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Optimum Performance: LSU quarterback Zach Mettenberger should be cautious with ACL rehabilitation as NFL looms |

With LSU quarterback Zach Mettenberger’s college career over as a result of a torn anterior cruciate ligament (ACL) in his left knee suffered Nov. 29 against Arkansas, it’s time to revisit this potentially devastating injury. The ACL prevents the lower leg from rotating inward or moving forward with respect to the thigh. | The Times-Picayune’s LSU beat writer Jim Kleinpeter said Mettenberger has not yet had ACL surgery, opting to temporarily rehabilitate his injured knee until the surgery is performed. With the Tigers preparing for the Outback Bowl on Jan. 1 against Iowa, Mettenberger is mentoring his backup, Anthony Jennings, who will be making his first start in college. “One of my biggest roles in this game is to help Anthony transition to a starting role,” Mettenberger said.

Mettenberger’s post-surgical rehab path to an improved draft status (he is damaged goods right now) will include a stop at the annual NFL Scouting Combine in February, where he will participate in non-physical activities and interview with teams, as he probably will in early March at LSU’s Pro Day.

According to Dr. Alfred Atanda, a pediatric orthopedic surgeon who did his sports medicine fellowship with the Philadelphia Eagles, Phillies and Flyers, “the three main things that dictate when an athlete is ready to return to sports after ACL surgery are: ACL healing, strength and flexibility, and confidence.”

Atanda told, “the biology of ACL healing is pretty complex, but basically the tissue and cells of the new ACL graft need to ‘heal into’ and become part of the knee. This healing process may be affected by things such as patient age, graft choice (patellar tendon, hamstring tendon or donor allograft) and overall health of the patient.”

Minnesota Vikings running back Adrian Peterson, who sustained his ACL tear Dec. 24, 2011, made what many said was an incredible comeback from multiple knee ligament tears in nine months with a great work ethic and guidance from physical therapist Russ Paine. Peterson went on to the win NFL MVP in 2012, but the 2013 season hasn’t been as rewarding as he’s battled through foot and groin injuries.

Washington Redskins quarterback Robert Griffin III sustained his ACL tear Jan. 6 in a wild-card playoff game and had surgery three days later performed by Dr. James Andrews, the noted orthopedic surgeon who also repaired Peterson’s knee. Griffin, however, has yet to return to his dynamic ability and was shelved for the rest of the season.

Most orthopedic surgeons say complete healing of the repaired ACL may take 12 to 18 months. After about six months, there is a school of thought that the ACL is healed enough to allow resumption of athletic activity. However, there isn’t anything short of prayer one can do to speed up the process.

Coming back too soon from any knee injury, especially a repaired ACL, can be risky. The Los Angeles Times recently reported, “the 2010 Olympic downhill champion (Lindsey Vonn), who tore two ligaments in the knee earlier this year, said she doesn’t think she sustained any more damage during the World Cup event at Val d’Isere, France, but said she will have to be careful as she continues to prepare for the 2014 Sochi Games in February.”

A supervised physical therapy program, said Atanda, “is vital to regaining quadriceps function, strength and control. Therapy is also critical to strengthening other muscles such as the core, calf and hip rotators.”

As to the confidence factor, Dr. Derek Steveson, who directs the Functional Training Center in Scottsdale, Ariz., said, “each athlete has an unmeasurable component of will/desire/financial or contract status/pressures from family, team management, agents that can all be variables that can affect how hard they are willing to press the issue of returning to play.”

How will Mettenberger know when he’s ready to return to action?

Steveson’s athletes tell him, “I won’t know if I’m ready to compete again until I actually return to my sport for a while in a cautious and sub-threshold way (controlled practice situations) and slowly build into the full-blown activity.”

Smart advice for an injured Tiger to follow.

Mackie Shilstone, a regular contributor to | The Times-Picayune, has been involved in the wellness sports performance industry for nearly 40 years. He is currently the fitness coach for Serena Williams and has trained numerous other professional athletes and consulted a litany of professional sports franchises. Contact him at

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