ROAD TO RECOVERY – CECILIA McINTOSH
Sadly ACL ruptures in the knee are quite common in many sports especially in football, netball and soccer and are extremely prevalent in females. For the active population and especially sportspeople the best option is to have a knee re-construction which usually involves taking some of your hamstring or quadriceps tendon and putting it in your knee to become the new ACL ligament.
It is usually a 9-12 month recovery and the rehabilitation period back to sport can take a big toll on athletes physically and mentally especially from being sidelined from their favourite sport. For more of an insight into this I have interviewed one of my patients who is an ex Olympian – Cecilia McIntosh.
Cecilia is an all round athlete and has an impressive sports history with a silver medal in javelin from the 2002 Commonwealth Games and later was recruited for a Bobsled team where she competed at the Vancouver Olympics.
She has since been a leader in Women’s AFL football and last year was recruited as a player for the Melbourne Football Club’s Women’s team. However, at the 14 minute mark of an Exhibition match on the MCG between Melbourne FC and the Bulldogs last May Cecilia ruptured her ACL. She has since had a knee reconstruction with a hamstring graft with well-known surgeon Julian Feller.
Unfortunately, Cecilia has already been through many awful sporting injuries throughout her career and is a 36 year old who has still been able to stay focused in the rehab of this knee injury considering she could have retired. She is now 6 months post this horrific injury and is as motivated as ever.
I sat down to chat with Cecilia recently about her rehabilitation so far and here is the insight into her sporting career and rehab process up to this 6 month mark. Enjoy the read.
Cecilia you have quite a long history in playing sport at an elite level, can you give us a summary of your best sporting achievements and sporting history?
Track & Field: (Javelin)
3 x State Junior Champion 96,97,98,
6 x State Open Champion 96,97,98,00,01,02,
3 x National Junior Champion 96,97,98,
Ranked 4th in the world as a Junior in 1998,
1 x National Open Champion 02
4 x 2nd and 1x 3rd at National Champs 98,00,01,04 , 97
Commonwealth Games Silver Medallist 2002
Qualified for the 2004 Athens Olympic Games but could not compete due to forced shoulder surgery 3 months prior to games.
Weightlifting (64kg Class):
1 x State Junior Champion 97, 1 x National Junior Champion, 1 x National Open 2nd, Oceania Record holder 97, Qualified for World Juniors in 1998 but it clashed with Track & Field World Junior so I didn’t compete.
5 x 2nd Americas Cup 2009 (Park City Utah x 2, Lake Placid New York x 2, Calgary Alberta x 1 )
2 x 3rd Americas Cup 2009 (Park City Utah x 1, Calgary Alberta x 1 )
Olympic Games Vancouver (Whistler) Canada 2010.
Baseball – State Runners up 2013 – State Rep & National Champion 2013
2007 – Best First year player (League), Club Leading Goal Kicker.
2008 – Winner of the Helen Lambert Medal (Equivalent to the Brownlow), League BNF- Metro Rep (Winners) – VWFL Runners up GF
2009 – Runner up Club BNF, Top 5 League BNF, State Team Rep & Premiers – All Australian. Club Leading Goal Kicker
2010 – Club BNF Winner,
2011 – All Australian Rep (All Stars Game MCG)
2012 – Runner up Club BNF, 3rd League BNF – Metro Rep (Winners)
2013 – Rd 2 tore hamstring off the bone – season ending. Surgery in October.
2014 – Injured L hamstring and then calf on return.
2015 – Melbourne FC selection – 1st match versus Bulldogs – ACL rupture.
I also remember when asking you for the first time in a physio consult about your past injury history and it was quite the list! Can you give everyone an insight into your injury background?
