My name is Rachel Van Hollebeke (formally Rachel Buehler). I play soccer for the US Women’s National team and the Portland Thorns. I am two time Olympic Gold Medalist (2008 and 2012) and World Cup Finalist (2011). Although I have been playing soccer for most of my life, my journey has not been without set backs and difficulties of many kinds. Like you, and many other soccer players out there, I have torn my ACL… in fact I have torn both of mine. Although I was a healthy, strong player for most of my youth, my senior year of high school I tore my left and then my right ACL. At that point, I played club soccer for the San Diego Surf. I was also involved in Cal-South ODP and the youth national team programs. Here is my story. I hope that sharing can help you during your process of injury and recovery.
It was September 1, 2002 and I was playing for the USA in the championship game of the inaugural U-19 Women’s World Cup. We were playing Canada in Canada. With 42,000 fans cheering passionately against us, the atmosphere in the stadium was electric. We were about fifteen minutes into the game when my injury happened. I lunged for a ball going out of bounds, planted weird, and felt a big pop in my left knee. I knew I had injured my knee badly. After an exciting and hard fought game, my team ended up winning in overtime. Overwhelmed with joy for my team’s success and sadness about my injury, I just couldn’t stop crying after the game. I returned home to San Diego, and after my swelling subsided, I had surgery.
I tore my right ACL exactly six months to the day after my left ACL surgery. My doctor had just cleared me to start playing light contact soccer and it was my first real practice back with my club team. I was the neutral player and I was jogging after a ball that had been deflected my direction. My foot got caught in a divot in the grass, I felt something weird in my right knee, and I collapsed to the ground. This time the injury seemed benign and I wasn’t quite sure what had happened. After seeing my doctor it was confirmed I had torn my other ACL. I was shocked and devastated to be injured again, but there was nothing I could do about it. I quickly got surgery and began rehab.
Until tearing my ACLs I had been a healthy player and I was quite surprised when I got injured. But my story is not unique. Women, and especially adolescent girls, are significantly more susceptible to having non-contact ACL tears. Additionally, my dad has torn both his left and right ACLs and I think I was genetically predisposed to hurting my knees. While I am strong, I lack flexibility and mobility, especially in the joints surrounding my knees. I was also overly quad dominant which could have been a contributing factor to my injuries. Through my rehab I identified these issues and have worked diligently to improve over the years.
There are a lot of questions you face when you tear your ACL. Which doctor to see, what type of graft to use, where to get physical therapy, what is the right rehab timeline… the list goes on and on. What I learned from my experiences, and from the experiences of my teammates, is that every player and situation is different. With each of my knee injuries I was lucky to have clean ACL tears. I just needed one straightforward surgery on each knee. Often players tear other ligaments or damage their menisci or cartilage. That can lead to multiple more complicated surgeries and slow down the recovery time line. It is important to understand your injury and figure out what is best for you.
Finding a doctor who has a good track record and who you feel comfortable with is a very important first step. I was lucky that my dad is a physician and was personal friends with an excellent orthopedic surgeon. In terms of what type of graft to choose, I have seen patella, hamstring, and cadaver grafts all be successful. I chose to do patella grafts because I did not have any existing knee problems and that is what my doctor did most frequently. It is also critical to find a physical therapist who you trust and has a good relationship with your doctor. I think excellent physical therapy is the most important part of the recovery process. I started physical therapy within a few days after surgery and went several times a week for two to three hours each time. We started with basic exercises focusing on range of motion, proprioception, and muscle strength/activation. As I got more advanced in my recovery, my therapist encouraged me come to the clinic to work out and do extra exercises in addition to my regularly scheduled sessions. My physical therapist not only helped heal and retrain my body, but she was my psychologist and personal cheer leader. I would not be where I am today without her guidance and encouragement.
With my two consecutive ACL tears, I ended up being out for over a year. The timing of my injuries was also difficult because they occurred in September and March of my senior year of high school – right before I set off to start my college soccer career. Luckily I had already committed to Stanford and the coaches were incredibly helpful and understanding of my situation. I was still not fully healthy when I started my freshman year and I spent all of preseason continuing my rehab and integrating into playing. I was nervous when I began playing again, especially after being out for so long. When returning to play I listened to my body and took everything one step at a time. I eased into running, then cutting, then ball work. Next, I put on my cleats and did all those activities again. I integrated into more game like situations by being the non-contact neutral player. And then I finally added in contact. I tried to not put too much pressure on myself to immediately be the player I was before. Instead I focused on the joy of being able to run and play soccer. It required much patience and hard work, but after playing again for about nine months, I reached my previous level and beyond.
I believe that we learn and grow through adversity. Although this was a difficult time, I became physically and mentally stronger and gained perspective about my life. This injury helped reinforce how much I loved and missed soccer. But I also enjoyed being able to spend more time with my family and friends, focus on my studies, and just be a high school kid. I was reminded that I am more than a soccer player and that balance is something I value. During the rehab process, I also learned how to set realistic goals and stay focused on the step at hand. Instead of getting frustrated by the things I could not do, I broke goals into small steps and celebrated the little victories along the way. During the early stages of rehab the stationary bike is your best friend. It helps with mobility and blood flow, and it is the first type of true exercise you are able to do. I vividly remember when I did my first rotation on the bike post-surgery. I was so happy after that small achievement and I continued to build from there.
Ultimately, I learned to “control the controllables”. I tried not to dwell on things that were out of my power. Rather, I identified what I could change, and worked systematically and diligently to make those changes. This is one of the most valuable lessons I have learned in my soccer career, and I come back to it time and time again in all aspects of life. I’m sure you will learn similar lessons throughout your injury. It will be challenging experience, but I truly believe you will come out stronger in the end. Remember to reflect and take note of what you learn along the way. Good luck!