Thoughts on Rose's Recovery

[SlimJim]

Hey fellow Bulls fans,

Not sure how many of you remember me, but last Spring I posted an analysis of Derrick's ACL injury. I don't post here often, but as a die hard Bulls fan myself, I'd like to drop by every now and again to give you guys a medical perspective of what is going on with our beloved players.

If you haven't read it, here is my last thread from pre-surgery: viewtopic.php?f=10&t=1178858&start=30

Disclaimer: I am an athletic training student, NOT a medical doctor. I also have no affiliation with the Bulls or any of the doctors associated with Derrick or the Bulls, so what I am telling you is not insider information, simply the typical expectations of an injury like this.

Ok, I'm gong to start with the surgery itself. It was performed back in May, and the details were kept VERY close to the chest, however, I can speculate for the purposes of this post.

There are 3 types of ACL reconstruction: Patellar Tendon Graft, Hamstring graft, and Donor Tissue Graft. PT graft is the most common type in athletes, as it allows for a quicker recovery and better overall performance. Surgeons love this type, because the Patellar Tendon is roughly the same length and consistency of the Anterior Cruciate Ligament. Quick Anatomy Lesson: The Patellar Tendon extends from the quadriceps (anterior thigh muscle) to the top of the Tibia (lower leg bone). It holds the Patella (kneecap) in place, and when force is applied by the quadriceps, moves the lower leg. In this type of surgery, the surgeon removes the middle 1/3rd of the tendon as well as small chunks of bone from the patella and the Tibia. The ACL is completely removed, and the two pieces of bone are attached to the attachment sites where the ACL was originally located. This allows for more complete healing, since bones are vascular tissue (they receive blood flow) and will attach & heal on their own. The main drawback of this surgery is anterior (front) knee pain.

I won't get into the other two surgeries, as they are meant for the more sedentary population, whose end goal is reduction of pain. Derrick's end goal is return to activity, so he needs the most effective method, regardless of minor pain. (the pain is minor and not permanent anyway, so don't worry about that.)

Now onto the rehab. From various reports (and again I'm speculating) Derrick appears to be well ahead of schedule. HOWEVER, that does not mean we will see him on the basketball court anytime soon. These reports are useless without some sort of context. For example, when we hear that he is jumping again, that doesn't mean he is grabbing the rim or elevating for jump shots or anything like that. He has most likely graduated from standing on his tiptoes and down again to some light two-footed hopping. I haven't heard anything about running, so I could be wrong, but I imagine he is mainly doing elipticals and such at this point.

Rehab is an incredibly grueling and disheartening process, however, meaning that any progress is good progress. What may seem like very little to us is often a monumental step towards him returning to activity. For a good look at the mental aspects of rehab and injury recovery, I really recommend Drew Brees's autobiography, Coming Back Stronger. Different injuries, obviously, but it gives a great perspective on how an elite athlete recovers from a horrific injury.

In the next couple months, we will start hearing reports about Derrick running (again, will be something closer to a light jog) and participating in timed shooting drills and such. Remember, this is a very long process, he still has several months to go. At this point, he is really not anywhere close to being ready to play in a basketball game. The big step will be jumping and landing on one leg. When he can do that comfortably, it will only be a matter of time before he is at full contact again.

At this point, we can most likely expect him to be cleared for full contact around mid to late January, possibly streching into February. However, the team makes the ultimate decisions, so it is not clear whether he will actually start playing at that time.

Unfortunately, his timetable puts him right in the middle of an awkward NBA season schedule. He doesn't have an entire week to determine whether he's game-ready like Adrian Peterson. When he does play, the games will be treated like practice time for him, allowing him to be comfortable with his body and his teammates. He will start off playing less than 10 minutes per game, slowly working his way up from there. If this timetable is accurate, he will likely be prepared to handle 30 or more minutes of gametime by the playoffs. It is really all up to the organization how his minutes are handled, as we all know Derrick will be trying to go all out from day 1.

