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September 6, 2005     Cape Gazette
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September 6, 2005

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26 CAPE GAZETTE, Tuesday, Sept. 6 - Sept. 8, 2005 HEALTH & F'ITNESS tl ii Life with sports continues after ACL surgery By Rachel Swick Cape Gazette staff Matt Carter was an avid outdoorsman and soccer player until the day he hit a brick wail. Carter's wail was an anterior cruciate ligament (ACL) tear. The central ligament for the knee split in half as he stopped and turned on the soccer field. "I heard a pop and felt nauseous," said Carter. "I knew it was my ACL from seeing other ACL injuries." That was July 1, 2004. After an x-ray, Carter learned that in ad- dition to the ACL tear, he also had a menis- cus tear. He underwent his first surgery to repair the meniscus in August 2004. Then he strength-trained to build up his muscles and get through the busy season at his business, Quest Fitness, which opened in January 2004 at the Village of Five Points. "If you go into surgery strong it helps you when you come out," said Carter. Dr. John Spieker, an orthopaedic surgeon in Lewes who also repaired Carter's menis- cus, replaced Carter's ACL using a cadaver ligament Dec, 9. As soon as he could, Carter started physical therapy, completing 12 sessions with Joe Whaien at Tidewater Physical Therapy in Lewes. At the same time, he continued working out at Quest. "Keeping Matt down was a tough job," said Whaien, who worked with Carter from the beginning. Whaien said right after surgery most peo- ple come in with their knees bent, and the first phase is getting them to straighten it. When Carter came in his knee was at nega- tive 5 degrees, less bent than most patients. Since Carter knew his knee was unstable, he worked on other muscles, in the ankle Rachel Swick photo Matt Carter stands in front of a treadmill at Quest Fitnessn the Village of Five Points. Carter tore his ACL in 2004, but through hard work he is back playing sports. and the hip area, to take some of the pres- sure off the new knee ligament. He also did stability training and Pilates to help train the new ligament in unstable environments. "My goal was to play soccer in July," said Carter, who later decided not to risk playing this year, but to wait until next year. "People who are athletes are usually very motivated," said Spieker. He said Carter came in with an attitude that was motivated and aggressive, just like his attitude toward sports. Spieker said it takes a year before a pa- tient is considered healed, even though the patient's knee will never be as strong as it was before the ACL tear. Spieker has been doing ACL repairs since the 1980s and he said a lot has changed in that time. In 1985, most of his patients tore their ACLs on the ski slopes. He said a patient would tear and come in the next day for surgery. Now, he said, patients wait longer for surgery because the" patient has to under- stand that they have a problem. He wants them to feel the trick knee. He said if they don't feel the problem, then after surgery they will be disappointed because they nev- er felt what it was like to have the injury. Both Spieker and Whaien have tom ACL ligaments, but neither has had replacement surgery. Both said at the time it seemed like a better option to retrain the knee and give up high-impact sports. Now, neither one is a candidate for ACL surgery because their injuries were so long ago that their knees have adapted. However, they will never be able to play sports like Carter will. Speiker said in the past, knee surgery ex- posed the whole knee. Now it only takes an inch-and-a-haif incision and is minimally invasive. "There have been huge advances in20 years," said Spieker, who does the surgery regularly for Beebe Medical Center. They both said working with motivated patients like Carter allows them to see new- er technologies in action. Carter also gets to use his personal knowledge of ACL injuries at Quest. He said since his surgery, he has met many oth- er people who are coming back from sur- gery. Now he understands what they are going through and can help them with the physical therapy. "I pushed myself a lot harder than I would push a client, but I would push that client harder than they push themselves," said Carter. Today Carter is running five miles, doing kayak tours and training clients at Quest Fitness. He also plans to start playing flag football. Carter, who has an exercise science de- gree and is a certified personal trainer, start- ed Quest Fitness because he wanted to mix , two things he loved: physical fitness and outdoor sports. He calls Quest an adventurous exercise experience and has made plans to open an- other Quest in the Milford area. "You'll never be 100 percent," said Carter, "but I'm not looking to be a pro ath- lete for five years. I want to be athletic for the rest of my life." Journal writing can lead to .better physical health "Grief can take care of itself," ing about troubling experiences ing through, she may make light of writing going more easily. Mark Twain wrote. He was wrong. Unexpressed negative feelings are heavy. An expression like "get it off your chest" can help you see the mind=body connec- tion. You may lie awake at night feeling like-you've got a boulder holding your down. When you carry weight like that around you may sigh or yawn fre- quently because even your breath- ing is affected. Your muscles tighten. You might develop a headache or a backache as a result of physical tension. Writing about how you feel can actually lighten the load. In a project begun in the late 1970s, psychologist James W. Pennebaker set out to discover why people around the world need to tell the stories of their lives. Unexpectedly, he found specific evidence that holding back, stop- ping ourselves from disclosing our thoughts and feelings, has a nega- tive effect on the body. Suppressed feelings and thoughts can affect the immune system, the heart and vascular sys- HEALTH TOPICS Beth Joselow Beth Joselow is a psy- chotherapist practicing in Lewes. She leads Writing to Heal workshops for The Wellness Community in Re- hoboth Beach and Dover, and is the author of "Writing Without the Muse: 60 Begin- ning Exercises for the Cre- ative Writer." tem, as well as the biochemistry of the brain. Pennebaker's subse- quent research showed that writ- can actually hax, e a positive effect on health. He found that "people who wrote about their deepest thoughts and feelings surrounding traumatic experiences evidenced heightened immune function," and showed measurable improvements in their ability to combat disease. Dr. Pennebaker's scientific evi- dence simply confirms what long has been common knowledge: Confession is good for the soul. Many times, however, people have experiences or memories that we are not comfortable sharing with others. A woman Who is going through chemotherapy for breast cancer, for example, may be overwhelmed by the thought that she might be unable to do many of the things she has been counting on, that she may die. At the same time, she may be- lieve that talking about her own fears might frighten her family it, hiding her fears and anxieties. Lots of times people are comfort- able only when we show others the most optimistic, positive sides of ourselves. Keeping a joumai can help you get past negative thoughts and in- troduce thought processes to help you heal. Writing regularly, for as little as 15 minutes several times a week, can help you feel better. Even if writing doesn't come naturally to you, journal writing should be easier than most other writing you have done. It is en- tirely free form. There are no rules. No one will examine your spelling or your grammar. This is private writing. Relax. The following are a few sugges- tions for getting started: Choose a journal that is appeal- ing to you - the right size and shape, lined or unlined pages, whatever you most like. Choose a place for writing. "and friends. She may feel that giv- _Make it a place where you are un- ing voice to those feelings will likely to be interrupted or distract- make them too real. Even when ed. Returning to that place will she does talk about what she is go- help prime the pump and get your Write about how you are feeling right now. You may begin by de- scribing what you are thinking about, what is going on in your life, but you must include how it is making you feel and why. Aim for your deepest emotions. Write quickly. Don't stop to censor yourself or to find just the right word. Keep your jouruai secure so that you and you alone can read it. Some people find it helpful to de- stroy what they write: to bum it or tear it into tiny pieces. It is not the writing itself that is valuable but the act of putting your thoughts on paper. Journal writing is not magic. It is unlikely to provide instant re- lief. By itself, it cannot carry you through the traumas of losing someone you love or facing a per- sonai crisis. But it is a useful tool, one that is relatively cost free, and there for you 24 hours a day. It can help you discover new per- spectives on your life that can lead to change, acceptance and resolu- tion.