’t recommend googling ACL surgery if you get kind of queasy,” she said. “They move your leg all around, they’re drilling.”

It’s in this part of the process where a surgeon grafts either part of a hamstring, quad tendon or even a cadaver. The first 12 weeks after surgery are the most important. This is when swelling needs to reduce and strength needs to be rebuilt.

The first bar to reach is building enough strength to walk. Over time, players move into jogging, cutting and making soccer moves in training. An area that doesn’t jump to the top of the mind, about rehab, is the loss of endorphins.

Endorphins are a chemical released by the body during physical activity. Professional athletes release them in droves, but once there’s an injury like an ACL tear, they have to occur in other ways. That’s when they use other exercises such as hand bikes or training in a pool. Not only does it build strength elsewhere, but it fills that void.

Mental and emotional recovery

For professional athletes, physical exertion isn’t difficult. They know what their body can do and how to control it, which is part of the difficulty of rehabilitation. With ACL tears, athletes don’t have the same control. The body will do what the body will do. A bigger hurdle for some is fighting the mental side of recovery.

“There’s this up and down and up and down and up and down,” said Angeli. “There’s ups where you’re feeling like, ‘I’m going to the next step, I’m getting there.’ Then your knee swells up and you get defeated. It’s a roller coaster of emotional highs and lows in this progression stage to be able to appreciate it, but not know that sometimes nothing you do can affect it.”

Dealing with mental recovery goes beyond withstanding physical setbacks. Injury thrusts a soccer player, like Morris and Angeli, from being part of a locker room and team dynamic to isolation. They are no longer part of the every day team dynamic. Instead, they are often recovering on their own.

Outside of friends or family that are part of a player’s everyday life, they no longer have the same interactions with teammates and coaches. It breaks the routine of practice, match preparation and competitive play. When players recovering from ACL tears do return to the team, it’s not in the way it was before. Returning brings another ripple in the mental struggle.

“It’s so long that there are times in your rehab that you look like you’re injured. People are asking, ‘Are you ok? How’re you doing? How’s it going?’” said Angeli. “Then there’s times where you look totally normal but maybe you’re going through a really tough mental hurdle and since you look normal, people don’t ask.”

Angeli’s third ACL tear happened on April 9, 2011. It wasn’t until the 2014 season that she returned to the field. She felt the emotions of being alongside a team and also making the difficult decision to take time away. Making tough decisions is key in recovery too.

“There were times when I was at every training session and then there was a year where I said ‘I have to leave. I can’t be around it. I’m just so hurt,’” said Angeli. “The mental side of just knowing and trusting what your body and your mind is telling you and to take that seriously, because healing is not just a physical healing. It’s mental, it’s emotional healing, it’s all those things.”

Improving on the emotional and mental health of an athlete is just as important as the physical. Athletes that go through ACL-induced trials form a bond with each other. Angeli learned this lesson early, soon after her first tear. One comment by a teammate changed the trajectory of Angeli’s life.

Welcome to the club

“I remember the day I tore my ACL, I was lying on my couch afterward and just real distraught and knowing in my gut that I think I tore my ACL because you just have never felt anything like that in your body before,” said Angeli. “My teammate came over who had torn both of her ACLs and she said, ‘Well kid, welcome to the club.’ I was so mad at that moment and I realized after going through my injuries that that is so true.”

In 2015, then a member of the Western New York Flash of the NWSL, Angeli knew that playing professional soccer was not in her long-term prospects. She began planning for life after competition, and part of that plan came in what she felt was a calling to help others that have felt this pain. It came in the form of the ACL CLUB.

ACL CLUB’s mission is to “support, empower and inspire” athletes through the “trials and triumphs of the ACL journey.” The ACL CLUB provides a positive community for people to connect in their recovery. They have resources available for people like Morris and the individuals that support the injured. Angeli’s group provides lists of surgeons, therapists and sports psychologists, helpful podcasts and social media stories about recovery.

Her organization is growing, with over 21,000 Instagram followers. Every day ACL CLUB is tagged in stories and posts from both amateur and professional athletes that share a view into their recovery roads.

One partnership is through a storytelling campaign called Scarred Together. NWSL players like Alyssa Mautz from the Chicago Red Stars and Ally Watt of OL Reign post videos from home, physical therapy and as they return to their clubs after ACL tears. All of it strives to build mental and emotional strength.

“I know what you’ve got ahead of you and you can do this, there’s going to be times where you feel just down and out and that’s ok,” Angeli gave an example of the conversations she’s had with affected athletes. “It’s ok to feel that, but it’s not ok to stay there.”

It’s conversations like these, from people like Angeli who have lived through the difficulties of ACL recovery, that create grateful athletes, and families of athletes. But it’s not about the recognition for the former pro. It’s about the countless positive connections that are created.

Returning to the field

Through all the setbacks and scars, there’s a culminating moment of recovery for any athlete with an ACL tear: the return. It comes after all of the nervousness of the first run, the anguish of the return of swelling and after watching a team compete without you. Angeli has experienced it and also has seen it in her time with the Crew.

“I remember when I saw Milton (Valenzuela) play his first game back from his ACL, he just was smiling the whole time. I talked to him about it at training afterward and he was like, ‘Yeah, it was just the greatest thing,’” said Angeli. “Because you know everything that you’ve put in and you don’t think about it. You just are thinking of how happy you are to be back on the field. Once you get out there, it really is this true joy of ‘I’ve just overcome something and here I am getting to do what I love to do again,’ and you’re just smiling from ear to ear.”

New York City FC v Columbus Crew SC
Milton Valenzuela started 90 minutes in the first match of 2020, against NYCFC. It was his first since returning from his 2019 preseason ACL tear.
Photo by Emilee Chinn/Getty Images

Before that moment of joy happens, Morris has a long journey in recovery. A journey made easier through the support of teammates, those around the team like Angeli and the Crew supporters. The outpouring of Columbus support is something he’s already acknowledged.

Through this support, team doctors and a community of people that have felt the same pain he’s feeling, the Black & Gold will help him to return to the field in 2022. At that point, even if the team isn’t celebrating another addition to Columbus’ trophy case, Morris’ name available for selection will be a cause for celebration.