By FRANCO PANIZO
Two months after recovering from a right anterior cruciate ligament injury, Terrence Boyd has injured it again.
Boyd sustained his second serious knee problem at RB Leipzig on Sunday, tearing his right ACL and meniscus in the 2. Bundesliga club’s 1-0 loss to FC Ingolstadt. Boyd picked up the the injury in the first half, and was replaced in the 37th minute.
While RB Leipzig confirmed the severity of the injury, they did not provide a timetable for his return.
The 23-year-old forward had a similar issue in July when he partially tore the same ACL in the club’s preseason finale, and that injury sidelined him for more than two months.
If Boyd is out for much longer than that this time, it appears unlikely that he makes it onto the U.S. Men’s National Team’s Gold Cup roster. The CONCACAF tournament will be held in the United States next summer.
Boyd signed with Leipzig in late June, and made his debut in mid-October after recovering from the previous ACL injury. He scored his first goal for RB Leipzig in a cup match on Oct. 29, then bagged a brace in a league game on Nov. 23.
In total, Boyd has made eight appearances this season across all competitions.
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What do you make of this development? Chalk it up to bad luck? What do you think are Boyd’s chances now of making the U.S. Men’s National Team’s Gold Cup roster next summer?
Share your thoughts below.
another case of a player rushing back too soon (Stu, Gatt)…. he needs to lay off for at least 2 years then constant rehab for 1 yr if he wants to have a 10yr career in soccer…
I don’t think it’s fair to throw Holden into the came back too soon category.
I would opt against your suggestion that Boyd should take 2 years off. In my observation and unscientific opinion, I believe Holden’s re-injuries are in large part due to lengthy absences away from the game, and not due to a lack of reasonable time to rehab.
I think it’s totally fair to throw Stu’s name in there re. his last re-injury…clearly came back to soon
I don’t, and I follow up with some reason instead of speculation.
Most information I can find regarding his injury, prognosis and recovery estimated 6-9 months. Holden came back at exactly 9 months. Additionally, six months appears to be the benchmark for most ACL injuries, with caution favoring 9 months.
Hindsight is 20/20, but Holden was not rushed back.
No offense, you are making a blanket statement that is not, frankly, based upon any real knowledge of his injury, Even with the most severe injury, 3 years is a bit on the extreme.
Too early to know the severity and therefore medical options so let’s all add our prayers for this kid and hope for the best.
I’m not a trainer and I’ve never experienced this kind of injury. Curious if he (or was) rushed back too soon or lacked adequate physical therapy after the initial injury.
I’m not ready to say he’s done, but I do think a visit to Dr. James Andrews may be in order. That guy appears to work miracles.
I guarantee that’s the case. First off, this is the first I’ve read of the original injury being a partial tear. That means he didn’t have surgery, which would be a good thing….IF the ligament repairs itself. I have had two ACL repairs (different knees), and I will tell you that athletes are being rushed into returns from surgery. The protocol is different now than when they first started doing this. Instead of rest, rehab begins immediately after surgery. The result is that the flexibility of the joint is recovered much, much more quickly, and the leg is restored to nearly full strength much quicker as well. But, they’re doing things they shouldn’t be doing given everything I learned at the time about how long it takes a transplanted tendon to serve as the framework for a new, stable ACL. They’re operating at a professional level in combat sports at a point that surgeons used to put as the most optimistic point for full recovery. It was always 6-9 months, just for the ligament to be restored. So, why are they playing again 6 months later? To my mind, given what they’re being exposed to — and given that we’re talking about their livelihood — athletes should take a much more cautious approach than your average recreational athlete. Instead of being active sooner, they should actually take more time. The reality is that no one ever gets back to full speed in less than a year anyway. So, why are they playing before then? I imagine that would apply to a partial tear, as well. It’s gonna take 4-6 months for your own ligament to repair — and it’s at that point that the hard work of recovery should begin, but full speed, with all the awkward steps and falls that occur in games, not to even mention the contact? That should wait for months more of progressively tougher rehab work, which should not really begin before the ligament is fully healed.
One thing we know now that we didn’t even know 2 years ago is that there’s at least a fifth ligament that had never been known, and that this is almost always certainly torn when the ACL goes– and there is no protocol for repairing this newly discovered ligament. So, we know now that even after ACL repairs, the knees are never as stable as they were before. All of which begs the question as to why teams and players aren’t being more conservative in approaching recoveries for new injuries.