1996-2006 – Compartment Syndrome (Track & Field)
1998 – Right Elbow Reconstruction (Javelin)
2003 – Right Shoulder Scope (Javelin)
2004 – Right Shoulder Reconstruction (Javelin)
2005 – Right Shoulder Scope (Javelin)
2007 – Left Osteitis Pubis (AFL)
2011 – Right Knee Patella Tendon Damage (No Surgery Required)
2013 – Hamstring tear off bone (AFL but began and initially caused through Baseball)
2014 – Left Hamstring tear (AFL)
2014 – Present – Bulged lumbar disc and stress fractures in back.
2015 – Present – Ruptured Right ACL (AFL)
– Plus a fractured wrist from weightlifting training and dislocated ribs and a broken nose from AFL.
What do you remember from the day of your ACL injury in terms of the mechanism and what happened afterwards?
What I can remember and very clearly is as soon as I went to change direction my knee just gave way with excruciating pain like I’d actually not only snapped the ACL (knew that straight away ) but also like it had dislocated it and when I hit the ground and was lying there it actually felt like it was still dislocated.
About 30-40 seconds later and by this stage the trainers and Dr had reached me, my pain was pretty much gone and I walked off the field with only a little assistance. I didn’t hear anything but the players on the field later told me they heard it snap. So I was walked from the field by the team medics down to the rooms where the Dr confirmed what I was already sure of – ACL Rupture.
The only thing we didn’t know was just how severe the damage was. I wasn’t to find this out until the next day when I had my MRI. To be honest I was actually quite calm about the whole thing and if you were to know me that’s very unusual as I had already been through 6 major surgeries in my career and was looking down the barrel of my 7th. I knew before I hit the ground what had happened and that I just had to switch straight into rehab mode which I did instantly.
I had to stay upbeat for the team and support them through the rest of the game as my injury occurred so early on. Silver lining was my team went on to win the game by 8 points.
In the first two weeks after your surgery what were the hardest things to deal with physically and mentally?
Not being allowed to do any kind of training was annoying and not to mention being stuck at home in my room alone. And I guess this was the hardest as I couldn’t drive to go anywhere and ended up feeling so isolated and alone like the world didn’t exist. This was made extremely hard as it was actually my birthday 3 days post op and I just felt so depressed. But not at any stage did I have a thought about giving in or giving up no matter how hard it’s been and I must say this next to my Shoulder Reconstruction has been the hardest challenge of my life.
No athlete wants to be sidelined from their sport but on top of this in your early rehabilitation phase you were very limited with the amount of exercise you could do such as no running Etc.
How did you get through this time?
Before I went into surgery I had an idea to document on film (Go Pro Cameras/ Photos) my whole recovery – the good the bad and the ugly and this has helped me through. I started doing it to help inspire others and I’ve ended up inspiring myself. There’s a quote that I heard once and have pretty much lived by and it goes like this “ It’s not about whether you’re the best athlete or if you’re the most talented athlete out there. A lot of people are talented, but how far are you willing to go?! What are you willing to give up? How much are you willing to sacrifice? “
For me competing and training is about testing the limits of the human will and how far I’m willing to go to achieve everything I’ve dreamed of! A lot of people think I’m crazy, I prefer to look at it as going beyond reason where many don’t like to go. Without Limits. Also helps that I’m a massive dreamer and have an urge to succeed and be the best I could ever imagine.
Have there been any positives that have come out of this injury/rehabilitation experience so far?
That there is always another way. I have trained so differently after this surgery and phase of my career and it’s given me an extra boost to just keep going and that I’m just not ready to retire and move on. As long as I still love what I do I’ll continue to compete. I’ve also become a calmer person whether it be because I’m older (haha) or that I’ve worked with a new Strength and Conditioning coach and staff who challenge me every day that I don’t have to always be a beast at training and sometimes less is more. It’s been enlightening.
Check out Cecilia working on her balance, core and proprioception with some amazing work on the Bozu ball at 5 months post ACL Reco with ESS Performance.
How have your teammates been during the long recovery?
To be honest I haven’t really heard that much from them. Everyone has their own issues in their lives and these days people are so busy I don’t hold it against them. I’m pretty damn self-motivated and that helps. There are the few special people who surprise you with kind words and support and that’s what I’ve appreciated during this time.
