ACL Injury and Recovery: Michael's Story
For 17-year-old Michael Shultz, football isn’t just a game—it’s an experience—an experience that’s about suiting up with his teammates, jogging out to the field, warming up, then playing his heart out for the Sumner Academy Sabres. It’s an experience that puts a smile on his face. Every time. Guaranteed.
For a competitive high school athlete like Michael, nothing can compare. Game night is the ultimate reward for all the off-season workouts, hours and hours of practice, and enduring every bump and bruise along the way, from pee wee to varsity ball.
But when Michael injured his left knee playing defensive end for the Sabres last fall, then reinjured it during a wrestling match, it was more than a bump or bruise.
That injury was the biggest challenge Michael has ever faced in his athletic career. It’s a challenge that has made him work harder than ever to recover in time for the start of the 2019 football season—a challenge that has kept him from the very game he loves, and made him long to get back to the action.
Meeting that challenge makes Michael’s return to the field as No. 30 this fall all the sweeter for the senior who is now playing middle linebacker and tight end.
“I am really looking forward to playing again with my teammates. We’re like brothers, a tight-knit family, and we’re ready to go,” he said, smiling from ear to ear. And after all he’s been through this past year, Michael’s not taking one second of this experience for granted. Not one.
Three-sport athlete, two-sport injury
A stand-out, three-sport athlete at Sumner Academy, Michael not only plays football, he wrestles and throws the javelin on the track and field team. He injured his left knee last fall during the Sabres’ third football game.
“I was playing defensive end, and as I was making a tackle on the running back, my left knee got caught under both of us, then I heard a loud 'pop’ out of nowhere.”
In pain and unable to move, Michael was helped off the field and to the bench by the team’s coach and trainer.
“Our trainer said I couldn’t go back in the game,” Michael said. “I was bummed out because I love playing football.”
Later that night, Michael went to a local emergency room where the doctor said his knee was fine structurally, but advised him not to return to play until the swelling went down.
Two weeks later, Michael was back on the field, finishing the season, and hoping that was the last time he’d hear that loud “pop.” But during the first wrestling tournament of the season, Michael reinjured his knee.
“I won my first three matches, and in the championship match, as I was performing a wrestling move on my opponent, I heard another loud ‘pop,’” Michael said. After taking his allotted injury time, Michael limped back to the mat, determined to finish the match.
“My opponent went right for my knee,” he said. Sumner’s coach stopped the match, and Michael ended up in second place.
The athletic trainer at the tournament gave Michael an ice pack and advised him to stay off the knee and see a doctor. The physician he visited prescribed six weeks of physical therapy at a local facility, but it didn’t seem to help.
That’s when Michael and his family decided to up his game, scheduling an appointment with Kevin Latz, MD, a pediatric orthopedic surgeon with Children’s Mercy Kansas City, and Chief, Section of Sports Medicine.
Rebuilding Michael’s knee
Dr. Latz quickly determined that Michael had torn his anterior cruciate ligament, or ACL. The cruciate ligaments control the back and forth motion of the knee. The ACL also provides rotational stability for the other structures in the joint.
He also had a torn meniscus, one of two wedge-shaped pieces of cartilage that act as "shock absorbers" between the thighbone and shinbone. The menisci are tough and rubbery to help cushion the joint and keep it stable.
“Unfortunately, it’s not usual for high school athletes to injure their knee, continue to play on it, then injure it again,” Dr. Latz said. Michael’s injury was obvious from his history and symptoms, but imaging confirmed the diagnosis.
“This was a career-changing injury for Michael,” Dr. Latz said. “We could repair it, but I told him we wouldn’t be making his knee normal. We would be making it normal enough that he could go back to his sports, if he properly rehabilitated it.”
With the clock ticking toward the football season and at least six months of rehabilitation ahead, Michael was in.
To surgically rebuild Michael’s knee, Dr. Latz performed outpatient surgery at Children’s Mercy on Feb. 13, 2019. He replaced the torn ACL with donor tissue from Michael’s hamstring, and repaired the meniscus.
“From a surgical standpoint, everything went well,” Dr. Latz said. “I tell patients all the time that it’s the rehabilitation process that makes the difference though. That’s where Children’s Mercy shines.
“We have a very adolescent-centric program in physical spaces that allow us to mimic the sports these athletes are returning to. That’s absolutely key to recovery.”
A physical therapist who “gets it”
One week following surgery, Michael started physical therapy with Nick Wedel, DPT, at Children’s Mercy Sports Medicine Center at Village West.
“We are very thoughtful about pairing our patients with the same therapist throughout rehabilitation,” Dr. Latz explained. “This relationship is critical to recovery. Our therapy process is very goal oriented.”
For Michael, the connection with Nick was immediate, and an experience he’ll always remember.
“Nick and I can talk about anything and everything,” Michael said. “That personal connection has really helped me get through the tough times.”
Nick earned his doctorate in physical therapy from the University of Kansas Medical Center, and studied athletic training at Kansas State before becoming a certified athletic trainer.
