Sports Rehab Write-Up: CB Trevon Diggs
Urgh! It was looking like this could be their year!
Dallas Cowboys star corner Trevon Diggs is out for the rest of the 2023 season, after suffering a left ACL tear during the team’s Thursday practice.
That Dallas defense was looking extremely dominant so far this season; this is a huge blow for them! In his three years in the league, Trevon has had an All-Pro season, led the league in interceptions, & been selected to two Pro Bowls!
Apparently, Diggs went down during a fairly innocuous 1-on-1 drill! That’s generally the nature of ACL injuries, they often come out of nowhere – most involve little to no contact! In fact, 70% of ACL injuries are non-contact injuries (Boden & Sheehan, 2022)!
We hear a ton about ACL injuries in sports, but how much do we know about the ACL as an anatomical structure?
The Anterior Cruciate Ligament, or ACL, is a small, sturdy ligament that connects the front of the tibia to the back of the femur. When we look at its structure & its attachment sites, the ligament’s function is pretty intuitive!
To keep things short & simple, the ACL keeps an athlete’s shin bone from travelling too far out in front of the thigh bone. Interestingly enough, other structures play a big role in that process as well -- specifically the hamstrings! So as important as the ACL is, we sometimes see guys continue to play with torn or even completely missing ACLs. See Odell Beckham Jr.!
So what does this all mean for Diggs long-term?
An ACL tear is the most common knee injury we see in athletes! An ACL reconstruction & good rehab are the major keys to success for making a comeback!
Luckily for Cowboys fans, we’ve got a huge record of pro-athletes coming back from ACL injuries looking as strong & explosive as ever! Just look at how 2nd year New York Jets running back Breece Hall performed in his first game back from his ACL tear this season:
It’s not uncommon that we see an athlete make a return to sport after only 6 months, though it is pretty impressive! On the flip side, we also see that returning to sport anywhere before 9 months comes with an extremely high risk of reinjury (Brinlee et. al, 2022)! This is likely because the tendon graft used in ACL reconstructions won’t typically reach full integration before 3 months and won’t reach full maturity until 1 to 2 years have passed (Gupta et. al, 2021)! Graft integration & maturity are extremely closely linked to return to play & functional outcomes!
Research also shows us that quad strength is extremely important both before an ACL surgery & during recovery! According to the findings of The Delaware-Oslo ACL Cohort Study, 33% of athletes that returned to sport from an ACL injury, and didn’t have at least 90% quad strength when compared to the unaffected leg, suffered a reinjury! So, the recommendation for ACL recoveries is that players shouldn’t return to action before 9 months have passed & they have a symmetrical level of quad strength between legs!
Luckily, Diggs has well over 9 months to focus on his rehab, and strengthening shouldn’t be an issue at all! With how prevalent ACL injuries are, rehab specialists have an overwhelming amount of well-researched & evidence-based clinical guidelines & recommendations to pull from! For athletes, clinicians, and even fans interested in looking further into the latest evidence-based ACL rehab protocols, check out this review by Filbay & Grindem, where they’ve put together a really solid, extensive set of rehab recommendations by stage!
Trevon Diggs flying high after catching a key interception against the New York Jets!
Wishing Trevon a safe, healthy rehab! Hoping to see him back out there with the Cowboys next year, in the Super Bowl conversation, yet again!
Works Cited & Further Reading
Boden, B. P., & Sheehan, F. T. (2022). Mechanism of non-contact ACL injury: OREF Clinical Research Award 2021. Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 40(3), 531–540. https://doi.org/10.1002/jor.25257
Brinlee, A. W., Dickenson, S. B., Hunter-Giordano, A., & Snyder-Mackler, L. (2022). ACL Reconstruction Rehabilitation: Clinical Data, Biologic Healing, and Criterion-Based Milestones to Inform a Return-to-Sport Guideline. Sports health, 14(5), 770–779. https://doi.org/10.1177/19417381211056873
Gupta, R., Singh, S., Kapoor, A., Soni, A., Kaur, R., & Kaur, N. (2021). Graft tunnel integration occurs early in the tibial tunnel compared with the femoral tunnel after anterior cruciate ligament reconstruction with preserved insertion hamstring tendon graft. Knee surgery & related research, 33(1), 37. https://doi.org/10.1186/s43019-021-00119-x
Grindem, H., Snyder-Mackler, L., Moksnes, H., Engebretsen, L., & Risberg, M. A. (2016). Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study. British journal of sports medicine, 50(13), 804–808. https://doi.org/10.1136/bjsports-2016-096031
Filbay, S. R., & Grindem, H. (2019). Evidence-based recommendations for the management of anterior cruciate ligament (ACL) rupture. Best practice & research. Clinical rheumatology, 33(1), 33–47. https://doi.org/10.1016/j.berh.2019.01.018
