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Physical and emotional impact of multiple knee surgeries
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  1. Nicole Whitehill
  1. Student of School of Health Sciences DNB, Podiatry, Physio & Radiography, Queen Margaret University, Musselburgh, UK
  1. Correspondence to Nicole Whitehill, Queen Margaret University, Musselburgh, UK; nicolewhitehill2001{at}gmail.com

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Football was everything to me; no stress, just pure enjoyment and freedom. My entire identity has centred around football since I began playing at the age of five. My training with my team increased as I progressed through the youth football ranks, and a ball was always at my feet when I wasn’t at training or school. My dream was to move to America to study and play football with the hope that I might be able to play professional football after I graduated, but multiple knee injuries robbed me of that.

Injury journey

My journey with injuries in my right knee began in March 2015. I was 14 years old and tried to change direction in training, but my right foot planted and stayed in the astroturf while the rest of my body turned. I felt and heard a ‘pop’ in my right knee and following private consultations, tests and scans I discovered I had completely ruptured my ACL. In October 2015, I had ACL reconstruction (ACLR) surgery and began working hard on my rehabilitation, making sure I was doing my exercises every day and following all of the physiotherapist’s instructions so I could achieve my goal of returning to football.

Unfortunately, my hard work did not pay off. Six months into my rehabilitation, my right knee gave way with the same ‘pop’ sensation as I was walking down the stairs, and I knew right away that I had ruptured my ACL again. After more scans and tests, it was determined that I needed another ACLR, which was performed in June 2016. After surgery, another year of rehabilitation began, and I was determined to complete it in order to return the following season. Again, I followed the advice of medical professionals, making sure I was consistent with my rehabilitation and avoiding any risks that could impede my return to football in any way. This time, the surgery and rehabilitation went well, and after a lengthy recovery, I was cleared to play football again. After a few months of training and increased game time, I felt like my time with knee injuries was over, and my dream of playing football in America was still a possibility.

My playing time was cut short after only 18 months on the field because of persistent right knee pain. It was later discovered that I had been playing with a ruptured ACL that I was completely unaware of, but I was able to play without it because there was no pain or other issues of instability. In February 2019, I was told I needed my biggest surgery yet. At the age of 18, I needed a third ACLR, a high tibial osteotomy (HTO), a distal femoral osteotomy (DFO), and a lateral tenodesis in my right knee. The surgery was postponed due to the COVID-19 lockdown, and I didn’t have the first part of this major surgery until July 2021. After a 6-hour surgery involving two internal plates and 14 pins in my leg, my double osteotomy was completed (figure 1). I expected a lengthy rehabilitation period, but thanks to NHS physiotherapists in the United Kingdom, I was back doing daily activities in just 5 months.

Figure 1

Recovering after surgery.

In May 2023, my journey continued with more surgery to remove the internal plates and complete the ACLR and lateral tenodesis in my right knee.

New path

With the realisation that football would not be my career and that a scholarship to the United States would not be possible, it was time to consider a new career path. Because of my extensive injury history, interest in rehabilitation, and desire to help others who have been injured, I decided to create a new path for myself in 2019 and enrolled in a Sports Therapy course at college. I’m now a BSc Sports Rehabilitation student, and I’m having a blast! Although my injuries prevented me from participating in my sport, they did introduce me to the field of rehabilitation which I am very passionate about.

Mental health

During my extended period of injuries, I felt both positive and negative emotions towards football: the joy of finishing rehabilitation and knowing you’ll be back playing soon is the best feeling because it means all your hard work has paid off, only to be cut short by the disappointment of another injury. The cycle of injuries, as well as the constant uncertainty of whether or not I would ever play again, put my mental health to the test. I fell out of love with the game as I struggled emotionally with processing my feelings about my injuries because I felt like a huge part of my identity had been taken away from me. Due to having different physical goals to my team mates, a long period of time on the side-lines, and working alone caused my mental health to deteriorate. I struggled to break free from this negative cycle; my mindset was that it was time to give up football.

Perspective

With injuries and mental struggles, it’s been a difficult road, but I try to remind myself how far I’ve come. I have been chastised for fabricating my injuries. People who don’t understand how difficult a complex injury can be will always make comments, particularly about multiple ACL surgeries and the impact they have on daily life and recovery time. They also don’t understand how injuries can affect your mental health, self-esteem, and feelings of guilt over something outside of your control. It has, however, taught me about my own resilience and determination, but the most important lesson I’ve learned from this journey is how the ups and downs of injuries can affect your mental health. But, with the help of family, friends, orthopaedic consultants, and physiotherapists, I always made it through the difficult times in rehabilitation and emerged both physically healthier and stronger. Most importantly, I became mentally stronger, allowing me to continue pushing towards my goals, whether in career or sport, no matter what challenges are thrown at me.

Ethics statements

Patient consent for publication

Ethics approval

This study involves human participants but no ethical approval was sought for this as the patient was the focus in this Patient Voices piece that they wrote themselves. Participants gave informed consent to participate in the study before taking part.

Footnotes

  • Contributors NW is the sole author of this Patient Voice submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.