But it’s Nick’s personal experience with sports that helped him empathize with Michael’s circumstances.
“I am from a small town in the middle of Kansas. I played the same positions in football as Michael, plus played basketball and ran track,” Nick said. “My high school athletic career ended when I dislocated my ankle in the second football game of the season. I missed playing sports the rest of my senior year, but the rehabilitation I went through led me to a career in physical therapy.”
Rehabbing like the pros
Michael’s rehabilitation took place at Children’s Mercy’s newest sports physical therapy gym, Village West. The facility is designed to meet the needs of all athletes who want to rehab in an environment specific to their sport.
Village West offers a 13,000-square-foot gymnasium and state-of-the-art equipment, including an anti-gravity treadmill, the first of its kind in the area. And because the gym is also used by Sporting Kansas City and U.S. Soccer, it’s not uncommon for student-athletes to work out alongside the pros.
Though Michael had done physical therapy at another facility, he was “blown away” by Village West.
“I thought rehab would be in a small room where I might do a few exercises and some stretching. I had never seen anything like this in my life!” he said.
“Here, we do sports-specific rehab, and that’s really cool,” Michael said. “It’s great to be able to play the sport you want to return to while getting better.”
Slow and easy
Like many highly competitive athletes, Michael was anxious to get back in action, but Nick and Dr. Latz were careful not to allow him to do too much, too soon.
“I was on crutches for the first six weeks after surgery,” Michael said. “Nick explained why it was so important for me to stay off my leg initially.”
Instead, Nick worked with Michael to improve his leg and hip strength, gradually increasing how much he could bend his knee.
“After six weeks, I stood up on my own in this gym for the very first time. That felt amazing!” he said, smiling.
Gradually, Nick gave Michael more and more work to do, adding stretches, leg presses, squats and lunges to his routine.
At 12 weeks, BioDex testing revealed Michael’s left quad strength measured 80% compared to his right, but his hamstring was only at 60%. “That hamstring definitely wasn’t where we wanted it to be,” Michael admitted.
Thirteen weeks after surgery he started jumping and added stairs on the VersaClimber, a vertical climbing exercise machine. Then three weeks later, Nick began asking Michael to do some running and cutting drills.
“I would quickly bounce reaction balls at Michael and he would toss them back to me. Whichever one of us dropped a ball would have to climb 25 feet on the VersaClimber,” Nick said.
As Michael continued to progress, Nick gave him real-life defensive drills to perform. He dove for the ball 23 weeks after surgery, something he wasn’t sure he’d ever do again.
“That felt awesome!” Michael said, grinning.
Twenty-four weeks post-surgery, Michael’s left quad measured 97-100% compared to his right, and his hamstring measured 60-70%.
“My hamstring still wasn’t where I wanted it to be, but on functionality testing, I ranged from 91-98%,” Michael said.
The goal was to measure over 90% when performing several different types of single leg jump tests, as well as running and cutting tests. With those results in hand, Michael scheduled a follow-up appointment with Dr. Latz.
“Michael has worked his tail off, and his athletic mindset has really helped his rehab go well,” Dr. Latz said. “But the data is pretty clear that those first six to 12 months after surgery are when the athlete is most vulnerable to injury.
“For now, we have released Michael to practice, and will probably release him to play at eight or nine months, if all continues to go well. Even though he feels awesome, we still need to be cautious,” Dr. Latz added.
Nick agreed and said, “I’m confident that Michael is ready to transition back to practice. Right now, he can go through the non-contact drills, but we want to see how he is doing with those before we release him to play. We’ll continue to work on hamstring strength, as well as overall conditioning and agility.”
Nick believes that Michael’s rehabilitation has been successful because the senior has remained focused on his goals, has had a good attitude and has done everything that was asked of him.
Michael understands his limitations, but is excited to be back at practice, gearing up for his senior year.
“I can go back to practice if I wear my brace,” he said. “When this happened, in my mind, I was worried that I wouldn’t be able to play football or wrestle this year, but Nick has really helped me get over my injury physically and mentally. With all the great therapists and equipment at Children’s Mercy, it really is amazing how well I have recovered,” he added.
“After this injury and rehabilitation, I actually feel like I have gotten stronger both physically and mentally, and I am ready for the season to start. Nick, has pushed me and driven me super hard in ways I never expected. He says my recovery has been fast, but he has had to be cautious and rein me in a little to help me develop more control in my knee.
“The Children’s Mercy Sports Medicine experience has blown me away,” Michael said. “They’re caring, reliable and they really know their stuff. I’ve never been in such good hands as I have been here.
“With their help, I’m ready to get back to football, and chase this championship.”
And Michael is going to do just that with a big smile on his face, because it’s almost game time!
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Chief, Section of Sports Medicine; Pediatric & Adolescent Orthopaedic Surgery; Associate Professor of Orthopaedic Surgery, University of Missouri-Kansas City School of Medicine; Clinical Assistant Professor of Orthopaedic Surgery, University of Kansas School of Medicine