What’s happening now is scandalous, and it’s happening because that’s what the teams think they want — but, it’s actually not in anyone’s best interest. Patience is required.
I love your passion here. Many of your points are spot on. Let me add a couple things based on the fact that this is what I do every day.
Ligament injuries are graded on severity from 1-3. Grade 1 is a low grade stretch injury, grade 2 a partial tear, and grade 3 a complete disruption. Based on the timetable for his recovery, I would assume Boyd’s was a grade 1 or low grade 2 injury. The treatment for such would be rehab. I am very surprised he returned to playing without a brace, however. Most doctors would brace such an injury during the return to play period for ~3-6 months, although I would admit the science behind that is mixed. The goal is to try to avoid surgery, but a partially injured ACL can also complete itself even with a great rehab program. The ACL functions at the limits of our physiology, so it only takes relatively minor trauma to push it to its tipping point.
Here’s how I think about ACL reconstructions: A normal ligament has collagen for structural integrity and cells which are responsible for maintaining the health of the collagen. If an autograft (your own tissue is used), it is easier for the cells to grow back in and maintain the collagen. If an allograft (donor tissue) is used, the process takes a lot longer. Until the cells grow into the graft, all the collagen can do is weaken (and lengthen). Range of motion and strength are nice, but it’s really the health of the ligament that ultimately matters, and right now there is no great protocol to assess that aside from assuming all goes well with time. I agree with slightly longer rehab times (which patients hate to hear and sometimes shop for a doc with a shorter timeframe).
Players like Adrian Peterson do everyone a disservice. An abnormally rapid recovery should be seen as an…. ahem…. “outlier”, and should not be seen as some new goal.
As for the mysterious new ligament… It’s an interesting anatomical study and no one is quite sure what to make of it yet with regards to actual clinical knee function. It is still pretty far from moving the needle with any changes in clinical treatment for ACL injuries…
Great posts/responses Fischy/Concerned MD.
+1 I learned more in these two posts than most any other news item this year.
A physical therapist my son worked with for a knee injury told me ACL injuries are common in soccer players due to weak hip muscles. He said soccer players rely too much on their leg muscles and this results in weak hip muscles. The strength of the hip muscles are crucial to knee stability. Of course Boyd’s PT likely included hip exercises since I believe that is common practice, but perhaps it is why he suffered the initial injury. Also, even if Boyd’s training did include hip strengthening exercises someone needs to be sure they are done correctly to insure they have the desired impact. Sometimes strength and conditioning trainers are working with too many athletes at a time to insure they are doing the exercises adequately.
Hip and core strength are a large factor in risk of knee injury and preventing reinjury. This has been well studied, especially in adolescent athletes in general and young women in specific.
Most pro athletes are well ahead of the curve with their core strength, but it is an important thing to look at during recovery for sure.
came back too soon, rushed it for whatever reasons, paid the price. soccer players are not super humans, there are limits. coaches and trainers should know this and coach that way, but clearly many don’t and are plenty willing to put players at risk.
Interesting how everyone is rushing to say he came back too soon. Isn’t it possible, or even more likely, that he was more susceptible to an ACL injury given that he had a partial tear? This seems more like bad luck than poor rehab protocol to me.
To my knowledge, ligaments are not like bones in that they do not heal stronger than they were before. After suffering an injury like Boyd your chances of re-injury to the knee are increased.
Not only are we soccer geniuses, but we also are medical practitioners on SBI. We’re a talented bunch, the unmistakeable Ronadinho.
I see he’s following the Giuseppe Rossi career path.
Stick a fork in him because
Terrible news. Best wishes to Terrence.
Let’s hope he’s one of these athletes who can return from multiple surgeries and thrive.
NNNNNNOOOOOOOOOOOOOOOOOOOOOOOOOO…….
you are in our prayers
Absolutely horrible news. Love this kid’s passion for the US jersey and his free-spirited approach to the game. Wasn’t it just last week that he scored two outstanding goals? I’m really bummed for him personally as he’d just gotten over the injury and was looking like it was going to be his year. We’re already thin at striker and was hoping for Terrence to have a breakout gold cup. Get well soon!!
Such a bummer.
uh no…
Feel for the kid.
Saw this story earlier, very sad to see, hope to see a speedy recovery.
Gutted. I was hoping he’d finally knock Jozy off his untouchable perch.