Any other hurdles to overcome along the way – mentally and physically?
This damn disc bulge in my lower back. I’ve been suffering with this back pain for the past 2 years which has caused me so much pain but I’ve refused to let it beat me. My crew just keep finding ways for me to train around it and to keep getting me back out on the playing field. Also the hamstring graft caused me a lot of problems for a while at the beginning with hamstring pain but I feel I’m just on the other side of that after 6 months.
Can you give us an insight into what your rehabilitation program looks like currently?
At the moment my program is a little altered to allow for my back pain:
Weights 2-3 times a week
Pilates 2 x times a week
Running/Football specific sessions (no contact) 1-2 times a week
Pool 3-4 times a week and recovery after every session – Ice and heat pools.
What is the next rehab goal that you’re excited to get to?
My next goal would be to train as pain free as possible as quickly as possible more so with my back than knee as the knee is in real good knick at the moment and I’m hanging to do more on feet conditioning.
After that it will be to start contact footy which I’m really looking forward to. That will give me more confidence before coming in to my first game hopefully in May if all goes well.
Is there someone or something that helped keep you on track?
Some special people I’d like to mention would be first and foremost my Surgeon Julian Feller, what a brilliant and kind man. Without his talented surgical skills and bedside manner I don’t know where I’d be. Slav Tortevski and Jenni Screen and the crew at ESS Performance for their tireless work at keeping me mentally upbeat and adapting to the challenges I give them with my old body. The entire Melbourne FC Family I’ve had so much social media support from the club and supporters it’s been fantastic. And of course yourself with all your physio and supporting texts getting me through.
Any advice for someone who has just injured their ACL and about to start the long rehabilitation journey?
I guess my best advice would be as follows:
- Try to switch into rehab and recovery mode as quickly as possible as dwelling on what has happened only prolongs what needs to be done to get back and the sooner you can move forward and just get stuck into the hard road ahead the better off you’ll be and the sooner you will be back out there playing.
- Also prepare yourself to feel down and depressed as it will get to you and you have to be tough mentally more than physically for the first 3-6 months.
- Just keep thinking of the bigger picture and what you want to achieve when you get back to full strength.
Road to Recovery Videos:
For further insight into Cecilia’s ACL Road to Recovery journey check out these amazing videos she has made along the way with her GO-PRO showing all her progressions. Inspiring stuff!! I have depicted each ACL rehab phase but it is always important to note that every athlete will go through these phases at slightly different timeframes.
Part 2 Video Rehab Goals:
- Post Op Phase
- Focusing on Regaining full knee extension and full knee bend with physio (Athlete Advantage)
- Focusing on returning the inner quad strength after this muscle often goes to sleep post surgery and reduces in bulk. Regaining this muscle strength is crucial for knee stability.
- Focusing on regaining strength in the hamstring as this is often used as the graft which is essentially like having a hamstring tear.
- Elite athletes such as Cecilia will work on maintaining the rest of their strength such as arms and abs as much as possible.
Part 3 Video Rehab Goals:
- Continuing to regain full knee Range of motion
- Start to strengthen the gluts, quads and hamstrings more in the gym
- Beginning pool running to maintain fitness and increase knee strength with a pool program
- Learn self recovery techniques to cope with the increase in strength work and tight muscles that follow.
Part 4 Rehab Goals:
- 4 Months post op
- More intense sessions in the gym to really build up quad, glute and hamstring strength and bulk.
- Pilates – to help with back injury as well as core and knee stability exercises.
- Keeping apart of the team and being apart of their success by working on the interchange bench.
Part 5 Video Rehab Goals: (4-6 Months)
- Return to running via the Alter G machine.
- Return to straight line running on land.
- Higher level balance and proprioception exercises.
- Returning to kicking and other football specific exercises.
- Returning to higher level agility exercises.
Cecilia’s Journey is still continuing and we will certainly be following her road to recovery all the way to her return to play! More of her journey videos will be posted as she continues to make them.