On Monday, we received word about reports stemming from Saturday night.
Chiefs wide receiver Marcus Kemp suffered an ACL (anterior cruciate ligament) injury, which will require surgery to fix, and he will therefore be done for the 2019 season. We also learned that he suffered a torn MCL (medial collateral ligament) at the same time. We have not yet been told whether or not there was any meniscal damage.
In a way, this is easier to quantify and explain, as there was trauma. The player suffered what appeared to be a blow above his knee. At the same time, albeit very briefly, he appeared to have his foot still in contact with the playing surface. This caused a hyperextension and also likely a rotational force, which the ligaments couldn’t withstand.
Surgery is most likely already scheduled and a plan of care has been made—not only for the short term, but also the long term.
What we don’t know is what level of damage to the MCL occurred. This will tell us whether or not the MCL will need to be repaired. I have seen many variations of this same injury, where the ACL is always repaired and the MCL may or may not be left to heal or scar on its own. The devil is in the details here, and location of damage and severity dictate this.
The only main difference is time. If the MCL needs to be fixed, some surgeons will stage the procedures and repair the MCL first, allowing it to heal and go back and do the ACL a bit later—maybe six weeks.
At any rate, this is an approximately nine-month process. Obviously, results in athletes vary, but that is a good place to discuss a return-to-play plan for athlete.
What lies ahead
Since ACL injuries have become very common and well-publicized, everyone has their own method and program to getting athletes back on the field.
I am a fan of early motion (if MCL protocol allows), even walking people in underwater treadmills as soon as the scar is healed. I have even been part of a rehab plan where we did Alter-G walking just one day out of surgery. Getting motion back is key, as that opens up doors for the rest of the recovery to progress.
Heavy quad strengthening occurs as well. I will admit that early on in my career, I thought I knew what enough quad work was. I didn’t and had to incorporate more into my programs. The science is currently telling us that when we think we have done enough quad work, we should probably do some more.
More and more people, including myself, are utilizing advances in rehab such as Blood Flow Restriction (BFR) for these cases—fresh techniques that allow for earlier gains in strength than what we had previously gotten.
As the athlete goes through this process, the normal progression continues, per the athlete’s tolerance. Running, jumping, cutting all fall in line progressively. The topics of how to rehab an ACL “properly” have been, continue to be and will be discussed forever. This piece is way too brief for that.
Possible return date
Given the timeline before us, barring any setbacks in rehab, I would expect this athlete to participate on some level in next years’ offseason program, hopefully with the goal of full participation by OTAs and minicamp. In the end, I expect this athlete to participate fully in training camp next year.
Aaron Borgmann is the founder of Borgmann Rehab Solutions. He spent 12 years in the NFL as an assistant athletic trainer and physical therapist before joining Arrowhead Pride.