– Interview by Paul Read and Darren Paul
APPLIED INSIGHTS: WHAT IS THE PLAYER’S PERSPECTIVE ON ACL INJURY,
REHABILITATION AND RETURN TO PERFORMANCE?
– Lewis Cook (AFC Bournemouth and England International)
Lewis cook is a professional football player who began his career at Leeds United before moving to AFC Bournemouth during the 2016-2017 season. He has also represented his country at various youth levels, captaining the U20 side to a stunning world cup victory in South Korea before making his debut for the senior team against Italy in 2018. This was a landmark moment as Lewis became AFC Bournemouth’s first ever senior England international player.
Unfortunately, the England midfielder ruptured his anterior cruciate ligament during Bournemouth’s victory over Huddersfield on 4th December 2018. This was a devastating blow for the then 21-year-old, who had been described by his manager as ‘a very talented player who has been an important part of our side over the last 18 months’. Lewis was also in contention for selection as part of the European Championship qualifying campaign after making an impressive England debut.
Despite this set back, Lewis who has also been described by his manager as ‘a strong character’ and with the full support of his club, was determined to return to play better than ever before. During his rehabilitation, Lewis left no stone unturned, worked tirelessly with the clubs outstanding medical staff, and even travelled to Doha (Qatar), Dubai (UAE), Dublin (Ireland) and Philadelphia (USA) in pursuit of every advantage he could find.
Here we talk to Lewis in order to understand the player’s perspective on ACL injury and discuss his rehabilitation journey as he aimed to return to performance! This is a unique insight for any medical or conditioning professional to hear from a top international player his experiences and pearls of wisdom. We would like to thank Lewis for giving up his time and believe this information is highly beneficial for those in the sports medicine community as they look to support athletes during this important and often career defining period.
Can you describe the situation leading up to your injury?
I had a great start to the season, making 13/15 appearances leading up to the game during which the injury occurred (against Huddersfield on the 4th December 2018). Everything was normal during training in the week leading up to the game and I felt good.
Mid way through the second half, I lunged into a tackle and this left my knee in a compromising position. There was minimal contact from the opponent but I fell to the ground instantly holding my leg. Although I immediately fell to the ground I didn’t feel any pain, just a numb feeling in the knee and I was unable to move it for a few seconds. I then began to play the game and was able to continue till the end with small twinging sensations when not running.
From a player’s perspective, what do you think are the main risk factors for an ACL injury?
I think although you can just be unfortunate with injuries like these, for me one of the main risk factors is not properly conditioning yourself. What I mean by this is working hard regularly in the gym, focusing on reducing your risk of injury, getting strong, training all muscle groups and working on reducing asymmetries.
What strategies did you find effective in helping you cope and stay positive during the rehabilitation period and what strategies will you continue to employ moving forward to help maximize your performance?
The main strategy that helped me through this period was to keep in mind every day the end goal of proving I can return to performance. Also, as I’m a competitive person, I wanted to be the best possible injured player in terms of how I applied myself. This was consistent if was in the gym or how I conducted myself in general, always aiming to work as hard as possible and stay focused.
I also spoke to psychologists during this period along with my girlfriend, family and staff and this was extremely helpful and I will continue to do so moving forward.
Outside of football, did you do anything to help you get away from it all and refresh?
Although Jonny King (AFC Bournemouth physiotherapist) and I spent a lot of time together during the rehabilitation process, there were still extra things I would do when I got home. However, I did get the chance to have a few days off here and there and during this time I went to Leeds to see my family. Also, on recovery days Jonny and I tried to get away from the club and play golf, badminton or go for a bike ride, which was a nice change.
I also travelled away from the club on a few occasions, and the first trip was to Aspetar (Qatar). This was great and it helped me so much. It provided a change of scenery and allowed us to get some additional opinions. We completed some really good work while I was there.
Following this, I also went to Dubai, once with the rest of the team and once with my partner. During the trip with the team I mainly concentrated on my rehab but we still had time to relax so it was a good change. The second trip to Dubai was in the summer. I took a physio with me and another injured player also came and we were able to complete a lot of focused rehab work.
Towards the end of the rehabilitation phase I went to Dublin for a screening and testing day, which allowed me then to go to Philadelphia (USA) to see Bill Knowles. Bill is a specialist in late stage rehabilitation who he helped me refine my running and cutting mechanics before returning to training.
Finally, I also had a few de load weeks later on in the process, which allowed me to go on holiday to Italy during which I proposed to my fiancée.
How important do you feel the role of rehabilitation professionals is in helping players return to play/ performance?
The role of rehabilitation and medical professionals is massive; without them it would be incredibly hard to return fit to play let alone perform! Their role is firstly to assure you that you will return to play and then provide the process and ‘road map’ of how you're going to do it. I believe their role is also to answer questions - of which I asked a lot! In my opinion and experience, they have to become more than just a professional - but also importantly a friend. They also have to work just as hard and me.
What are the biggest lessons you have learnt during the rehabilitation and return to play process?
To always appreciate the little things, as you don’t know what’s round the corner in sport. I also believe that hard work and persistence is a massive part of life, and you can achieve anything if you put the time in. For example, straight after surgery you think there’s no way I can bend this knee again – but with hard work and support from those around me, I believe anything is possible.
The current issue is about re-defining and shifting the focus towards return to performance - how would you define return to performance?
Return to performance, in my opinion is returning to the level of sport you were competing at before your injury/surgery.
Finally, what advice or pearls of wisdom would you have for players who are aiming to return from long-term injury?
Celebrate the little milestone and enjoy them, but not for too long!
Exciting start to Lewis’ return to performance journey
At the time of writing, Lewis has returned to full competitive football with AFC Bournemouth and is ‘loving being back and playing’. He capped his return with a starring performance against Everton in a 3-1 victory and the rest of the season is looking very promising! His manager has stated that ‘he was hugely impressive and has done everything right during his recovery – I have never seen a player run as much as he has and we are pleased to have him back!’.
We wish Lewis and AFC Bournemouth the best of luck and will be eagerly watching their progress for the rest of the season and beyond!
Header image by Ivan Yordanov/MI News/NurPhoto via Getty Images (Cropped)