With the progress Rose has made in his rehab and recovery, I honestly see no reason he will not return to his old form. Barring some unforseen complications, he looks like he should make a full recovery. So yes, get excited Bulls fans, our hero is coming back. His biggest hurdle at this point will be mental, and we all know how mentally tough this kid is. (Again, we can never know 100%, but if reports are true, he has given us plenty to be confident about.)

Hopefully this helps, I tried to be as thorough and clear as I could. If you have questions, leave them here as I would love to answer them! Thanks for listening!

[BahamaBull]

Great read. Thank you very much!

I still believe he will be ready by late December though...That doesnt mean he will play an official game but I believe he will be participating in full practices by Xmas...

[Michael Jackson]

Wow an informative positive thread!

[JDRochholz]

Great thread man, thanks. Can I ask, what do u do for a living?

[SlimJim]

^ College student. Studying Athletic Training.

[Dieselbound&Down]

Good post OP. I've only been through this as a patient but "ahead of schedule" is so subjective and something like jumping, while nice, doesn't mean much in terms of him being ready to hit the floor. Of course I want him back but I have a hard to getting too excited about a report about Rose doing much right now.

Anyway, below is some talk about ACLs from an article on Univ or Iowa football that I thought was relevant.

That brings us to Jordan Canzeri.

Canzeri suffered a torn ACL at the beginning of spring practice in March. Ferentz has maintained all along that his surgery and rehab have gone exceedingly well. Canzeri, a 5-9, 188-pound sophomore, returned to practice prior to Iowa State. He was in uniform and on the sidelines last week.

“He was cleared to play last week,” Ferentz said. “He looked OK [in practice]. To the casual observer, you wouldn’t know he was injured, but he hasn’t done a great volume of work, either.”

For the ACL math you have in your head, yes, roughly six months for Canzeri does sound extremely fast. Minnesota Vikings running back Adrian Peterson suffered a torn ACL and MCL last December and played on opening day this year for the Vikings. That’s a nine-month span, which is considered industry standard.
.....
Ferentz emphasized Tuesday that this decision doesn’t lie with the coaches. He added that there’s “medical clearance” and actually being able to play the game.

“The medical people tell us when it’s safe for a player to return. They’re the experts, not us,” Ferentz said. “Then, our job is to look at the player practice and perform. It’s conceivable that a guy could be cleared medically and then not by us. It depends on the position, the injury, that type of thing. It’s just a day at a time. . . . Part of it is player’s level of confidence, too.”

[heir_jordan22]

Thanks for all the info! I;m fairly sure I remember seeing some reports or rumors that he started running about a month ago (light running/jogging). I remember Rubio started running just shortly after Rose did.

[Gregnice33]

Explain this to me: how did this guy recover so quickly with a severe knee injury?

http://www.youtube.com/watch?v=8Rpf29AjbyM

American Parkour sponsored athlete Drew Drechsel starting to do Parkour again, 7 weeks after surgury on both meniscus and ACL which he injured during Sasuke 27 on the Half Pipe attack. This video is to show some basic parkour movements that can be carried out using mainly only one leg. It was shot with a Go Pro HD on the University of Florida Campus, in Gainesville, Florida.

[McBulls]

With the progress Rose has made in his rehab and recovery, I honestly see no reason he will not return to his old form. Barring some unforseen complications, he looks like he should make a full recovery. So yes, get excited Bulls fans, our hero is coming back. His biggest hurdle at this point will be mental, and we all know how mentally tough this kid is. (Again, we can never know 100%, but if reports are true, he has given us plenty to be confident about.)

That's quite an optimistic statement, and I hope you are right.

On thing that bothers me is that Rose's game seemed to depend a lot on rather dramatic changes in direction on high speed dribble drives to the basket. More than most other players. This has to put a lot of stress on the knee in general, and the cruciate ligament in particular.

So one question is, in your opinion is the transplant going to be as strong as his original ligaments? If it is not, it seems to me that re-injury is not a small possibility if he plays the same way in the future as he did in the past.

A second question arises in regard to the damage done to the patellar tendon by the surgery. It seems to me that this tendon should be weakened as well, or perhaps scarred. What effect would this have on his speed and elusiveness?

[Air Poohdini]

Good read, we shouldn't be in any real rush to throw Derrick back out there.